Type Of Infectious And Inflammatory Disorder Of Female Genitalia

Type Of Infectious And Inflammatory Disorder Of Female Genitalia

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Please give a response to each question with their reference separately , at least 2 reference.

#1

Scenario 1: Polycystic Ovarian Syndrome (PCOS)
A 29-year-old female presents to the clinic with a complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarche at 11 years of age. She began to develop dark, coarse facial hair when she was 13 years of age, but her parents did not seek treatment or medical opinion at that time. The symptoms worsened after she gained weight in college. She got married 3 years ago and has been trying to get pregnant for the last 2 years without success. Height 66 inches and weight 198. BMI 32 kg.m2. Moderate hirsutism without virilization noted. Laboratory data reveal CMP within normal limits (WNL), CBC with manual differential (WNL), TSH 0.9 IU/L SI units (normal 0.4-4.0 IU/L SI units), a total testosterone of 65 ng/dl (normal 2.4-47 ng/dl), and glycated hemoglobin level of 6.1% (normal value ≤5.6%). Based on this information, the APRN diagnoses the patient with polycystic ovarian syndrome (PCOS) and refers her to the Women’s Health APRN for further workup and management. Type Of Infectious And Inflammatory Disorder Of Female Genitalia

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Question
What is the pathogenesis of PCOS?#2
Scenario 1: Polycystic Ovarian Syndrome (PCOS)
A 29-year-old female presents to the clinic with a complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarche at 11 years of age. She began to develop dark, coarse facial hair when she was 13 years of age, but her parents did not seek treatment or medical opinion at that time. The symptoms worsened after she gained weight in college. She got married 3 years ago and has been trying to get pregnant for the last 2 years without success. Height 66 inches and weight 198. BMI 32 kg.m2. Moderate hirsutism without virilization noted. Laboratory data reveal CMP within normal limits (WNL), CBC with manual differential (WNL), TSH 0.9 IU/L SI units (normal 0.4-4.0 IU/L SI units), a total testosterone of 65 ng/dl (normal 2.4-47 ng/dl), and glycated hemoglobin level of 6.1% (normal value ≤5.6%). Based on this information, the APRN diagnoses the patient with polycystic ovarian syndrome (PCOS) and refers her to the Women’s Health APRN for further workup and management. Type Of Infectious And Inflammatory Disorder Of Female Genitalia
Question
How does PCOS affect a woman’s fertility or infertility?

#3
Scenario 2: Pelvic Inflammatory Disease (PID)
A 30-year-old female comes to the clinic with a complaint of abdominal pain, foul smelling vaginal discharge, and fever and chills for the past 5 days. She denies nausea, vomiting, or difficulties with bowels. Last bowel movement this morning and was normal for her. Nothing has helped with the pain despite taking ibuprofen 200 mg orally several times a day. She describes the pain as sharp and localizes the pain to her lower abdomen. Past medical history noncontributory. GYN/Social history + for having had unprotected sex while at a fraternity party. Physical exam: thin, Ill appearing anxious looking white female who is moving around on the exam table and unable to find a comfortable position. Temperature 101.6F orally, pulse 120, respirations 22 and regular. Review of systems negative except for chief complaint. Focused assessment of abdomen demonstrated moderate pain to palpation left and right lower quadrants. Upper quadrants soft and non-tender. Bowel sounds diminished in bilateral lower quadrants. Pelvic exam demonstrated + adnexal tenderness, + cervical motion tenderness and copious amounts of greenish thick secretions. The APRN diagnoses the patient as having pelvic inflammatory disease (PID)Type Of Infectious And Inflammatory Disorder Of Female Genitalia.
Question:
What is the pathophysiology of PID?

#4
Scenario 3: Syphilis
A 37-year-old male comes to the clinic with a complaint of a “sore on my penis” that has been there for 5 days. He says it burns and leaked a little fluid. He denies any other symptoms. Past medical history noncontributory.
SH: Bartender and he states he often “hooks up” with some of the patrons, both male and female after work. He does not always use condoms.
PE: WNL except for a lesion on the lateral side of the penis adjacent to the glans. The area is indurated with a small round raised lesion. The APRN orders laboratory tests, but feels the patient has syphilis.
Question: Type Of Infectious And Inflammatory Disorder Of Female Genitalia
What are the 4 stages of syphilis

Scenario 3: Stages of Syphilis

What are the 4 stages of syphilis?

One of the common infectious sexually transmitted disease is Syphilis, brought by spirochete Treponema pallidum. When the disease remains untreated for long, it progresses through four stages which include primary, secondary, latent and tertiary stages.

In the first primary stage, chancres of painless sores start appearing on the sites of infection including the vagina, penis, anus, mouth and rectum. After a period of 3-6weeks, these sores start healing by themselves despite the fact that one can still spread the disease. Syphilis at this stage can however be treated easily using medications. The second stage is the secondary stage and is usually characterized with features such as fever, extreme tiredness, swollen lymph nodes, reddish brown rushes developing on soles of feet and palms of hands, patchy hair loss and headaches & body aches (Tuddenham, Katz & Ghanem, 2020)Type Of Infectious And Inflammatory Disorder Of Female Genitalia. These symptoms vanish without treatment but can worsen when not treated.

The third stage is the latent stage. It is a face where the bacteria of syphilis are still thriving in the body with no signs or symptoms of the infection. At this stage, a person is not contagious but the syphilis bacteria can have a long-term effect on their nerves, heart, bones, brains and other body parts. This is a stage that is however not a must for anyone who has syphilis to go through. Some people therefore go directly from secondary to tertiary stage. Finally, tertiary stage is the last syphilis’ stage. It is a point where syphilis is not contagious but has started affecting an individual’s organs (Cornelisse et al., 2020). It is a stage that can easily impact death. Some of the symptoms at this stage include Dementia, Numbness, difficulties in muscle movement and vision problems.

References

Cornelisse, V. J., Chow, E. P., Latimer, R. L., Towns, J., Chen, M., Bradshaw, C. S., & Fairley, C. K. (2020). Getting to the bottom of it: sexual positioning and stage of syphilis at diagnosis, and implications for syphilis screening. Clinical Infectious Diseases, 71(2), 318-322. https://doi.org/10.1093/cid/ciz802

Tuddenham, S., Katz, S. S., & Ghanem, K. G. (2020). Syphilis laboratory guidelines: performance characteristics of nontreponemal antibody tests. Clinical Infectious Diseases, 71(Supplement_1), S21-S42. https://doi.org/10.1093/cid/ciaa306 Type Of Infectious And Inflammatory Disorder Of Female Genitalia

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Scenario 2: Pelvic Inflammatory Disease (PID)

What is the pathophysiology of PID?

            The pelvic inflammatory disease (PID) is a type of infectious and inflammatory disorder that develop in the upper parts of female genitalia, including the fallopian tubes, uterus and the pelvic structures (Koninckx et al., 2019). It is a disease that may spread its infections and inflammations to other parts of the abdomen. The infections ascending from the vagina and cervix are the main cause of PID. The predominant sexually transmitted organism known as Chlamydia trachomatis is associated with PID. Of the total cases of acute PID, the percentage that test positive for Chlamydia trachomatis and Neisseria gonorrhea is about 50%. The other percentage is shared among the Gardnerella vaginalis, which encompasses Haemophilus influenzae, bacterial vaginosis (BV) and anaerobes species such as the Bacteroides and the Peptococcus (Jennings & Krywko, 2022)Type Of Infectious And Inflammatory Disorder Of Female Genitalia. In most cases, inflammation in the uterus and the fallopian tubes causes necrosis and swellings in these areas. As a result of inflammation in the fallopian tubes, infertility is impacted. After Chlamydia trachomatis infection, Neisseria gonorrhea is the second most primary cause of PID.

References

Jennings, L. K., & Krywko, D. M. (2022). Pelvic inflammatory disease. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499959/

Koninckx, P. R., Ussia, A., Tahlak, M., Adamyan, L., Wattiez, A., Martin, D. C., & Gomel, V. (2019). Infection as a potential cofactor in the genetic-epigenetic pathophysiology of endometriosis: a systematic review. Facts, views & vision in ObGyn, 11(3), 209. PMID: 32082526; PMCID: PMC7020943.

Scenario 1: Polycystic Ovarian Syndrome (PCOS)

What is the pathogenesis of PCOS?

There are various factors attributed to PCOS pathogenesis. The factors include resistance to insulin, having an altered action of the luteinizing hormone (LH) and a potential predisposition of hyperandrogenism. According to the recent research, hyperandrogenism is worsened by the underlying insulin resistance through the suppression of sex hormone binding globulin as well as through increasing ovarian and adrenal synthesis of androgens, thus impacting accumulation of androgens (Walters et al., 2018)Type Of Infectious And Inflammatory Disorder Of Female Genitalia. The accumulation of androgen levels is attributed to hyperandrogenism manifesting physically and the observed irregular menses (Ryu et al., 2019). One key characteristic of PCOS is its hyperandrogenic nature thus makes it insulin resistance. Hyperinsulinemia on the other hand is the hyperandrogenic nature thus making the signs and symptoms of PCOS to be more severe.

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References

Ryu, Y., Kim, S. W., Kim, Y. Y., & Ku, S. Y. (2019). Animal models for human polycystic ovary syndrome (PCOS) focused on the use of indirect hormonal perturbations: a review of the literature. International journal of molecular sciences, 20(11), 2720. https://doi.org/10.3390/ijms20112720

Walters, K. A., Gilchrist, R. B., Ledger, W. L., Teede, H. J., Handelsman, D. J., & Campbell, R. E. (2018). New perspectives on the pathogenesis of PCOS: neuroendocrine origins. Trends in Endocrinology & Metabolism, 29(12), 841-852. https://doi.org/10.1016/j.tem.2018.08.005 Type Of Infectious And Inflammatory Disorder Of Female Genitalia