4. Next best step.

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4. Next best step.

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DrVirgo
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11/11/06 - 03:39 PM

4. A 33 y/o married man comes to the doctor complaining of severe pain wnen urinating. The patient reports weveral sexual encounters in the past three weeks with partners other than his wife and says, "I think maybe I picked up something." Examination shows a purulent discharge from the penis. The physicial makes a preliminary diagnosis and takes a sample of the discharge to send to the lab for confirmation of the diagnosis. The lab confirmation will be available in two days. At this point, which of the following is the most appropriate NEXT step in management?

A. Ask the patient if his wife has experienced any similar complaints
B. Discuss treatment options with the patient
C. Discuss with the patient the value and use of barrier methods during sexual relations
D. Inform the patient of the suspected diagnosis
E. Inquire as to what sexual practices the patient engages in
F. Schedule a time to see the patient in two days when the diagnosis has been confirmed
G. Tell the patient that the likely diagnosis must be reported to local health authorities.

Will post correct answer later.....Please answer, and EXPLAIN/DISCUSS.
Thanks.

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DrVirgo
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11/12/06 - 12:06 PM

Bump...

Do you all want me to post the answer? OR Does anyone want to give it a try??? smiling face

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npas
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11/13/06 - 08:05 AM

I guess the answer is 'a'..Find out if the wife is also having similar complaints.
regards

DrVirgo
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11/13/06 - 09:30 PM

No.

Right Answer is D. Inform the patient of the suspected diagnosis FIRST...

All the other stuff can come later.

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noori
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01/03/07 - 10:55 AM

DrVirgo which book is this question from? asking about the wife's symptom is family history/sexual history, telling about the suspected diagnosis is a part of differential diagnosis, i thought we give diff diag only after we know about the whole history in detail.

please correct me if i am wrong

fox
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01/06/07 - 09:47 PM

noori wrote:
DrVirgo which book is this question from? asking about the wife's symptom is family history/sexual history, telling about the suspected diagnosis is a part of differential diagnosis, i thought we give diff diag only after we know about the whole history in detail.

please correct me if i am wrong

makes sense

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DrVirgo
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01/09/07 - 09:47 PM

You already have a presumptive diagnosis. so now you have to inform the patient. and THEN ask about other contacts... Don't forget who your patient is.

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