NURS 6501 Week 7 Knowledge Check .docx - Question 1 A 28-year-old woman presents to the clinic with a chief complaint of hirsutism and irregular menses

NURS 6501 Week 7 Knowledge Check .docx - Question 1 A...

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Question 1:A 28-year-old woman presents to the clinic with a chief complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarcheat 12 years of age. She began to develop dark, coarse facial hair when she was 14 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. Question 1 of 2:What is the pathogenesis of PCOS? Answer:Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by hyperandrogenism and chronic anovulation. Depending on diagnostic criteria, 6% to 20% of reproductive aged women are affected. PCOS presents as a phenotype reflecting a self-perpetuating vicious cycle involving neuroendocrine, metabolic, and ovarian dysfunction. PCOS reflects the interactions among multiple proteins and genes influenced by epigenetic and environmental factors. Functional ovarian hyperandrogenism due to ovarian steroidal dysregulation is at the center of the pathogenesis of polycystic ovary syndrome. Functional ovarian hyperandrogenism due to ovarian steroidal dysregulation is at the center of the pathogenesis of polycystic ovarysyndrome. This has both genetic and environmental factors. The genetic factors are polycystic ovary morphology, insulin resistance, hyperandrogenemia, defects in insulin secretion. The steroidal dysregulation may lead to anovulation, irregular menses, virilization, hirsutism and infertility. Insulin resistance may also occur.How does PCOS affect a woman’s fertility or infertility? Question 2:
A 20-year-old female college student presents to the Student Health Clinic with a chief complaint of abdominal pain, foul smelling vaginal discharge, and fever and chills for thepast 4 days. She denies nausea, vomiting, or difficulties with defecation. 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

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