STI Screening

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents for routine sexually transmitted infection screening

Current symptoms: ‍none

‍abnormal vaginal discharge, ‍clear, ‍thin, ‍withwithout fishy odor

‍penile discharge

‍burning on urination

‍genital itching

‍genital irritation

‍scrotal pain

‍lower abdominal pain

‍pelvic pain

‍rectal pain

‍bleeding between periods

‍bleeding after intercourse

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills



Sexual activity: ‍activeinactive, ‍ partners, ‍menwomenmen and women

Condom use: ‍alwayssometimesnever

History of STIs: ‍none ‍

STI risk factors: ‍

HPV vaccination: ‍up-to-dateincompleteunvaccinated

Last Pap smear: ‍ ‍monthsyears ago

Last menstrual period: ‍ ‍daysweeksmonths ago



Smoking: ‍neversmokerformer smoker, ‍ pack-years

Alcohol: ‍nonesociallyexcessive, ‍ drinks per ‍dayweek

Recreational drugs: ‍none ‍cannabis, ‍IVDU





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Throat: ‍normal, ‍erythema, ‍exudate, ‍

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍

Heart: ‍RRR, ‍MRG, ‍normal S1 and S2

Lungs: ‍clear bilaterally, ‍abnormal sounds, ‍retractions

Abdomen: ‍soft, ‍non-tender ‍, ‍non-distended, ‍guarding, bowel sounds ‍normal, ‍, ‍CVA tenderness ‍

Anorectal: DRE ‍normal, prostate ‍normal, ‍blood, ‍mass, anus ‍

Pelvic: external genitalia ‍normal, vagina ‍normal, cervix ‍normal, uterus ‍normal, adnexa ‍normal, ‍cervical motion tenderness

Genital: penis ‍normal, testes and epididymis ‍normal, ‍inguinal hernia





ASSESSMENT:

‍Asymptomatic STI Screening ‍likelysuspectedpossible

DDx: chlamydia, gonorrhea, HPV, HSV, trichomoniasis, bacterial vaginosis, yeast infection, mycoplasma genitalium, ureaplasma urealyticum, pubic lice, scabies, HIV, hepatitis B, hepatitis C, syphilis





PLAN:

Investigations:

- Blood work: ‍HIV, ‍syphilis, ‍HBsAg, ‍anti-HBs, ‍hepatitis C, ‍HSV, ‍β-HCG

- STI screening: ‍Chlamydia, ‍Gonorrhea, ‍Trichomonas, ‍Herpes Simplex Virus

- Pap smear

Treatments:

- ‍Antibiotics

- ‍Topical treatments

- ‍HPV vaccine

- Sexual partners treatment

- Abstinence until treatment completed and symptoms resolved

- Counseling on condom use

Further care:

- Referral to gynecologist

- Referral to urologist

- Referral to infectious disease specialist

- Follow-up in ‍ ‍weeksmonths

- Return if symptoms worsen or if new symptoms develop such as fever, abdominal pain, or increased discharge