You are seeing a 22-year-old male patient at the college student health clinic. His chief complaint is scrotal pain and swelling. He has had some frequency of urination and purulent penile discharge, but no fever. He admits to being sexually active, with his new girlfriend of two weeks. He has tried Tylenol and ibuprofen at home and nothing helps.

1. As you enter the treatment room, the patient appears anxious and uncomfortable. What additional history should you obtain from the patient?

2. What physical examination components are indicated for this presentation?

3. Based on the presentation and history, you recognize the need to screen for sexually transmitted infections (STIs). What are the most common STIs for this presentation?

4. After your assessment, all subjective and objective findings should be considered when developing differential diagnoses for scrotal pain and swelling with accompanying urinary complaints. What may be included on a differential list?

5. Name your priority diagnosis and provide the treatment plan. If you elect to treat with medications, provide full prescription details and follow up plan.

6. As the practitioner, you are required to report certain STIs to your state health department. Provide a list of the STI’s that must reported in your state along with the information that needs to be included when reporting these.

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