Bleeding Defecation

Cases Studies 3 & 4 – Primary CareA 47-year-old male patient (A) presents to your office c/o painful and bleeding defecation that started acouple of days ago. Pt also states that he noticed some intermittent pruritus on his back. Pt comesaccompanied by his male husband of 45 years old (B), who states that he had noticed a painless “blister”on his genital area, but he is not quite sure when it appeared.Patient A: with no past or family relevant history and NKAPatient B: PMH of seasonal allergic rhinitis and NKS. No other family or relevant history.On complete physical examination:On Patient A: a visible anal fissure in the inferior region of the sphincter was noted. It is also noticeddisseminated papules in the trunk and macules on palms and soles.Patient B: A visible ulceration in the genital area noted and patient denies pain on palpation. Noadenopathy noted or reported by patient (B).Since patients are a marital couple, you proceed with serological testing for each patient (A &B) becauseyou suspect a sexually transmitted disease. Both patients deny having or being treating in the past forSTD’sLab Results:Patient A: Leukocytosis – Treponema (Positive) – Non-Treponema (Positive) – HIV (Negative) – Hepatitis(Negative)Patient B: Treponema (Positive) – Non-treponema (Negative) – HIV (negative) – Hepatitis (Negative)——————— Do not include the above section in your paper. ONLY THE QUESTIONS BELOW——-Please answer the following questions in APA format and include in-text references.1) What serological lab works would you order to obtain the above results? (Be specific with the labnames)2) What is the diagnosis for Patient A?3) What is the diagnosis for Patient B?4) What would it be the differential diagnosis for patient A and patient B?5) How are you going to treat Patient A? (Be specific and include the time of treatment)6) How are you going to treat Patient B? (Be specific and include the time of treatment)7) What would be the possible cause of this infection if both patients did not have any sexual encounteroutside their relationship in the last year?

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