What is your presumptive diagnosis based on the facts presented? What other conditions might be in the differential diagnosis?
A sophomore named Michellepresents at the college health service (where you are observing forthe day Show more A sophomore named Michellepresents at the college health service (where you are observing forthe day) with fever (105oF)malaiseheadache and pain in her genital region that is severe upon urination. The physician examines her genital region and finds four blister-like lesions on the outer labiaeach 2-3 mm in size. The lesions are filled with clear fluid; there is no sign of bleeding from them. While you are taking her history Michelle reports that she has had two successive abnormal Pap smears in the past year. After the first abnormal Pap she was treated with an anti-protozoal drug. She reports taking the full course of the antibiotic. 1. What questions about the patients behavior should the physician ask during the history? 2. What is your presumptive diagnosis based on the facts presented? What other conditions might be in the differential diagnosis? 3. Why do you suppose the patient was treated with an anti-protozoal drug after her first abnormal Pap? 4. Of what importance is the patients history of abnormal Pap smears? 5. What tests should be ordered to confirm the presumptive diagnosis? Show less
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