1. Keep it zipped!

3. According to the patient’s chart his temperature, blood pressure and heart rate are all normal. The physician puts on a pair of blue nitrile exam gloves and begins examining the patient. The physician notes a yellow urethral discharge and tenderness at the tip of the penis. 7. Why does the physician use nitrile gloves and not latex? 8. In one column list the symptoms for this patient and in a second column list the signs. 9. What is your next step? 10. What culture media would you recommend?

4. Gram Stain of Urethral Discharge

5. Urinanalysis Urine clear upon gross examination. Sample positive for leuckocytes esterase. Growth on SBA and EMB negative.

6. 1. Are the urine results consistent with each other? 2. Why is the urine culture negative?

7. Growth on Thayer-Martin Agar

8. 1. Why is the urine culture negative on SBA and EMB? 2. What is your diagnosis? 3. What virulence factors contribute to this disease? 5. What is the reservoir and mode of transmission for this bacterium? 6.Why did his partners have a negative history for sexually transmitted diseases? For what complications are his sexual partners at risk? 7. What is the recommended treatment?