Nancy is a 24-year-old female who is sexually active with multiple partners who presents to the clinic with painful blister-like sores on the vagina, pain when having sex, and a foul-smelling vaginal discharge for the past two weeks. She is diagnosed with genital herpes and chlamydial infection. Describe your treatment plan for Nancy and for her multiple sexual partners. How should you assist Nancy in getting her sexual partners to come for treatment? What are your obligations to report sexually transmitted diseases?
Assignment Nolan is a 55-year-old male with a 5-day history of nasal congestion, rhinorrhea, malaise, and irritated sore throat. His nasal discharge has gone from clear to yellow in color. He took OTC acetaminophen at onset of symptoms with minimal relief. He has no health history and his examination in your office today is unremarkable. He has already missed 2 days of work and insists he needs an antibiotic. He adds that he “always gets an antibiotic” when he sees the other clinician in your clinic. When looking at his chart, you confirm this to be true. You have diagnosed Nolan with a viral URI. What medication treatment plan do you recommend, if any? Discuss your patient education and outcome evaluation for this patient. What does the literature say about the over prescribing of antibiotics?
Maria is a 19-year-old exchange student from Brazil. She was started on daily isoniazid (INH) 4 months ago for latent tuberculosis (TB). She would like to be seen at your clinic now because it is closer to school. She has not taken her medication for 4 weeks and cannot recall when her labs were drawn last. She has no other health history and does not take any other medications. According to the national guidelines, how long would Maria likely need to take INH? Can she restart her medication even though she has been off for 1 month? How often should she be seen for follow-up? What are the black box warnings of INH?
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