NURS 6501 Week 11 Advanced Pathophysiology

The Factors That Affect Fertility (STDs)

Sexually transmitted diseases (STDs) significantly affect fertility, especially in women.  A common STD associated with infertility is Pelvic inflammatory disease (PID) (Curry et al., 2019). PID is characterized by infection of the upper female genital tract organs, including the uterus, fallopian tubes, and pelvic structures (Curry et al., 2019). The infection results in inflammation, which results in scarring and adhesions in the tubal lumens. The risk of developing infertility in a woman increases with each PID episode.

Why Inflammatory Markers Rise In STD/PID

PID is marked by an increase in inflammatory markers due to infection and inflammation in the upper genital tract. Chlamydia infection is marked with the sharpest rise in inflammatory markers since it causes a worse irritation compared to other STI-causing organisms (Park et al., 2017). Inflammatory markers that rise in STDs and PID include white blood cells, Erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).

Why Prostatitis and Infection Happens

            Prostatitis is an inflammation of the prostate gland and is often a complication of STDs in males. It occurs when an infection from the lower urinary tract ascends through the urethra or reflux of infected into the prostate ducts (Coker & Dierfeldt, 2016). This results in infection and eventually inflammation of the prostate gland.  A systemic reaction in prostatitis occurs when the pathogens spread from the rectum to other organs via the lymphatic system (Coker & Dierfeldt, 2016). The pathogens cause an infection of the lymph nodes resulting in lymphadenopathy.

Why a Patient Would Need a Splenectomy after a Diagnosis of ITP

Immune thrombocytopenia (ITP) is a blood disorder marked by a decrease in the number of platelets.  It is an autoimmune condition where there is an immune reaction against one’s platelets (Nomura, 2016). The autoimmune reaction contributes to a reduced platelet lifespan and decreased platelet production resulting in a reduced number of circulating platelets. The first-line treatment of ITP is corticosteroid therapy. A patient will need a splenectomy following a diagnosis of ITP if they fail to attain a stable, safe platelet count after corticosteroid therapy (Nomura, 2016).  A splenectomy is indicated for achieving a fast, complete, and lifetime clinical remission (Nomura, 2016). Besides, a splenectomy prevents sequestration and phagocytosis of platelets by mononuclear macrophages located in the spleen.

Anemia and the Different Kinds of Anemia

Anemia manifests with a decrease in red blood cell (RBC) mass. It is marked by a reduction in hemoglobin level below the normal range below 12.5 g/dl (Nagao & Hirokawa, 2017). Hemoglobin and RBCs play a vital role in the transport of oxygen in the circulation. When the two are decreased, oxygen delivery to body tissues is impaired (Nagao & Hirokawa, 2017). Other blood components used in diagnosing anemia include reduced levels of Hematocrit (HCT), Mean corpuscular volume (MCV), Mean corpuscular hemoglobin (MCH), and Mean corpuscular hemoglobin concentration (MCHC).

Morphologic characteristics of RBCs in a healthy person are normocytic and normochromic. Anemia present with varying morphologic features of RBCs (Nagao & Hirokawa, 2017). In macrocytic anemia, RBCs are large, nucleated, and misshaped, termed as megaloblasts (Nagao & Hirokawa, 2017). Macrocytic anemia occurs in anemia caused by Vitamin B-12 and Folic acid deficiency. Iron-deficiency anemia is characterized by hypochromic and microcytic RBCs. Erythrocytes in microcytic anemia are usually small in size.

The patient in the case study has low hemoglobin and hematocrit levels, which indicate anemia. The low reticulocyte count suggests a decreased production of RBCs in the bone marrow, which may be causing the low hemoglobin and hematocrit levels (Nagao & Hirokawa, 2017) (Nagao & Hirokawa, 2017). The low serum B1 2 levels denote that the anemia is caused by Vitamin B 12 deficiency, which plays a vital role in the synthesis of RBCs (Nagao & Hirokawa, 2017).  The patient has high levels of MCV, plasma iron, and ferritin levels, while Folate and Total Iron Binding Capacity are normal. The results mean that the anemia is caused by Folic acid or Iron deficiency. In other words, the patient has Vitamin B 12 deficiency anemia, also known as Pernicious anemia.

References

Coker, T. J., & Dierfeldt, D. M. (2016). Acute bacterial prostatitis: diagnosis and management. American family physician, 93(2), 114-120.

Curry, A., Williams, T., & Penny, M. L. (2019). Pelvic inflammatory disease: diagnosis, management, and prevention. American family physician, 100(6), 357-364.

Nagao, T., & Hirokawa, M. (2017). Diagnosis and treatment of macrocytic anemias in adults. Journal of general and family medicine, 18(5), 200-204. https://doi.org/10.1002/jgf2.31

Nomura S. (2016). Advances in Diagnosis and Treatments for Immune Thrombocytopenia. Clinical medicine insights. Blood disorders, 9, 15–22. https://doi.org/10.4137/CMBD.S39643

Park, S. T., Lee, S. W., Kim, M. J., Kang, Y. M., Moon, H. M., & Rhim, C. C. (2017). Clinical characteristics of genital Chlamydia infection in pelvic inflammatory disease. BMC women’s health, 17(1), 5. https://doi.org/10.1186/s12905-016-0356-9

Week 11 Knowledge Check

Pediatrics

In this exercise, you will complete a 10-20 question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

Growth and development

Normal growth patterns

Scoliosis (ortho)

Kawasaki

Alterations in children

Congenital (heart syndrome)

PDAs

Sudden Infant Death Syndrome (SIDS)

Asthma

Lead poisoning and effects on neurological functioning

Sickle cell

Hemophilia

Question 1What is the function of Protein S?

Question 2 Von Willebrand disease is a genetic condition that causes: (thrombotic, hemorrhagic) condition.

Question 3During the first five years of life, the respiratory system continues to develop and the number of what structure increases?

Question 4Children with Down’s Syndrome has an increased risk of developing which type of cancer?

Question 5Infants that have seizures typically have what types of symptoms due to the normal development of the nervous system?

Question 6A child with MYCN oncogene is at risk for developing which type of cancer?

Question 7Pruritic linear lesions that itch more at night that may have more vesicles and papules describes which of the following conditions?

Question 8Marasmus is a severe deficiency of what?

Question 9A ventricular septal defect will cause what type of  blood shunting?

Question 10Which of the following about Roseaola is FALSE?

Question 11Which of the following characteristics of Impetigo is FALSE?

Question 12Cerebral palsy involves what type of defects?

Question 13Children who have atopic dermatitis often have elevated levels of ______________________.

Question 14Which of the following is true of people that have sickle cell anemia?

Question 15An infant with a congenital defect involving a hole in the septum between the two lower chambers of the heart has a _______________________.

Question 16A coarctation of the aorta will cause what type of  blood shunting?

Question 17What are the two most common malignant bone tumors of childhood?

Question 18What is the function of G6P4?

Question 19A tetrology of flow will cause what type of  blood shunting?

Question 20Red, round, and scaling patches with a clear center that occur mostly on the face, trunk, and limbs in an asymmetrical distribution describes which of the following conditions?