1. Case Study Assignment  This week you will be reviewing another SOAP note and reflecting on the additional information that you would be needing.  This is not in SOAP format, you will use headings for each section, and give me dialogue on what information is missing in each section.  You will provide 5 differentials and reflect on the questions posed for the assignment.  Be sure to support with scholarly references. Week 10: Special Examinations—Breast, Genital, Prostate, and Rectal GENITALIA ASSESSMENT Subjective:• CC: “I have bumps on my bottom that I want to have checked out.” •HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner during the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed. •PMH: Asthma•Medications: Symbicort 160/4.5mcg •Allergies: NKDA •FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD •Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys) Objective:•VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs•Heart: RRR, no murmurs•Lungs: CTA, chest wall symmetrical•Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia•Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, neg McBurney•Diagnostics: HSV specimen obtained Assessment:•Chancre The Lab Assignment Using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature. · Analyze the subjective portion of the note. List additional information that should be included in the documentation. · Analyze the objective portion of the note. List additional information that should be included in the documentation. · Is the assessment supported by the subjective and objective information? Why or why not? · Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis? · Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature. .

1. 1.
Case Study Assignment This week you will be
reviewing another SOAP note and reflecting on the additional
information that you would be needing. This is not in SOAP
format, you will use headings for each section, and give me
dialogue on what information is missing in each section. You
will provide 5 differentials and reflect on the questions posed
for the assignment. Be sure to support with scholarly
references.
Week 10: Special Examinations—Breast, Genital, Prostate, and
Rectal GENITALIA ASSESSMENT
Subjective:•
CC: “I have bumps on my bottom that I want to have checked
out.”
•HPI: AB, a 21-year-old WF college student reports to your
clinic with external bumps on her genital area. She states the
bumps are painless and feel rough. She states she is sexually
active and has had more than one partner during the past year.
Her initial sexual contact occurred at age 18. She reports no
abnormal vaginal discharge. She is unsure how long the bumps
have been there but noticed them about a week ago. Her last Pap
smear exam was 3 years ago, and no dysplasia was found; the
exam results were normal. She reports one sexually transmitted
infection (chlamydia) about 2 years ago. She completed the
treatment for chlamydia as prescribed.
•PMH: Asthma•Medications: Symbicort 160/4.5mcg •Allergies:
NKDA
•FH: No hx of breast or cervical cancer, Father hx HTN, Mother
hx HTN, GERD
•Social: Denies tobacco use; occasional etoh, married, 3
children (1 girl, 2 boys)
Objective:•VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”;

2. WT 169lbs•Heart: RRR, no murmurs•Lungs: CTA, chest wall
symmetrical•Genital: Normal female hair pattern distribution;
no masses or swelling. Urethral meatus intact without erythema
or discharge. Perineum intact. Vaginal mucosa pink and moist
with rugae present, pos for firm, round, small, painless ulcer
noted on external labia•Abd: soft, normoactive bowel sounds,
neg rebound, neg murphy’s, neg McBurney•Diagnostics: HSV
specimen obtained
Assessment:•Chancre
The Lab Assignment
Using evidence-based resources from your search, answer the
following questions and support your answers using current
evidence from the literature.
· Analyze the subjective portion of the note. List additional
information that should be included in the documentation.
· Analyze the objective portion of the note. List additional
information that should be included in the documentation.
· Is the assessment supported by the subjective and objective
information? Why or why not?
· Would diagnostics be appropriate for this case, and how would
the results be used to make a diagnosis?
· Would you reject/accept the current diagnosis? Why or why
not? Identify three possible conditions that may be considered
as a differential diagnosis for this patient. Explain your
reasoning using at least three different references from current
evidence-based literature.