Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders

NURS 6501 Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders

The case study concerns a 60-year-old man with complaints of urinary frequency and incontinence that started after having chemo and radiotherapy three years ago to treat prostate cancer. The patient is more worried about his low back and hip pain that started roughly one month ago, which he thought was caused by lifting heavy boxes. Lab results show a normal urinalysis and CBC, and PSA of 7.2. The prostate is enlarged and nodular on DRE. The purpose of this assignment is to discuss prostatitis as it relates to the patient case.

Why prostatitis and infection happen and causes of a systemic reaction.

Prostatitis occurs due to inflammation of the prostate gland. Bacterial prostatitis mainly occurs with urethritis or a lower urinary tract infection (UTI). It is commonly caused by Enterobacter, Escherichia coli, Group D streptococci, and Proteus (Pirola et al., 2019). The microbes reach the prostate through the urethra or bloodstream. The patient presents with symptoms of chronic bacterial prostatitis like urinary frequency and incontinence. This could have been caused by the inoculation of bacteria during therapy or microorganisms from a lower UTI spreading to the prostate (Pirola et al., 2019).

Furthermore, chronic prostatitis manifests with pain in and around the penis, testicles, anal area, lower abdomen, and lower back. It also presents with an enlarged or tender prostate on digital rectal examination (DRE). Therefore, the patient’s low back and hip pain, as well as findings of an enlarged, nodular prostate, can be pointed to chronic prostatitis. 

Benign prostatic hyperplasia (BPH) is a risk factor for prostatitis. The patient’s history of prostate cancer can be attributed to chronic bacterial prostatitis. The bacteria may have been inoculated to the prostate during the chemotherapy and radiotherapy. The patient has an elevated PSA level of 7.2 and an enlarged nodular prostate, which can be attributed to prostate cancer (McCance & Huether, 2019). Local clinical manifestations of prostate cancer include lower urinary tract symptoms, hematuria, hematospermia, erectile dysfunction, and urinary retention. The patient’s urinary frequency and incontinence can further be attributed to the current prostate cancer.

The patient’s mild degenerative changes in the spine and cystic mass near the spine can be due to metastatic spinal cord compression (MSCC). MSCC occurs when cancer cells spread from the prostate and grow in or near the spine, pressing on the spinal cord (Patnaik et al., 2020). A systemic reaction occurs in a patient with prostatitis when the causative organisms enter the circulation through the lymphatic or blood system and cause infection to other body organs. This results in systemic symptoms like fever, chills, malaise, tachycardia, tachypnea, and myalgia.

Conclusion

The patient has symptoms consistent with chronic bacterial prostatitis, like urinary frequency and incontinence. Chemotherapy may have caused prostatitis when pathogens are inoculated into the bladder. Besides, the patient has symptoms consistent with prostate cancer, like an enlarged, nodular prostate and elevated PSA levels. The degenerative changes and cystic mass near the spine are likely due to the spread of cancer cells from the prostate. A systemic reaction can occur when causative organisms migrate from the prostate to the circulation. 

References

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier

Patnaik, S., Turner, J., Inaparthy, P., & Kieffer, W. K. (2020). Metastatic spinal cord compression. British journal of hospital medicine (London, England : 2005), 81(4), 1–10. https://doi.org/10.12968/hmed.2019.0399

Pirola, G. M., Verdacchi, T., Rosadi, S., Annino, F., & De Angelis, M. (2019). Chronic prostatitis: current treatment options. Research and reports in urology, 11, 165–174. https://doi.org/10.2147/RRU.S194679

Question 1

4 / 4 pts

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.  

Question

1.     What is the pathogenesis of PCOS? 

Your Answer:

The pathogenesis of Polycystic Ovarian Syndrome (PCOS) is not fully understood, but it is believed to be a complex and multifactorial condition with both genetic and environmental factors playing a role. The exact cause is not known, but the following key factors contribute to its development:

1. Hormonal Imbalance: PCOS is characterized by an imbalance in sex hormones, particularly elevated levels of androgens (male hormones) such as testosterone. This hormonal imbalance disrupts the normal menstrual cycle and leads to irregular or absent ovulation.
2. Insulin Resistance: Many women with PCOS also have insulin resistance, which means their cells have a reduced sensitivity to insulin. This leads to increased insulin production to maintain normal blood glucose levels, but it also triggers the ovaries to produce more androgens, further contributing to the hormonal imbalance.
3. Hyperandrogenism: Increased androgen levels in PCOS lead to the development of symptoms like hirsutism (excessive hair growth, particularly on the face, chest, and abdomen), acne, and male-pattern baldness.
4. Follicle Abnormalities: In PCOS, the ovaries often contain multiple small follicles that appear as cysts. These follicles do not mature properly, and the lack of dominant follicles results in infrequent or absent ovulation.
5. Genetic Predisposition: There is evidence to suggest that PCOS may have a genetic component, as it often runs in families.
6. Lifestyle and Environmental Factors: Excessive weight gain or obesity can exacerbate PCOS symptoms, as adipose tissue (fat cells) can produce androgens and worsen insulin resistance.

In summary, PCOS is a complex hormonal disorder involving a combination of hormonal imbalances, insulin resistance, hyperandrogenism, follicle abnormalities, and potentially genetic predisposition. These factors collectively lead to the characteristic symptoms and manifestations of the syndrome, such as irregular menses, hirsutism, and difficulty in achieving pregnancy.

NURS 6501 Knowledge Check Women’s and Men’s Health, Infections, and Hematologic Disorder

Literature, cinema, and other cultural references have long examined differences between women and men. These observations extend well beyond obvious and even inconspicuous traits to include cultural, behavioral, and biological differences that can impact pathophysiological process and, ultimately, health.

Understanding these differences in traits and their impact on pathophysiology can better equip acute

care nurses to communicate to patients of both sexes. Furthermore, APRNs who are able to communicate these differences can better guide care to patients, whatever their gender.

This week, you examine fundamental concepts of women’s and men’s health disorders. You also explore common infections and hematologic disorders, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.
Learning Objectives

Students will:

Analyze concepts and principles of pathophysiology across the life span
Analyze processes related to women’s and men’s health, infections, and hematologic disorders
Identify racial/ethnic variables that may impact physiological functioning
Evaluate the impact of patient characteristics on disorders and altered physiology

Learning Resources

Required Readings (click to expand/reduce)

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

Chapter 24: Structure and Function of the Reproductive Systems (stop at Tests of reproductive function); Summary Review
Chapter 25: Alterations of the Female Reproductive System (stop at Organ prolapse); pp. 787–788 (start at Impaired fertility) (stop at Disorders of the female breast); Summary Review
Chapter 26: Alterations of the Male Reproductive System (stop at Hormone levels); Summary Review
Chapter 27: Sexually Transmitted Infections, including Summary Review
Chapter 28: Structure and Function of the Hematological System (stop at Clinical evaluation of the hematological system); Summary Review
Chapter 29: Alterations of Erythrocytes, Platelets, and Hemostatic Function, including Summary Review
Chapter 30: Alterations of Leukocyte and Lymphoid Function, including Summary Review

Low, N. & Broutet N. J. (2017). Sexually transmitted infections – Research priorities for new challenges. PLoS Medicine, (12), e1002481

Kessler, C. M. (2019). Immune thrombocytopenic purpura [LK1] (ITP). Retrieved from https://emedicine.medscape.com/article/202158-overview

Nagalia, S. (2019). Pernicious anemia[LK1] . Retrieved from https://emedicine.medscape.com/article/204930-overview#a3

Stauder, R., Valent, P., & Theurl, I. [LK1] (2019). Anemia at older age: Etiologies, clinical implications and management. Blood Journal, 131(5). Retrieved from http://www.bloodjournal.org/content/131/5/505?sso-checked=true

Credit Line: Anemia at older age: Etiologies, clinical implications and management by Stauder, R., Valent, P., & Theurl, I., in Blood Journal, Vol. 131/Issue 5. Copyright 2019 by American Society of Hematology. Reprinted by permission of American Society of Hematology via the Copyright Clearance Center.

Document: NURS 6501 Final Exam Review (PDF document)

Note: Use this document to help you as you review for your Final Exam in Week 11.

Required Media (click to expand/reduce)

Module 7 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 7 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check and your Assignment. (3m)

Khan Academy. (2019a). Chronic disease vs iron deficiency anemia[LK1] . Retrieved from https://www.khanacademy.org/science/health-and-medicine/hematologic-system-diseases-2/iron-deficiency-anemia-and-anemia-of-chronic-disease/v/chronic-disease-vs-iron-deficiency-anemia

Note: The approximate length of the media program is 5 minutes.

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 24, 26, 28, and 30 that relate to the reproductive and hematological systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders

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

Possible topics covered in this Knowledge Check include:
Sexually transmitted diseases
Prostate
Epididymitis
Factors that affect fertility
Reproductive health
Alterations and fertility
Anemia
ITP and TTP
DIC
Thrombocytopeni

Photo Credit: Getty Images

Complete the Knowledge Check By Day 7 of Week 10

To complete this Knowledge Check:

Module 7 Knowledge Check

Module 7 Assignment: Case Study Analysis

An understanding of the factors surrounding women’s and men’s health, infections, and hematologic disorders can be critically important to disease diagnosis and treatment in these areas. This importance is magnified by the fact that some diseases and disorders manifest differently based on the sex of the patient.

Effective disease analysis often requires an understanding that goes beyond the human systems involved. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact..

An understanding of the symptoms of alterations in systems based on these characteristics is a critical step in diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (not all may apply to each scenario):

The factors that affect fertility (STDs).
Why inflammatory markers rise in STD/PID.
Why prostatitis and infection happens. Also explain the causes of systemic reaction.
Why a patient would need a splenectomy after a diagnosis of ITP.
Anemia and the different kinds of anemia (i.e., micro and macrocytic).

Day 7 of Week 10

Submit your Case Study Analysis Assignment by Day 7 of Week 10

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.
Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “M7Assgn+last name+first initial.(extension)” as the name.
Click the Module 7 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Module 7 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M7Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Module 7 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Module 7 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 10

To participate in this Assignment:

Module 7 Assignment

What’s Coming Up in Module 8?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 8, you will examine pediatric pathophysiology. You will identify diseases, disorders and issues relevant to the treatment of children. You will also take the Final Exam for the course.

Week 11 Knowledge Check: Pediatrics

In the Week 11 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 11. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Week 11 Final Exam: Pediatrics

Photo Credit: Giii / iStock / Getty Images Plus / Getty Images

In the Week 11 Final Exam, you will demonstrate your understanding of the topics covered during Weeks 7–11 of the course. This Final Exam will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Final Exam, since the resources cover the topics addressed. Plan

Next Module

To go to the next module:

Module 8

Results Displayed All Answers, Submitted Answers, Correct Answers, Feedback, Incorrectly Answered Questions

Question 1

1 out of 1 points

Correct

What clinical symptoms are caused by multiple myeloma because the malignant cells reside in the bone marrow and not in the circulating blood?
Selected Answer:
Correct

Hypercalcemia and bone lesions
Answers:
Correct

Hypercalcemia and bone lesions

Hypocalcemia and bone lesions

Hyperkalemia and bone spurs

Hypokalemia and bone spurs
Question 2

1 out of 1 points

Correct

Defective DNA synthesis in bone marrow precursors usually creates erythrocytes that are _____________________.
Selected Answer:
Correct

macrocytic and normochromic
Answers:
Correct

macrocytic and normochromic

microcytic, and normochromic

macrocytic and hypochromic

microcytic and hypochromic
Question 3

0 out of 1 points

Incorrect

Reed-Sternberg cells are the classic abnormal cells in _______________________.
Selected Answer:
Incorrect

Hodgkin lymphoma
Answers:
Correct

Non-hodgkins lymphoma

Hodgkin lymphoma

Multiple myeloma

Leukemia
Question 4

1 out of 1 points

Correct

Central precocious puberty is driven by what hormone?
Selected Answer:
Correct

GnRH
Answers:

ACTH

FSH

LH

Correct

GnRH
Question 5

1 out of 1 points

Correct

The major symptom of invasive vaginal cancer is vaginal _________________.
Selected Answer:
Correct

bleeding
Answers:

dryness

Correct

bleeding

discharge

atrophy
Question 6

1 out of 1 points

Correct

What type of organism is Chlamydia caused by?
Selected Answer:
Correct

Gram-negative intracellular bacterium
Answers:

Gram-negative diplococci

Anaerobic spirochete

Correct

Gram-negative intracellular bacterium

Gram positive rod
Question 7

1 out of 1 points

Correct

What type of organism is gonorrhea caused by?
Selected Answer:
Correct

Gram-negative diplococci
Answers:
Correct

Gram-negative diplococci

Anaerobic spirochete

Gram-negative intracellular bacterium

Gram positive rod
Question 8

0 out of 1 points

Incorrect

The risk for developing gonorrhea from vaginal or anal intercourse with an infected partner is greater for the receptive partner.

Selected Answer:
Incorrect

False
Answers:
Correct

True

False
Question 9

0 out of 1 points

Incorrect

Lactoferrin released by neutrophils during bacterial infection binds iron, thus contributing to iron- deficiency anemia.
Selected Answer:
Incorrect

True
Answers:

True

Correct

False
Question 10

0 out of 1 points

Incorrect

In the bone marrow, hematopoietic stem cells in the osteoblastic niche are active.
Selected Answer:
Incorrect

True
Answers:

True

Correct

False
Question 11

0 out of 1 points

Incorrect

Benign prostatic hyperplasia (BPH) begins in the what area of the prostate?
Selected Answer:
Incorrect

periphery
Answers:

periphery

Correct

inner layers

central zone

transition zone
Question 12

1 out of 1 points

Correct

The release of what chemical causes chronic inflammation leading to anemia of chronic disease by decreasing the availability of iron and inhibiting erythroid progenitors?
Selected Answer:
Correct

cytokines
Answers:

macrophages

Correct

cytokines

antibodies

hapten
Question 13

1 out of 1 points

Correct

Platelets that are activated have what shape?
Selected Answer:
Correct

Jagged with spiky edges
Answers:

Smooth and round

Long and narrow

Correct

Jagged with spiky edges

Thick and rugged
Question 14

1 out of 1 points

Correct

How does bacteria reach the prostate to cause acute bacterial prostatitis?

Selected Answer:
Correct

through the urinary tract
Answers:

blood circulation

Correct

through the urinary tract

via the testes

through the epididymis
Question 15

1 out of 1 points

Correct

Which of the following cells are granulocytes?
Selected Answer:
Correct

Neutrophil, basophil, and eosinophil