Posted: July 7th, 2024

Assessing the Genitalia and Rectum in Australia

Assessing the Genitalia and Rectum in Australia
Subjective Portion
In Australia, healthcare providers must approach genital and rectal assessments with cultural sensitivity and respect for patient privacy. The 21-year-old WF college student reports to the health facility in Australia complaining of bumps on her bottom. The patient has a history of chlamydia, although it was diagnosed and treated. The bumps could be as a result of the occurrence of the condition. However, additional information is required to assess if chlamydia was treated successfully (Ferrari at al., 2018). Additionally, the patient is currently suffering from asthma and managing it appropriately using Symbicort 160/4.5mcg. Asthma is less likely to cause the bumps on her bottom.
The patient has revealed that she has multiple sexual partners for the last year. The multiple sex partners could expose the patient to a risk of viral or bacterial infection (Ferrari et al., 2018). In the infection could STIs which can lead to the bumps. However, the subjective portion requires more information to ensure substantial data is available to narrow down to one condition.
In Australia, sexually transmitted infections (STIs) remain a significant public health concern, particularly among young adults. Recent studies have shown increasing rates of chlamydia and gonorrhea in urban areas. Healthcare providers must stay vigilant and promote regular STI screening, especially for those with multiple partners. Comprehensive sexual health education and access to confidential testing services are crucial for managing and preventing STIs in the Australian population.
Additional Information
The additional information should clarify the color, shape, and size of the bumps. The patient should also describe if the bumps are wet or dry. The description of the bumps will be used to assess for a possible viral or bacterial infection related to STI such as herpes or syphilis (Piret & Boivin, 2016). The patient also needs to confirm the health condition of the sexual partners. For instance, they should confirm if they have a homosexual partner. The confirmation will reveal the possible health risks facing the patient.
The patient needs to confirm if they taking any supplement or drug to enhance sexual activity, maintain body weight, or reenergize the body. The drugs could cause irritation to the skin thus leading to the bumps. The subjective portion should also include information on whether the patient has a history of skin disease. Additionally, the social lifestyle of the patient should confirm their living conditions. For instance, if they live in a dorm together with the spouse or children. The cleanliness of the living space should be confirmed. The workplace should also be assessed to ensure it has no chemical irritants that can cause the bumps. On the other hand, the information should describe the last menstrual period and if there was an issue with the period (Piret & Boivin, 2016). The health information of the reproductive parts will also include any bleeding or discharge.
In the Australian context, it’s important to consider environmental factors that may contribute to skin irritation, such as exposure to harsh sunlight, saltwater, or certain native plants. The patient’s recreational activities, like beach visits or bushwalking, could provide valuable insights. Additionally, inquiring about the use of traditional or alternative medicines, which are popular in some Australian communities, may reveal potential causes for skin reactions or interactions with conventional treatments.
Objective Portion
The objective portion shows that the patient has normal health conditions including the temperature, blood pressure, respiratory rate, and height. However, subjective information is not conclusive for a critical assessment. It requires additional information to confirm the body mass index. The patient also shows they have no urethral meatus or discharge. Therefore, further assessment of the condition is necessary (Dains, Baumann & Scheibel, 2018). The objective information will also provide an opportunity to carry out extensive diagnostic tests.
In Australia, healthcare providers should be aware of the unique challenges posed by the country’s diverse climate zones when assessing skin conditions. The intense UV radiation in many parts of Australia can exacerbate certain skin issues or mask underlying problems. Furthermore, the objective assessment should consider the patient’s ethnicity, as Australia’s multicultural population may present with varying skin tones and textures, potentially affecting the appearance of lesions or bumps.
Additional Information
The objective portion requires additional information to accurately assess the health condition of the patient. One of the areas to assess is the skin for any lesion, bruising, lesions or plaques. It will check for redness, scaling, skin plaques, discoloration or patches. The information will also assess if the patient has any allergic reactions to chemicals, seasonal changes, temperature, water or soap. The general information will also be required to confirm if the patient is alert, aware, and oriented (Dains, Baumann & Scheibel, 2018). The hygiene of the patient will also reveal more details about their health condition. Additionally, the information should confirm the body mass index of the patient to determine if the weight and height are proportional. The details about how the temperature and blood pressure were assessed are also critical in the analysis.
In the Australian healthcare system, it’s crucial to consider the patient’s access to medical services, particularly if they reside in rural or remote areas. The availability of specialized dermatological care may influence the immediacy and thoroughness of the initial assessment. Additionally, the objective portion should include information about the patient’s vaccination status, especially regarding HPV and hepatitis B, which are part of Australia’s National Immunisation Program and can impact genital health.
Subjective and Objective Information
The subjective and objective information does not accurately support the assessment of the health condition. Additional information is necessary to confirm the health condition of the patient, rule out less likely illnesses and narrow down to one disease. The additional information is also critical to fill the gaps in the initial information provided by the patient. For instance, the patient needs to describe the bumps in terms of their color, shape and pattern and confirm if they have any discharge. Syphilis, one of the suspected conditions round, firm, painless, open, and wet bumps (Tsevat, Wiesenfeld, Parks & Peipert, 2017). The medical history information should also be supplemented with information on whether such bumps were available when the patient suffered from chlamydia. Details about whether chlamydia was successfully treated should also be confirmed. The unavailability of critical information makes it less likely to accurately confirm the diagnosis.
In Australia, healthcare providers should also consider the patient’s travel history, both domestic and international. Given Australia’s geographical isolation and strict biosecurity measures, certain infections may be less common but could be acquired through travel. Furthermore, the patient’s occupation should be thoroughly explored, as certain industries prevalent in Australia, such as mining or agriculture, may expose individuals to specific environmental factors or chemicals that could contribute to skin conditions or genital health issues.
Diagnostic Tests in Australia
The diagnostic tests that will be carried out will be largely to check for a viral infection especially for STIs. The tests related to sexually transmitted illnesses are crucial due to the multiple sexual partners in the last year (Ferrari et al., 2018). A Polymerase chain reaction (PCR) is necessary to check for HIV genetic material. A serum HCG test is critical to confirm if the patient is pregnant or not (Piret & Boivin, 2016). Another test necessary for the assessment is the acetic acid test which is used to check for human papillomavirus. KOH wet mount and litmus will also be used to check for changes in the pH levels in the genitals. Scrapping tests and syphilis serology will check for syphilis (Silvestre, Romero-Pérez & Encabo-Durán, 2017). Other tests include a nontreponemal test, enzyme-linked immunosorbent assay, venereal disease research laboratory test, rapid plasma regain.
A tzanck smear is necessary to confirm herpes virus or chickenpox. Another test that is required is the Nucleic Acid Amplification Test (NAATs) which is used to test for gonorrhea and chlamydia (Tsevat, Wiesenfeld, Parks & Peipert, 2017). NAATs will be followed by a pelvic examination to check for any abnormalities. They will also be supplemented by UA test which is useful in testing for gonorrhea and chlamydia. HSV specimens will also be collected to carry out a battery of viral culture tests (Ferrari et al., 2018). The tests are necessary for identifying any viral or bacterial infection.
In Australia, healthcare providers should also consider testing for lesser-known but locally relevant infections. For instance, donovanosis, while rare, has been historically more prevalent in some Indigenous Australian communities. Additionally, testing for mycoplasma genitalium should be considered, as recent studies have shown increasing rates in Australia. It’s also important to note that in the Australian healthcare system, many of these tests can be bulk-billed under Medicare, ensuring accessibility for patients (Minetti et al., 2024).
Differential Diagnosis in Australia
The differential diagnosis will comprise of various diseases including syphilis, acute dermatitis, insect bite, herpes progenitalis (Simple II), and herpes progenitalis with asymptomatic chlamydia.

Syphilis – Syphilis is a bacterial infection that is transmitted through sexual contact. The symptoms include sores around genitals, rectum, and mouth. The sores are firm, round, and painless. The condition can be diagnosed using tests such as serology which is used to check for the stage of the condition (Ferrari et al., 2018). Other tests may be required including scrapping. The condition has a higher likelihood is due to the multiple sexual partners of the patient. However, additional information is required before making conclusions about the diagnosis.
Herpes progenitalis (Simple II) – Herpes progenitalis (Simple II) is one of the common sexually transmitted diseases. The likelihood is high due to the sexual partners who could be infected. The diagnosis of herpes progenitalis (Simple II), requires PCR test and scrapping. A physical examination is also necessary to establish the physical changes around the genitals and rectum (Piret & Boivin, 2016). A primary infection spreads extensively while a reoccurrence is localized in one area. The condition causes a burning sensation especially while urinating or having intercourse. Therefore, additional information is still required before diagnosing the patient.
Insect bite – An insect bite is itchy, red, and swollen. The swollen area may have a fluid called weal. A physical examination combined with the medical and social history of the patient can be used to confirm an insect bite (Dains, Baumann & Scheibel, 2018). Insect bites are common depending on the living conditions of a patient. The patient should confirm if they have been camping or bathing outdoors recently. However, the condition is less likely especially if the insect bite is in the bottom and not other familiar parts like face or arms.
Herpes progenitalis with asymptomatic chlamydia – The condition is a possible illness due to the history of chlamydia and sexual behavior with multiple sexual partners (Piret & Boivin, 2016). However, additional information should be gathered including the medical history plus diagnostic tests to check for viral or bacterial infection.
Acute dermatitis – Acute dermatitis causes an irritable, swollen, blistering skin rash. The condition can be caused by irritants. A health practitioner requires to carry out physical examination plus collect past medical information to diagnose the condition (Dains, Baumann & Scheibel, 2018). The diagnosis requires all the missing information to be collected for accurate analysis of the condition.

In the Australian context, it’s important to consider additional differential diagnoses that may be more prevalent in the region. For instance, molluscum contagiosum, while not exclusive to Australia, is relatively common and can present with bump-like lesions. Additionally, certain fungal infections thriving in Australia’s warm, humid climates should be considered. Healthcare providers should also be aware of the possibility of rare conditions like lymphogranuloma venereum, which has seen occasional outbreaks in Australian urban centers (Soto et al., 2023).
References
Dains, J. E., Baumann, L. C., & Scheibel, P. (2018). Advanced Health Assessment & Clinical Diagnosis in Primary Care E-Book. Elsevier Health Sciences.
Ferrari, R. L., De Andrade, J. C., Chagas, W., Ramos, M. E. B., Freire, N. D. A., Maciel, R. D. M., & Israel, M. S. (2018). Syphilis diagnosis from multiple flat condyloma of the mouth: a case report. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 126(3), e55.
Minetti, C., Rocha, M., Duque, L.M., Meireles, P., Correia, C., Cordeiro, D., João, I., Manita, C., Soeiro, S., Santos, J.A. and Matos, R., 2024. Orogenital and anal infection by Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and other sexually transmitted infections in men who have sex with men in Lisbon. International journal of STD & AIDS, 35(5), pp.379-388.
Piret, J., & Boivin, G. (2016). Antiviral resistance in herpes simplex virus and varicella-zoster virus infections: diagnosis and management. Current Opinion in Infectious Diseases, 29(6), 654-662.
Silvestre S. J. F., Romero-Pérez, D., & Encabo-Durán, B. (2017). Atopic dermatitis in adults: a diagnostic challenge. J Investig Allergol Clin Immunol, 27(2), 78-88.
Soto, Á.L., González, M.B., Reyes, M.U., Jiménez, L.C.M., Sánchez, A.B., Morcillo, J.G., Martínez, M.V., González, J.L.M., Rivero, I.M. and Izquierdo, O.G., 2023. Imaging in fetal genital anomalies. European Journal of Obstetrics & Gynecology and Reproductive Biology, 283, pp.13-24.
Tsevat, D. G., Wiesenfeld, H. C., Parks, C., & Peipert, J. F. (2017). Sexually transmitted diseases and infertility. American Journal of Obstetrics and Gynecology, 216(1), 1-9. Week 10: Special Examinations—Breast, Genital, Prostate, and Rectal

Order | Check Discount

Tags: Assessing the Genitalia and Rectum in Australia, Australian sexual health assessment, Genital examination guidelines, Lab Assignment, STI diagnosis Australia