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1. What are some of the significant clinical findings that would lead to the diagnosis of an STD? 2. What are some of the significant laboratory findings that would lead to the diagnosis of an STD? CASE STUDY 15.3 A 20-year-old woman presents to her family practice physician for a routine pelvic examination. It has been several years since her last visit to this clinic when she was diagnosed and treated for a nongonococcal sexually transmitted disease (STD). She is sexually active with her fiancé and has had sexual encounters with others in the past. She is currently considering the potential for becoming pregnant. There are no apparent physical abnormalities, but the physician decides to culture the cervical discharge for gonorrhea and to perform a DNA test (Gen probe) for chlamydia and gonorrhea. A serum sample is also collected for HIV testing. All laboratory tests are normal, with the exception of the test for chlamydia, which is positive. NOTE: Symptoms of chlamydial infections include dysuria and vaginal/urethral discharge, symptoms similar to those of gonorrhea. Many infected patients exhibit no symptoms of chlamydial infection. Multiple Choice Questions 1. Which of the following is the test of choice for the laboratory diagnosis of chlamydial infections? a. Nucleic acid amplification b. Immunofluorescent antibody test c. Enzyme immunoassay (EIA) d. Culture ANS: a. Nucleic acid amplification 2. If the patient is experiencing no symptoms, what would be the concern for the physician to order the laboratory tests in this case? a. To prevent unwanted transmission of the organism to the fiancé. b. The organism present could lead to future infertility. c. The patient could develop more serious infection prior to symptoms. d. All of the above statements are valid concerns in this case. ANS: d. All of the above statements are valid concerns in this case. Critical Discussion Questions 1. What are some of the significant clinical findings that would lead to the diagnosis of an STD? 2. What are some of the significant laboratory findings that would lead to the diagnosis of an STD?

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