PEER RESPONSE WEEK 5

Answer each classmate
4 sentence per response is fine
1 reference per each classmate response
Case Presentation:

An 18 year old female comes into the office with concerns about a foul vaginal odor and discharge. She reports not having had this problem before but it started about a month ago and has gotten worse. She denies UTI symptoms.
CC: “I have a vaginal odor and discharge”.
classmate 1
List the questions you would ask for a complete history for this patient.
a. Are you sexually active?
b. How many sexual partners have you had? and do you use protection?
c. Are your periods regular or irregular? Any history of abnormal bleeding
d. Are you taking any medications?
e. Have you recently been sick and on any antibiotics
f. Do you urinate after sex?
classmate 2
. How would you approach the physical exam for this patient?
For this patient, I would start with a gynecological exam to visualize any discharge that may be present. I would perform a whiff test/ pH/ microscopy depending on appearance of discharge. I would also order STD screening if indicated. Lastly, I would do a pelvic exam to monitor for tenderness and cervical motion.
classmate 3
Describe the comprehensive plan of care for this patient including diagnostics, labs, and treatments.
Diagnostics, labs, and treatments are going to be based on what is found during the physical exam. Depending on what is seen, labs and diagnostics include a vaginal culture, a gram stain, PAP test, cervical culture, and a UA. Treatment should be based on what is found.
classmate 4
What are the most common types of vaginal and urinary infections in sexually active adult women?
The most common causes of vaginitis are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis (Paladine & Desai, 2018). Escherichia coli is the most common organism that causes UTIs but can also be caused by Proteus mirabilis, Staphylococcus saprophyticus, Staphylococcus epidermidis, and Klebsiella pneumonia (Al-Badr & Al-Shaikh, 2013).

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