ohnis a 25-year-old male who comes to see to the health care provider with complaints of malaise, headache, sore throat and body aches, decreased appetite and a rash on the hands and feet.

Subjective Data

• Had a painless sore on the penis that "just disappeared" after about a month and a half.
• Starting feeling "real bad" 3 months after sore disappeared, and begin to notice a "scaly-looking" rash developing on the palm of hands and bottom of feet.
• Has had several male sexual partners over the past year anddoes not use condoms

Objective Data

• Temperature99.2F,pulse 104, respirations 22, blood pressure 108/56
• Scaly psoriasis-like lesions on palm on bilateral hands and sole of bilateral feet
• Penis circumcised, no lesions noted

Discussion Questions

• What additional information should John be asked to help identify the possible causative agent?

• Johnstates that he was having sex at least three times a week with a different man he met in a bar. Based on this information, what disease do you think John has and why? What diagnostic test(s) would confirm this diagnosis?
• What are some complications that John could develop because of this diagnosis, and how likely are they?

• What is the treatment for John's diagnosis?

• What instructions regarding his diagnosis should John. receive?
• What legal responsibilities does the health care provider have regarding this diagnosis of a sexually transmitted infection?