EXERCISE NO.

17
UTI AND SEXUALLY TRANSMITTED
INFECTIONS

KANT JAMES D. MAHAN

BSN 1-A

05/12/2022

SCORE:
 I. Case study

1. A 28-year-old seaman consulted a physician because of a solitary nodule on the

shaft of his penis that is hard and painless accompanied by painless enlargement
of his inguinal lymph nodes. The nodule later formed edges.

a. What is the most probable diagnosis and the most likely etiologic agent?
 The most probable diagnosis of the patient in the case study is syphilis and
the most likely etiologic agent that causes syphilis is Treponema pallidum.

b. Give two other conditions that can present a lesion like what is presented by the
patient. How are they different from the case presented?
 The two other conditions that can present lesion symptoms are gonorrhea
and Lymphogranuloma Venereum. They can differ in the case presented in a
way that gonorrhea presents a lesion with an erythematous base and only
occurs on disseminated infections. It may also present fever, migratory
arthralgia, and arthritis of the wrist, knees, and ankles. Lastly, the
Lymphogranuloma Venereum also displays a lesion that is either a tiny and
painless papule or an ulcer and it also heals rapidly. However, if this disease
is not treated as soon as possible it results in enlargement of lymph nodes
that are painful (buboes) and ruptures to form draining fistulas

Differentiate syphilis from gonorrhea yes or no on the table below

SYPHILIS GONORRHEA
CONGENITAL YES NO
TRANSMISSION
NEONATAL NO YES
TRANSMISSION
SYSTEMIC SPREAD YES YES
PRESENCE OF SKIN YES YES
LESION
PURULENT DISCHARGE NO YES
 c. In a patient with HIV infection, what is the specific target of the virus, and what
will be the effect on the infected person?
 In HIV infection, the specific target of the virus is our immune system
wherein a glycoprotein of HIV gp120 binds with the CD4+ receptor of helper
T cells and macrophages thus resulting in its destruction. Furthermore, If our
T cells (white blood cells) are being destroyed there are abnormalities happen
in the defense mechanism of our body against diseases and bacteria that may
lead to a fatal and complicated infection inside our body.

d. What is reverse transcriptase and what is its importance in the management of

HIV infection?
 HIV is made up of enzymes known as reverse transcriptase, which is an
enzyme that allows DNA to be created using RNA as a template, allowing HIV
to spread by transforming its RNA into DNA with reverse transcriptase.
Inhibitors are identified after recognizing this reverse transcriptase. These
inhibitors work by inhibiting reverse transcriptase, reducing the impact of
HIV.

2. A 25-year-old sexually active female sought consultation because of a burning

sensation during urination. She also complained of frequency and urgency in
urination. The attending physician is thinking of a probable urinary tract
infection.

a. Enumerate and explain briefly the factors that can predispose the
development of UTI.
Factors that can predispose the development of UTI are the following:
 GENDER – most common in Females that are school-aged and 60 years old
and above girls.
 Mechanical factors – this includes inappropriate execution of catheterization,
tampons, and douches. Also, engaging in sexual intercourse and having
kidney stones have a big chance to acquire UTI.
 Metabolic disorder - illnesses that contribute to an increase in bacterial
growth in the urinary tract, such as diabetes-related elevated blood sugar
levels, are a risk factor for UTI.
 
Anatomic abnormalities of the urinary tract: can cause voiding difficulties or
reflux of the urine.
b. Differentiate lower UTI from upper UTI as to clinical manifestations.
How do bacteria reach the kidneys?

LOWER UTI UPPER UTI

THIS INCLUDES: Upper UTI is a persistent infection
 URETHRITIS dysuria, frequency that predominantly affects the
urgency kidneys. Bacteria enter the kidneys
 Cystitis: tenderness and pain in the via the circulation or through an
suprapubic area, frequency, and ascending infection caused by
occasional hematuria. lower UTI, which includes:
 Urethrocystitis: May be  Acute Pyelonephritis: Flank pain,
asymptomatic, usually malodorous fever, and chills; hematuria; kidney
urine, especially in women, punch.
incontinence.

c. Why is urinary tract infection more common in females than males?

- Urinary tract infections are more common in females than males because
females have a shorter urethra than men. The anatomical structure of
women in their urinary system is easily invaded by bacteria because they
had a short distance to reach the bladder.

d. What is the proper way of collecting urine specimen? What

instructions should be given to the patient when collecting a urine
sample?
- There are numerous methods for collecting a urine specimen, such as the
mid-stream technique, catheterization, and suprapubic aspiration.   The
midstream technique, on the other hand, is the most commonly employed
strategy. The urine must be evacuated a few millimeters before being
collected for the specimen and bring it to the medical laboratory immediately
to be tested by our medical technicians. And the appropriate instruction that
can be given by a nurse in collecting urine samples is first, sanitize before
and after administering the procedure, second, to make sure to clean the
urethral meatus and rinse it, and lastly, the precise time of getting urine
sample is early in the morning or the first urination.
e. What possible complications can arise in persons with untreated and
repeated urinary tract infections?
- Complications and fatal conditions develop when persons are untreated and
repeatedly diagnosed with UTI. And the possible complications that may
develop are bacteremia and septic shock, severe renal damage, or end-stage
pyelonephritis leading to renal failure.