Reference no: EM133531237
Case: Upon completion of your nursing program, you take a job at a free clinic in Philadelphia. After several weeks of working there, you meet Howard, a 47 year old overweight male with several obvious health problems. Howard came to the clinic because he has been very confused over the past eight months and he thinks it is getting worse. He explains how he has episodes of ranting and raving, and how he has been "feeling crazy" and being very scared. You conduct a routine physical examination and find Howard has 3 infected toenails and his feet are cracked and blistered. There are seeping sores in the folds of his wrists and under his arms, and his gums are bleeding. During the examination he tells you he has been homeless at times during the past 10 years. His friends brought him to the clinic and are waiting outside.
The supervising physician quickly joins you in the examining room. Together you examine Howard and make a plan for addressing his pressing needs for wound care. The physician starts asking him about his health history. Howard says very little, but does go into great detail about his past sexual exploits.
Answer the following questions:
1: The physician speaks to you in the hallway, telling you that mental illness is very common among the homeless population. Howard needs a thorough psychiatric evaluation. The doctor is fairly sure that some of Howard's neural symptoms are caused by sexually transmitted diseases. Which sexually transmitted disease is the cause of Howard's condition? What is the etiological agent?
2: If the blood test comes back positive, does it mean that Howard can transmit the disease to others? Explain.
3: Should Howard be treated with antibiotics for his neural symptoms? Why or why not.
4: The patient's blood test came back positive. For what other infectious diseases should he be tested?
5: The doctor tells you to expect more of these cases in the future. However, a co-worker who graduated 10 years ago tells you that the disease, especially in this late form, is very rare. Who is right? Explain your answer.