Special Examinations—Breast, Genital, Prostate, and Rectal GENITALIA ASSESSMENT 2025

For this assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate at least 5 differential diagnosis with several possible conditions. Please remember to pretend that this is an actual patient and gives as much detail as possible! CASE STUDY: Subjective: • CC: “I have bumps on my bottom that I want to have checked out.” • HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner during the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed. • PMH: Asthma •Medications: Symbicort 160/4.5mcg •Allergies: NKDA •FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD •Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys) Objective: • VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs •Heart: RRR, no murmurs • Lungs: CTA, chest wall symmetrical • Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia • Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, negMcBurney •Diagnostics: HSV specimen obtained Assessment: • Chancre REQUIRED READINGS Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. · Chapter 17, “Breasts and Axillae” This chapter focuses on examining the breasts and axillae. The authors describe the examination procedures and the anatomy and physiology of breasts. · Chapter 19, “Female Genitalia” In this chapter, the authors explain how to conduct an examination of female genitalia. The chapter also describes the form and function of female genitalia. · Chapter 20, “Male Genitalia” The authors explain the biology of the penis, testicles, epididymides, scrotum, prostate gland, and seminal vesicles. Additionally, the chapter explains how to perform an exam of these areas. · Chapter 21, “Anus, Rectum, and Prostate” This chapter focuses on performing an exam of the anus, rectum, and prostate. The authors also explain the anatomy and physiology of the anus, rectum, and prostate. Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center. Chapter 5, “Amenorrhea” Amenorrhea, or the absence of menstruation, is the focus of this chapter. The authors include key questions to ask patients when taking histories and explain what to look for in the physical exam. Chapter 6, “Breast Lumps and Nipple Discharge” This chapter focuses on the important topic of breast lumps and nipple discharge. Because breast cancer is the most common type of cancer in women, it is important to get an accurate diagnosis. Information in the chapter includes key questions to ask and what to look for in the physical exam. Chapter 7, “Breast Pain” Determining the cause of breast pain can be difficult. This chapter examines how to determine the likely cause of the pain through diagnostic tests, physical examination, and careful analysis of a patient’s health history. Chapter 27, “Penile Discharge” The focus of this chapter is on how to diagnose the causes of penile discharge. The authors include specific questions to ask when gathering a patient’s history to narrow down the likely diagnosis. They also give advice on performing a focused physical exam. Chapter 36, “Vaginal Bleeding” In this chapter, the causes of vaginal bleeding are explored. The authors focus on symptoms outside the regular menstrual cycle. The authors discuss key questions to ask the patient as well as specific physical examination procedures and laboratory studies that may be useful in reaching a diagnosis. Chapter 37, “Vaginal Discharge and Itching” This chapter examines the process of identifying causes of vaginal discharge and itching. The authors include questions on the characteristics of the discharge, the possibility of the issues being the result of a sexually transmitted infection, and how often the discharge occurs. A chart highlights potential diagnoses based on patient history, physical findings, and diagnostic studies. Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis. · Chapter 3, “SOAP Notes” (Previously read in Week 8) Cucci, E., Santoro, A., DiGesu, C., DiCerce, R., & Sallustio, G. (2015). Sclerosing adenosis of the breast: Report of two cases and review of the literature. Polish Journal of Radiology, 80 , 122–127. doi:10.12659/PJR.892706. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356184/ Sabbagh , C., Mauvis, F., Vecten, A., Ainseba, N., Cosse, C., Diouf, M., & Regimbeau, J. M. (2014). What is the best position for analyzing the lower and middle rectum and sphincter function in a digital rectal examination? A randomized, controlled study in men. Digestive and Liver Disease, 46 (12), 1082–1085. doi:10.1016/j.dld.2014.08.045 Westhoff , C. L., Jones, H. E., & Guiahi, M. (2011). Do new guidelines and technology make the routine pelvic examination obsolete? Journal of Women’s Health, 20 (1), 5–10. This article describes the benefits of new technology and guidelines for pelvic exams. The authors also detail which guidelines and technology may become obsolete. Centers for Disease Control and Prevention. (2019). Sexually transmitted diseases (STDs). Retrieved from http://www.cdc.gov/std/# This section of the CDC website provides a range of information on sexually transmitted diseases (STDs). The website includes reports on STDs, related projects and initiatives, treatment information, and program tools.

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Case Study 2025

Assignment Details For this assignment you will be given a case study about a young lady named Sarah Smith. Review the information provided and answer the questions following. Be sure to cite your references. Look at Sarah as if she is a patient in your office seeking care. What are your immediate concerns? What needs to be done for her? Be thorough and succinct in your responses. Case Study: Sarah Smith is a 28 y/o African American female who presents to the office with c/o wound to her left foot for the past few days. States she had tripped and fell while barefoot scraping the top of her foot on the pavement. She denies any other injury from the incident. Over the past 24 hours the wound has had “smelly” drainage. Has been experiencing generalized achiness, but denies fever and chills. Did not seek medical attention at the time of injury. Has been using hydrogen peroxide to clean her wound. Is unclear of her last tetanus vaccination. Patient PMHx significant for DM II. States that she takes her medications when she remembers, and does not always check her blood sugar. PMHx: Asthma: no hospitalizations for exacerbation. DM II PSHx: Denies SHx: Former tobacco user: ceased smoking 2 years ago. Had smoked 1ppd x 5 years ETOH: socially Illicit drugs: denies FHx: Significant for paternal DM, otherwise unremarkable Medications: Metformin: 500mg BID po – did not take the last few days Albuterol MDI: 2 puffs every 6 hours prn – last use just PTA Singulair: 10mg po daily Trinessa: 1 tab po daily – last taken this am Allergies: PCN: hives LNMP: 2 weeks ago. G0p0 ROS: General: denies any weight changes, fatigue or fever; + body aches Skin: denies any rashes; + wound to left foot HEENT: denies headache, head injury, dizziness, lightheadedness; Denies any vision changes Denies any hearing changes, tinnitus, vertigo, earache Denies any nasal congestion, discharge, nose bleeds or sinus tenderness Denies any sore throat, difficulty swallowing Neck: denies any swollen glands, pain Breasts: denies any pain, discharge Respiratory: denies any dyspnea; positive cough and wheezing CV: denies any chest pain, edema GI: denies any nausea/vomiting/diarrhea/constipation; denies bloody stools PV: denies claudication, swelling to LE GU: denies frequency, urgency, burning; Denies vaginal discharge, itching, sores Denies penile discharge, itching or sores MS: positive pain to left foot Psych: denies nervousness, depression Neuro: denies Headache, dizziness, vertigo, syncope, weakness; + numbness to right LE Heme: denies any easy bruising Physical Exam: Vital signs: 100.5 (tympanic), 162/88, 118, 22, O2 sat 95% on RA Height: 5’5” Weight: 250 lbs. Blood glucose: 230 (Fasting; states has not eaten yet today) patient awake, alert, oriented x 4 in NAD Skin: warm, dry, color WNL. 4 cm lesion noted to anterior left foot with crusting and purulent drng; + surrounding erythema extending up 7 cm proximally HEENT: head nontraumatic, normocephalic Pupils PERRLA, EOMs intact; disc margins sharp, without hemorrhages, exudates; no AV nicking noted Ears: bilateral TM with good cone of light and intact Nose: mucosa pink, septum midline; no sinus tenderness appreciated Mouth: mucosa pink, moist; tongue midline; tonsils 1+ without exudate Neck: supple; trachea midline; no LAD Resp: regular and unlabored; lungs with end expiratory wheezing throughout CV: RRR, S1 and S2 noted; no s3, s4 or murmur appreciated Abdomen: soft, non-distended; Bs + x 4; no tenderness with palpation; no CVA tenderness with percussion Genitalia: deferred Rectal: deferred Extremities: warm and without edema; calves supple, non-tender PV: no LE edema MS: + swelling to left foot; + tenderness of 2-4th left metatarsals; + left pedal pulse; CMS intact; Cap refill < 2 sec. Neuro: alert, cooperative; thought coherent; oriented x 4; cranial nerves II-XII intact Questions: 1. List your differentials for her current problems. Remember you should have at least three different differentials for each problem. Include rationale for each differential. 2. At this time what medical diagnoses are you most concerned about? Do they impact other diagnoses? If so, how? 3. What diagnostic images would you order? Provide your rationale. What are you trying to rule in or out? 4. What laboratory work would you order? What would you anticipate to be abnormal? Provide your rationale for each. 5. What is your comprehensive plan of care? Include your rationales. To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources. Assignment Requirements Before finalizing your work, you should: be sure to read the Assignment description carefully (as displayed above) consult the Grading Rubric to make sure you have included everything necessary; and utilize spelling and grammar check to minimize errors. Your writing Assignment should: follow the conventions of Standard English (correct grammar, punctuation, etc.); be well ordered, logical, and unified, as well as original and insightful; display superior content, organization, style, and mechanics; and Nursing Assignment Help 2025