Ms. P.C. is a 19-year-old white female who reports a 2-day history of lower abdominal pain, nausea, emesis and a heavy, malodorous vaginal discharge. She states that she is single, heterosexual, and that she has been sexually active with only one partner for the past eight months. She has no previous history of genitourinary infections or sexually transmitted diseases. She denies IV drug use. Her LMP ended three days ago. Her last intercourse (vaginal) was eight days ago and she states that they did not use a condom. She admits to unprotected sex every once in a while. She noted an abnormal vaginal discharge yesterday and she describes it as thick, greenish-yellow in color, and very smelly. She denies both oral and rectal intercourse. She does not know if her partner has had a recent genitourinary tract infection, because he has been away on business for five days.

Microscopic Examination of Vaginal Discharge
(-) yeast or hyphae
(-) flagellated microbes
(+) white blood cells
(+) gram-negative intracellular diplococci

Case Study Questions

1. Can a diagnosis of PID be made based on the clinical manifestations of the illness at this point? Why or why not?

2. Which type of infection is suggested by microscopic examination of the vaginal discharge and other laboratory tests: chlamydial, gonococcal, or mixed chlamydial/gonococcal?

3. Should this patient be hospitalized and promptly given IV antibiotics? Why or why not?

Case Study 2: Alterations of the Integumentary Function

K.B. is a 40-year-old white female with a 5-year history of psoriasis. She has scheduled an appointment with her dermatologist due to another relapse of psoriasis. This is her third flare-up since a definitive diagnosis was made. This outbreak of plaque psoriasis is generalized and involves large regions on the arms, legs, elbows, knees, abdomen, scalp, and groin. K.B. was diagnosed with limited plaque-type psoriasis at age 35 and initially responded well to topical treatment with high-potency corticosteroids. She has been in remission for 18 months. Until now, lesions have been confined to small regions on the elbows and lower legs.

Case Study Questions

1. What has possibly triggered this patients current outbreak of psoriasis?

2. Why should a topical medication not be considered an option for this patient?

3. What is the preferred treatment for this patient?

4. Why is it important that the primary care provider know that the only medications that K.B. has been taking are ibuprofen and Rolaids?

Submission Instructions:

You must complete both case studies.
Your initial post should be at least 500 words per case study, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
All replies must be constructive and use literature where possible.
Please post your initial response by 23:59 ET Thursday, and comment on the posts of two classmates by 23:59 ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
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Grading Rubric

Your assignment will be graded according to the grading rubric.

Discussion Rubric
Criteria    Ratings    Points
Identification of Main Issues, Problems, and Concepts

5 points
Distinguished

Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts.

4 points
Excellent

Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts.

2 points
Fair

Identifies and demonstrate an acceptable understanding of most of issues, problems, and concepts.

1 points
Poor

Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts.

5 points
Use of Citations, Writing Mechanics and APA Formatting Guidelines

3 points
Distinguished

Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.

2 points
Excellent

Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.

1 point
Fair

Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.

0 point
Poor

Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.

3 points
Response to Posts of Peers   
2 points
Distinguished

Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.

1 points
Fair

Student constructively responded to one other post and either extended, expanded or provided a rebuttal.

0 point
Poor

Student provided no response to a peer’s post.

2 points
Total Points: 10