Problem
A 32-year-old female presents to the ED with a chief complaint of fever, chills, nausea, vomiting, and vaginal discharge. She states these symptoms started about 3 days ago, but she thought she had the flu. She has begun to have LLQ pain and notes bilateral lower back pain. She denies dysuria, foul-smelling urine, or frequency. States she is married and has sexual intercourse with her husband. PMH negative.
Labs: CBC-WBC 18, Hgb 16, Hct 44, Plat 325, ¬ Neuts & Lymphs, sed rate 46 mm/hr, C-reactive protein 67 mg/L CMP wnl Vital signs T 103.2 F Pulse 120 Resp 22 and PaO2 99% on room air. Cardio-respiratory exam WNL with the exception of tachycardia but no murmurs, rubs, clicks, or gallops. Abdominal exam + for LLQ pain on deep palpation but no rebound or rigidity. Pelvic exam demonstrates copious foul-smelling green drainage with reddened cervix and + bilateral adenexal tenderness. + chandelier sign. Wet prep in ER + clue cells and gram stain in ER + gram negative diplococci.
1. The factors that affect fertility (STDs).
2. Why inflammatory markers rise in STD/PID.
3. Why prostatitis and infection happens. Also explain the causes of systemic reaction.
4. Why a patient would need a splenectomy after a diagnosis of ITP.
5. Anemia and the different kinds of anemia (i.e., micro and macrocytic).