Name: Sarah Ellien Asuncion Traquena

Program/yr/blk: BS in Nursing – 1C

UTI AND SEXUALLY-TRANSMITTED INFECTION

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 an ulcer with
smooth edges.

a. What is the most probable diagnosis and the most likely etiology agent?
--- Adult syphilis is the most probable diagnosis and the most likely etiology agent is
primary syphilis cause by Triponema pallidum as it is hard, painless papule that later
becomes an ulcer with smooth or well-delineated border.

b. Give two other condition that can present with a lesion like what is presented by the
patient. How are they different from the case presented?

--- Gonorrhea is the second most common sexually transmitted disease infection
worldwide. It is caused by Neisseria gonorrhea. It takes 2-21 days to show the full
effect. Its symptoms are pain during urination, infection of the anus or sore throat, and
pain and bleeding in the rectum. It is transmitted through sexual contact with the penis,
vagina, mouth or anus of an infected partner. While syphilis is a caused by treponema
pallidum. It takes a long period of time until shows full effect. It occurs in four stages.
The symptoms are body rashes, mild fever, fatigue, sore throat, hair loss, swollen
glands, headache, and muscle pains. And transmitted through direct sexual contact,
congenitally, and through blood confusion.

c. Differentiate syphilis from gonorrhea by answering yes or no on the table below.

SYPHILIS GONORRHEA

CONGENITAL YES NO
TRANSMISSION
NEONATAL NO YES
TRANSMISSION
SYSTEMIC SPREAD YES NO

PRESENCE OF SKIN YES NO

 LESION
PURULENT DISCHARGE NO YES

d. In a patient with HIV infection, what is the specific target of the virus and what will be
the effect on the infected person?
--- HIV is the virus causes AIDS and targets the CD4+T cells as well as the
macrophages of the host. The effect of this virus is chronic in the latter years with
evidence of opportunistic infections and malignance. It is defined as clinical conditions
such as Wasting syndrome, dementia, soft tissue cancer, and some severe infections
that can cause death.

e. What is the reverse transcriptase and what is its importance in the management of
HIV infection?
--- The process in cells by which enzymes makes a copy of DNA from RNA is called
reverse transcriptase. It is present in some retroviruses as well. Non-nucleoside reverse
transcriptase inhibitors (NNRTIs) prevent HIV from replacing by blocking RT.

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. He attending physician is thinking of a probable urinary tract infection.

a. Enumerate and explain briefly the factors that can predispose the development of UTI
--- Sexual activity is one of the most common lifestyle risk factors for UTIs, particularly
for women. It’s thought that sexual intercourse may transport from the genitals and anus
into the urethra and, in turn, lead to infection.
--- Catheterization, in patient with comorbid condition, failure in infection prevention and
control frequently begins with indwelling urinary catheterization. Poor hand hygiene,
aseptic technique, and catheter placement all contribute to UTI’s. Unnecessary or
excessive catheterization is another risk factor, will poor urethral orifice asepsis being a
risk factor.

b. Differentiate lower UTI from upper UTI as the clinical manifestations. How do bacteria
reach the kidneys?
--- Upper UTI’s mainly refers to the kidney and the tube that lead from the kidneys into
the urinary bladder can cause pyelonephritis.
--- Lower UTI’s which is the tube that leads from the bladder, cystitis refers to
inflammation of bladder and urethritis refers to inflammation of urethra.
--- Hematogenous spread and through ascending infection from the lower urinary tract.

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

---UTI’s is most common to in female due to the shorter urethra and the proximity of the
anal opening to the urethral orifice in female.
d. What is the proper way of collecting urine specimen? What instructions should be
given to the patient when collecting a urine sample?
--- To collect a urine sample you should;
 Label a sterile, screw-top container with your name, date of birth, and the current
date.
 Wash your hands
 Start to pee and collect a sample of urine “mid-stream” in the container
 Screw the lid of the container shut
 Wash your hands thoroughly

The proper way of collecting urine specimens is through getting clean voided midstream
urine in the morning. Patient should instructed gently cleanse the urethral meatus using
swab and then rinse.

e. What possible complications can arise in person with untreated and repeated urinary
tract infection?
 Recurrent infection specially in women who experience two or more UTI’s in a
six-month period or four within a year.
 Permanent kidney damage from an acute or chronic kidney infection
(PYELONEPHRITIS) due to an untreated UTI.
 Increase risk in pregnant women in delivering low birth weight or premature
infants.
 Urethral narrowing (stricture) in men from recurrent urethritis, previously seen
with gonococcal urethritis.
 Sepsis, a potentially life-threatening complication of an infection, especially if the
infection works its way up your urinary tract to your kidney.