Answer:

Almost everybody who answered last week's puzzler recognized this man's symptoms as an STD, with answers ranging from gonorrhea to chlamydia to trichomoniasis. These are all possible answers, since it can be hard to distinguish among them without doing a culture, or microscopic exam, of the discharge. This type of STD has been called "the clap."

The clap is otherwise known as "urethritis," and this case was meant to be a type of urethritis known as "nongonococcal urethritis." Nongonococcal urethritis is the most common STD among heterosexual men. It is basically an infection of the urethra, the portion of the urinary tube that (in men) passes through the penis. There are several different organisms that can cause the infection, the most common being chlamydia.

You might be able to distinguish gonorrhea -- where the discharge looks like pus -- from chlamydia where the discharge looks more like mucous. And it is worth remembering that if you get urethritis, you may also have been the lucky recipient of another STD which you may have caught at the same time.

While the disease is annoying to a man, and occasionally causes other problems such as infection of the prostate, it is women who are at the greatest risk of serious problems such as infertility. Therefore, it is essential that the man notify his partner(s) who may not otherwise know they are infected. This is not a time to be embarrassed, shy, or angry, in a way that might cause permanent harm to another. Homosexual men should also notify their partners, also because of concerns about transmission to others.

In general, it is recommended to avoid all unprotected intercourse for about seven days after treatment is begun.

Bonus Question:
What are a woman's symptoms if she catches chlamydia?

Answer to Last Week's Bonus Question:
Congratulations to everyone who recognized that an enlargement of the thyroid is called a "goiter." This is most commonly seen in the setting of hypothyroidism (an underactive thyroid) and can be thought of as the gland working overtime to increase low thyroid hormone levels.

Iodine, obtained from the diet, is necessary for the production of thyroid hormone. Back before iodized salt, in areas of the world where the soil lacked iodine (the Great Lakes region of the U.S. is one example), people walked around with huge goiters, recognized as a mass at the base of the throat.

One word of caution: An enlargement of the thyroid may also indicate a nodule, or in rare cases, thyroid cancer. So it's always a good idea to get it checked out.