Emily B. is a 19-year-old Caucasian college sophomore who presents to the student health clinic for evaluation of increased vaginal discharge, occasional pelvic discomfort, and mild dysuria over the past week. She denies fever, chills, or abnormal bleeding.

She expresses concern about possible STIs, stating that one of her friends was recently diagnosed with chlamydia. She has not had a full gynecological exam since age 17.

She became sexually active at 17 and reports inconsistent condom use. She recently began a new relationship and has had three sexual partners in the last 12 months.

Emily expresses anxiety about her reproductive health and asks about long-term effects. She also confesses uncertainty about how to inform her partner and expresses guilt over not completing the HPV vaccine. She is receptive to education but has many questions.

PMH: Unremarkable Medications: None Social History: Full-time nursing student who works part-time at a local café. Immunization: One dose of the HPV vaccine at age 15, as she did not complete the series due to insurance changes and lack of follow-up.

Physical Exam: Appears well and afebrile. During speculum exam, mild cervical erythema and friability, no adnexal tenderness.

Diagnostic testing NAAT (nucleic acid amplification test): Positive Chlamydia trachomatis Reflex HPV: pending (Ordered due to an abnormal Pap smear result noted in her intake paperwork and prior screening indicated possible exposure to HPV type 16)

Explain how this information relates to the case 1. Describe the pathophysiologic process of chlamydia, including the two forms, intracellular development, and immune evasion. 2. Explain the host’s response to the infection, including pathogen recognition receptors and proinflammatory cytokines. 3. Explain the risk factors for STDs. 4. Explain the complications of Chlamydia.

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