Internal Medicine
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PREVENTION & SCREENING

CASE # 1

B.L. is a 27-year-old female who resides in Maywood. She presents to your Woman’s Health Center with a black eye and eye pain after an altercation. She was struck in her left eye by her live-in boyfriend of six months. She denies any other trauma and states that the altercation began after an argument concerning money. She has been to the Loyola E.R. twice in the past year for other skeletal and soft tissue injuries that occurred after arguments with her boyfriend. She uses the E.R. for her medical care and has not seen a primary care physician since high school.

Medical History

Adult: 1) Sickle Cell Trait with mild anemia  2) GC diagnosed at age 23

Meds: None

Allergies: Sulfa

Surgery: None

Habits: Smokes 1 pk/day since age 16, social drinker on weekends. Denies
            use of street drugs at any time

Social: Single, works as a manager in clothing store Carries a handgun in
            car, does not wear seatbelts

Family: Father, age 52, HTN & Sickle Cell Trait Otherwise
             non-contributory

OB/Gyn: G1P0A1
                Last pap had CIN I - 3 years ago Sexually active since age 16,
                4 sex partners in last 2 years.  Uses a spermicide for birth
                control

Vaccines: None since high school, completed childhood series

Diet: Fast food for lunch and dinner

Exercise: None regularly

QUESTIONS FOR DISCUSSION

1. Which vaccines is she eligible for? What are their indications, efficacy,
    and time intervals?

2. Which screening tests will she eventually need?

3. Please give your counseling recommendations concerning:

a) Injury and Violence prevention

b) Nutrition

c) Exercise

d) STDs and unintended pregnancy

e) Smoking cessation