Reproductive Health Cases

Reproductive Health Cases

Patient Name: Aboubacar Heinrich

Date of Birth: 2/11/1952

Clinical Notes: The male patient reports difficulty urinating. His symptoms started two weeks ago and were sporadic at first. He is now urinating more frequently, especially at night, and feels a sense of incomplete bladder emptying. He reports that he has a weak, interrupted stream of urine.

Current vital signs: BP 122/78, HR 82 bpm, Temperature 98.2°F

The physician suspects prostate issues and suggests a digital rectal exam and prostate-specific antigen test.

Question #1: If the issue is related to a structural abnormality of the prostate, which other symptoms (not mentioned here) may he experience?

The symptoms not mentioned include a burning sensation during urination, blood in urine, pain in the lower back, and stiffness in the thighs and rectal or pelvic region (Lawrentschuk et al., 2021).

Question #2: What is a prostate-specific antigen test, and why was it ordered in this case?

PSA is a blood test for prostate cancer screening. This test determines the levels of prostate-specific antigen in the blood (Ilic et al., 2018). It is formed by cancerous and non-cancerous cells.

Question #3: Mr. Heinrich’s digital rectal exam revealed abnormal bumps. Which other diagnostic procedures may be recommended as a follow-up?

The procedure the patient would require is a biopsy. This biopsy will involve removing sample tissue to rule out prostate cancer (Streicher et al., 2018).

Question #4: It is determined that Mr. Heinrich has benign prostatic hyperplasia, and a procedure called TURP is recommended. Explain what TURP stands for and how the procedure is completed.

Transurethral resection of the prostate (TURP) manages urinary problems caused by an enlarged prostate. In this procedure, a resectoscope is inserted through the tip of the penis into the urethra (Teo et al., 2017). The resectoscope helps to trim away excess tissue, blocking urine flow.

 Question #5: If Mr. Heinrich does not follow through with treatment, what types of complications may occur and why?

The complications of BPH include urinary retention, urinary tract infections, bladder and kidney (Lawrentschuk et al., 2021).  This is because untreated BPH will cause pressure on the urethra, which can damage the kidney or cause UTIs.

Patient Name: Deborah Spitzner

Date of Birth: 12/2/1999

Clinical Notes: Female patient reports vaginal pain that increases with sexual intercourse and abnormal vaginal discharge. She has mild burning pain during urination. Her symptoms have been present and progressively worsening for three weeks.

Current vital signs: BP 126/78, HR 66 bpm, Temperature 100.6°F

The physician refers her to a gynecologist for a pelvic exam and orders a complete blood count, urinalysis, and STD screening panel. Lab tests confirm a diagnosis of chlamydia.

Question #1: What is the etiology of chlamydial infection?

Chlamydia is a sexually transmitted infection caused by a bacterium known as Chlamydia trachomatis (Mohseni et al., 2021). It can be transmitted in the oral, vaginal, or anal route. It can also be transmitted from mother to child during birth.

Question #2: How might the symptoms in this case study be different if the patient was male?

The symptoms of chlamydia in male patients include cloudy discharge from the penis, burning sensation when urinating, and painful testicles (Mohseni et al., 2021).

 Question #3: Is chlamydia curable? What type of treatment is usually recommended?

Yes, it is curable. The recommended treatment for chlamydia is Azithromycin 1g stat or doxycycline 100mg BD for seven days (O’Connell & Ferone, 2016)

 Question #4: What type of complications may occur due to chlamydia?

Complications of chlamydia include pelvic inflammatory disease, ectopic pregnancy, infertility in women, chronic pelvic pain, and premature delivery (Mohseni et al., 2021)

Question #5: What preventative measures should Ms. Spitzner take to avoid recurrent infections and to avoid transmitting chlamydia to her partners?

1. Using a condom during sex
2. Having one sexual partner.
3. Avoid sharing sex toys.

References

Alimi, Y., Iwanaga, J., Loukas, M., & Tubbs, R. S. (2018). The Clinical Anatomy of Endometriosis: A Review. Cureus, 10(9), e3361. https://doi.org/10.7759/cureus.3361

Bani Mohammad, M., & Majdi Seghinsara, A. (2017). Polycystic Ovary Syndrome (PCOS), Diagnostic Criteria, and AMH. Asian Pacific journal of cancer prevention: APJCP, 18(1), 17–21. https://doi.org/10.22034/APJCP.2017.18.1.17

Ilic, D., Djulbegovic, M., Jung, J. H., Hwang, E. C., Zhou, Q., Cleves, A., Agoritsas, T., & Dahm, P. (2018). Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ (Clinical research ed.), 362, k3519. https://doi.org/10.1136/bmj.k3519

Lawrentschuk, N., Ptasznik, G., & Ong, S. (2021, October 7). Benign prostate disorders – Endotext – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK279008/

Mohseni, M., Sung, S., & Takov, V. (2021, March 1). Chlamydia – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK537286/

Ni, C. M., Huang, W. L., Jiang, Y. M., Xu, J., Duan, R., Zhu, Y. L., … & Xu, L. (2020). Improving the accuracy and efficacy of diagnosing polycystic ovary syndrome by integrating metabolomics with clinical characteristics: study protocol for a randomized controlled trial. Trials, 21(1), 1-12.

O’Connell, C. M., & Ferone, M. E. (2016). Chlamydia trachomatis Genital Infections. Microbial cell (Graz, Austria), 3(9), 390–403. https://doi.org/10.15698/mic2016.09.525

Parasar, P., Ozcan, P., & Terry, K. L. (2017). Endometriosis: Epidemiology, Diagnosis and Clinical Management. Current obstetrics and gynecology reports, 6(1), 34–41. https://doi.org/10.1007/s13669-017-0187-1

Streicher, J., Meyerson, B. L., Karivedu, V., & Sidana, A. (2019). A review of optimal prostate biopsy: indications and techniques. Therapeutic advances in urology, 11, 1756287219870074. https://doi.org/10.1177/1756287219870074

Teo, J. S., Lee, Y. M., & Ho, H. (2017). An update on transurethral surgery for benign prostatic obstruction. Asian journal of urology, 4(3), 195–198. https://doi.org/10.1016/j.ajur.2017.06.006

These case studies are real-life scenarios that will help you explore the concepts of reproductive systems, genetic and cancerous changes, diagnostic tests, and treatments.

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Patient Name: Fiona Miller

 Date of Birth: 4/13/1994

Clinical Notes: The patient reports to the clinic with increasing dysmenorrhea. She describes the pain as cyclical, increasing in intensity during menstruation. The pain started as mild cramps several years ago but has progressively become more severe and is now debilitating. The patient denies any abnormal vaginal discharge.

Current vital signs: BP 110/82, HR 68 bpm, Temperature 98.4°F

Her gynecologist completes a pelvic exam and notes no structural abnormalities of the vagina or cervix. The gynecologist suspects endometriosis or polycystic ovarian syndrome and recommends imaging studies for diagnosis and treatment.

Question #1: Why would the physician order imaging tests instead of lab tests?

Question #2: If Ms. Miller has polycystic ovarian syndrome, what other symptoms might you expect her to exhibit?

Question #3: Ms. Miller’s MRI report shows lesions surrounding the ureters, round ligaments, and bladder. Which of the physician’s diagnoses is correct and why?

Question #4: Why might hormonal birth control be a good treatment option for Ms. Miller?

Question #5: Should Ms. Miller be concerned about her chances of becoming pregnant in the future? Why or why not?

 Patient Name: Aboubacar Heinrich

Date of Birth: 2/11/1952

Clinical Notes: The male patient reports difficulty urinating. His symptoms started two weeks ago and were sporadic at first. He is now urinating more frequently, especially at night, and feels a sense of incomplete bladder emptying. He reports that he has a weak, interrupted stream of urine.

Current vital signs: BP 122/78, HR 82 bpm, Temperature 98.2°F

The physician suspects prostate issues and suggests a digital rectal exam and prostate-specific antigen test.

Question #1: If the issue is related to a structural abnormality of the prostate, which other symptoms (not mentioned here) may he experience?

Question #2: What is a prostate-specific antigen test, and why was it ordered in this case?

Question #3: Mr. Heinrich’s digital rectal exam revealed abnormal bumps. Which other diagnostic procedures may be recommended as a follow-up?

Question #4: It is determined that Mr. Heinrich has benign prostatic hyperplasia, and a procedure called TURP is recommended. Explain what TURP stands for and how the procedure is completed.

Question #5: If Mr. Heinrich does not follow through with treatment, what types of complications may occur and why?

Patient Name: Deborah Spitzner

Date of Birth: 12/2/1999

Clinical Notes: Female patient reports vaginal pain that increases with sexual intercourse and abnormal vaginal discharge. She has mild, burning pain during urination. Her symptoms have been present and progressively worsening for three weeks.

Current vital signs: BP 126/78, HR 66 bpm, Temperature 100.6°F

The physician refers her to a gynecologist for a pelvic exam and orders a complete blood count, urinalysis, and STD screening panel. Lab tests confirm a diagnosis of chlamydia.
Question #1: What is the etiology of a chlamydial infection?

Question #2: How might the symptoms in this case study be different if the patient was male?

Question #3: Is chlamydia curable? What type of treatment is usually recommended?

Question #4: What type of complications may occur as a result of chlamydia?

Question #5: What preventative measures should Ms. Spitzner take to avoid recurrent infections and to avoid transmitting chlamydia to her partners?