Reproductive Case Study 4*


James, a twenty year old male college student, visits the student health clinic because of a rash that has developed over the past few days and is becoming more widespread. He said that he did not come in sooner because the rash does not itch and he thought it would go away like a similar rash he had about a month ago. The rash actually appears to be clusters of smaller rashes dispersed over his entire body, including the palms of his hands and the soles of his feet. The individual rash clusters are also somewhat similar, but not identical. In addition to the rash, James notes that he has been feeling tired lately and has lost his appetite. He also complains of a stiff neck and joints as well as watery eyes and a runny nose.


In obtaining a patient history the nurse practitioner notes that James is sexually active and claims to have had intercourse with approximately 40 different women over the past nine months. He states that he rarely sees each woman more than twice and does not routinely use condoms or any form of birth control.


Physical examination revealed enlargement of the lymph nodes, the hair in his eyebrows and beard is thinning and he is beginning to suffer from a patchy alopecia. His body temperature is slightly elevated and his pulse, blood pressure and respiratory rate are all within normal ranges.


The nurse practitioner tells James that she suspects he has contracted syphilis, a sexually transmitted disease. She asks James if at some time in the past few months if he noticed a sore, known as a chancre, on his penis. James said he did notice such a sore, but it was small and healed within two weeks. In order to confirm her diagnosis she tells James that she needs to run some tests. These include a blood test and testing samples from the lesions on his skin. The results of the blood test indicate James is suffering from anemia and jaundice.


General Questions:

1.)  Desribe the mechanism by which a peptide hormone initiates a cell response; a steroid hormone initiates a cell response. How are they the same? How are they different? Give a specific example of each and state their effect on the human body.


2.) Compare the hormonal controls of the male reproductive cycle with the hormonal controls of the female reproductive cycle.  How are they the same?  How are they different?


Specific Questions:

1.             What symptoms / risk factors did James present with?


2.             Based on the difference in the external genitalia between males and females, why might it be more likely for women to remain unaware of the initial infection?


3.             Describe how the presence of chancre during the early stages of syphilis can be transmitted between sexual partners during intercourse.


4.             What is the cause of syphilis?  Why would it be possible for the lesions on the skin to be infectious?


5.             How can a sexually disease such as syphilis be treated?  What are the long term consequences of this disease? What should James do to prevent future infections?

6.             Identify other sexually transmitted diseases and the causative agent(s).

*Adapted from Essentials of Anatomy and Physiology, 3rd edition, Seeley, Stephens and Tate, McGrawHill 2003