Health Medical Homework Help

All replies must be constructive and use literature where possible.

Yerenis Llanes.

• Polycystic Ovary Syndrome

When females feature high levels of androgens, the underlying medical condition is known as hyperandrogenism. Chronic anovulation is one of the most common conditions that come along with hyperandrogenism. The disorder mainly associated with this condition is polycystic ovary syndrome (PCOS).

• Pathophysiology and Symptomology/Clinical Manifestations 

           Pathophysiology of this condition entails a vicious cycle that entails such issues as ovarian, metabolic, and neuro endocrine dysfunction. Other features clinical and biochemical hyperandrogenism (McCartney & Marshall, 2016). The main clinical manifestations include virilization, acne, hirsutism, and androgenic alopecia. The presence of virilization should be taken seriously because most of the times it implies that there is a likelihood of the patient having an androgen-producing tumor. Hirsutism entails the growth of hair among women in a pattern that would typically be associated with men. More than 80% of all women with hyperandrogenism present with this symptom.

Differential Diagnoses 

           Three key diagnoses for this condition include iatrogenic Cushing Syndrome (E24.2), polycystic ovarian syndrome (E28), and ovarian tumor (C56. 9). Iatrogenic Cushing’s syndrome (ICS) is typically associated with steroid use, particularly high-dose or prolonged usage. Sometimes topical steroid therapy may bring about systemic side implications, but this is rare though not impossible (Pektas, Dogan, & Cinar, 2017). PCOS is mainly characterized by excess male hormone or infrequent menstrual periods. In some situations, the ovaries may fail to release eggs on a regular basis. They may develop follicles. Lastly, ovarian tumor occurs when the tissue found on the surface of the ovaries develops abnormal cells. The low malignant potential tumors rarely develop into cancer. They respond well to medication interventions.

Patient Education

           For this condition, patient education is critical since it enables the patient understand some behavioral patterns that they should embrace, as well as the best practices needed. Most importantly, it should be noted that education and counseling about PCOS should take into consideration the fact that the condition is culturally sensitive (Witchel, Oberfield, & Peña, 2019). Therefore, patient education should be tailored to fit into the specific values and belief systems of each individual. Self-care should be promoted. The patient should be encouraged to join peer support groups so as to share and get access to indispensable experiences from other people going through the same condition. The counselor should also spend considerable time discussing with the patient issues to do with fertility. All along, the approach should be empathetic.

Management

           Management should entail lifestyle interventions, counseling, and the administration of relevant drugs that can help alleviate the severity of each of the different symptoms associated with the condition. The focus on any intervention should on the complaints of the patient. Some of the most common interventions here would include local treatments for acne and hirsutism, spironolactone, combined oral contraceptive pills, and metformin. Other management aspects would entail regular follow-up, management of any identified comorbidities, and transition plans. Clomiphene can also be used in situations where the patient is struggling to get pregnant. However, it should be used cautiously as it increases the likelihood of the conception of twins. In situations where the patient is experiencing excessive hair growth, hair removal drugs can be prescribed.

References

Pektas, S. D., Dogan, G., & Cinar, N. (2017). Iatrogenic cushing’s syndrome with subsequent adrenal insufficiency in a patient with psoriasis vulgaris using topical steroids. Case reports in endocrinology, 2017.

McCartney, C. R., & Marshall, J. C. (2016). Polycystic ovary syndrome. New England Journal of Medicine, 375(1), 54-64.

Witchel, S. F., Oberfield, S. E., & Peña, A. S. (2019). Polycystic ovary syndrome: pathophysiology, presentation, and treatment with emphasis on adolescent girls. Journal of the Endocrine Society, 3(8), 1545-1573.