However there is a firm round small painless ulcer noted on external labia

However there is a firm round small painless ulcer

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However, there is a firm, round, small, painless ulcer noted on external labia (Wangnapi, et al2015)., After physically assessing the genitalia and noting the ulcer, I would describe the ulcer to the client and explain to her; I would culture and acquire a herpes simplex virus (HSV) specimen and notify it may take up to a week for results. Diagnostics and Tests A pelvic and pap smear, will be completed during this exam, collecting several specimens, such as cervical cells to rule out cervical dysplasia, culture for gonorrhoea and chlamydia, as well as the HSV collection (viral culture). Lab work would include CBC, (elevated WBC) to rule out bacterial infection, Venereal disease research laboratory test (VDRL) to measure antibodies that cause syphilis and Human Immunodeficiency Virus
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Assessing the Genitalia and Rectum 5 (HIV) testing. The client has described risky sexual behaviours. This client should be offered the HPV and HBV immunizations as precaution and prevention. Support/Oppose Diagnosis As a provider, based on the subjective and objective information, I have obtained, I would refute the diagnosis Chancre, my diagnosis would be primary Syphilis. The client history of multiple sex partners, diagnosis with Chlamydia before (treated) and last PAP smear 3 years ago. The primary phase of syphilis, 21 days post exposure, a round, firm, ulcer noted over the external genatalia . This client will need to follow up post treatment, including education on STD prevention, and birth control, as well as sex education. Differential Diagnosis 1. Syphilis : a common STD. Syphilis is contracted through vaginal, anal, and oral sex. Syphilis causes ulcers on the genitals (chancres). The ulcers are usually painless but are contagions people. This can be confirmed with serology and can be a plausible condition because of her past STIs and multiple sexual partners (da Silva et al2017) 2. Condyloma acuminatum (genital warts or anogenital warts) refers to an epidermal manifestation attributed to the epidermotropic human papillomavirus (HPV), a sexually transmitted infection caused by certain types of human papillomavirus. They are generally pink and protrude out from the surface of the skin. Usually painless, but can occasionally be tender (Buchanan, et al 2016).
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Assessing the Genitalia and Rectum 6 3. Genital herpes : (HSV) is an infection by the herpes simplex virus) of the genitals, The disease is typically spread by direct genital contact with the skin surface or secretions of someone who is infected. This may occur during sex, including anal
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  • Summer '15
  • Human sexual behavior, Syphilis, chlamydia, Human papillomavirus

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