Module 7 Assignment: Case Study Analysis

Instructions:  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).

Week Ten Case Study Assignment

42-year-old man presents to ED with 2-day history of dysuria, low back pain, inability to fully empty his bladder, severe perineal pain along with fevers and chills. He says the pain is worse when he stands up and is somewhat relieved when he lies down. Vital signs T 104.0 F, pulse 138, respirations 24. PaO2 96% on room air. Digital rectal exam (DRE) reveals the prostate to be enlarged, extremely tender, swollen, and warm to touch.

NB:  For this week's case study, you are only required to answer the questions pertinent to the case study. You do not have to address the other questions. In addition, please review the rubric and only address the criterion specific to the case study for which you are responsible.

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Factors that Affect Fertility

Sexually transmitted diseases affect fertility. In women, sexually transmitted infections like gonorrhea and chlamydia cause infertility and PID (pelvic inflammatory disease). If these conditions remain untreated, they cause infections in the fallopian tube. The infection and PID damage the uterus, the fallopian tubes, and the surrounding tissues, resulting in infertility (CDC, 2013). STDs also cause infertility in men.  Diseases like Chlamydia Tranchomanis, Trichomonas vaginalis, and Ureaplasma urealyticum undermines sperm production. However, the relationship between STDs and impaired sperm production requires further investigation.

Overview of Inflammatory Markers Rise in STD/PID

Although cell damage and inflammation resulting from sexually transmitted infections are believed to contribute to prostrate disease, limited clinical studies have investigated the degree to which sexually transmitted agents induce and infect an individual inflammatory immune reaction to the disease (prostate).  According to Milbrandt et al.(2017), sexually transmitted infections may contribute to cell damage and prostatic inflammation in men infected with STIs.  Researchers use serum PSA (prostate-specific antigen) as a marker of prostate infection.  Men with exudative sexually transmitted infections like gonorrhea, chlamydia, non-gonococcal urethritis, and Trichomona vaginalis are likely to have elevated PSA (Milbrandt et al., 2017).  Large PSA elevation suggests that some sexually transmitted infections have infected the prostate, contributing to tissue injury and a local inflammatory immune reaction. For women, a rise of inflammatory markers like tubo-ovarian abscess, C - reactive protein, erythrocyte sedimentation rate, and tubal infertility are indicators of genital chlamydia infection in acute pelvic inflammatory disease PID (Park et al., 2017).

 Why Prostatitis and Infection Happens and Explaining Causes Of Systemic Reaction

Prostatitis is an inflammation and swelling of the prostate gland.  Bacterial infections cause chronic and acute bacterial prostatitis. Also, trauma or surgery in the lower urinary tract can cause nerve damage, thus contributing to prostatitis.  The 42- year- old man in the case study has prostatitis because of the presenting symptoms. They include low back pain, a history of dysuria, inability to fully empty his bladder, severe perineal pain, along with chill and fevers.

 Infection happens because bacteria, viruses, or other microbes have entered one’s body and are multiplying. Systematic reaction is caused by the spreading of inflammation from a localized area to other body organs. The inflammation can be attributable to infections, allergies, or toxins.

Why a patient would need a splenectomy after a diagnosis of ITP

 The immune system in patients with ITP considers platelets as foreign bodies and damages them (Chaturvedi, Arnold, & McCrae, 2018).  The spleen removes the destroyed platelets, and removing the spleen (splenectomy) is necessary to enhance the circulation of platelets in the body.

References

CDC.(2013). STDs and infertility. https://www.cdc.gov/std/infertility/default.htm

Chaturvedi, S., Arnold, D. M., & McCrae, K. R. (2018). Splenectomy for immune thrombocytopenia: down but not out. Blood, 131(11), 1172-1182.

Milbrandt, M., Winter, A. C., Nevin, R. L., Pakpahan, R., Bradwin, G., De Marzo, A. M., ... & Sutcliffe, S. (2017). Insight into infection‐mediated prostate damage: Contrasting patterns of C‐reactive protein and prostate‐specific antigen levels during infection. The Prostate, 77(13), 1325-1334.

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), 1-7.