A 45-year-old man presents with a long history of ulcers on the bottom of his feet. He recalls having a similar looking ulcer on the side of his penis when he was 19 years old for which he never sought treatment. The patient denies any fever, chills, or constitutional symptoms. He reports multiple sexual partners and a very promiscuous sexual history. He has also traveled extensively as a writer since he was 19. The patient is afebrile, and his vital signs are within normal limits. A rapid plasma reagin (RPR) test is positive, and the result of a Treponema pallidum particle agglutination (TP-PA) is pending. Which of the following findings would most likely be present in this patient?
AHyperreflexia
BMemory loss
CWide-based gait with a low step
DPositive Romberg's sign
EAgraphesthesia
A 17-year-old male, accompanied by his uncle, presents to a doctor with his arm in a sling. There is blood dripping down his shirt. He pleads with the physician to not report this injury to authorities, offering to pay extra for his visit, as he is afraid of retaliation from his rival gang. The physician examines the wound, which appears to be a stabbing injury to his left anterior deltoid. This case study in medical ethics asks: How should the physician best handle this patient's request?
AMaintain confidentiality, as reporting stab wounds is not required
BBreach confidentiality and discuss the injury with the uncle
CBreach confidentiality and report the stab wound to the police
DMaintain confidentiality and schedule a follow-up visit with the patient
EMaintain confidentiality, as retaliation may result in greater harm to the patient
A 23-year-old G1P0 female presents to her OB/GYN for her routine 36-week visit. Her current complaints include increased fatigue at the end of the day, and edema in her ankles. The patient’s physical examination is unremarkable except for inguinal adenopathy. Upon pelvic examination for cervical changes, the OB/GYN notices a vaginal chancre. The patient states that it is not painful when touched. Which of the following is the most likely diagnosis?
ASecondary syphilis
BCardiovascular syphilis
CPrimary syphilis
DGummatous syphilis
ENeurosyphilis
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