Case 2: A 16-year-old female comes to the physician's office because of menstrual cramps. She had menarche at age 13. Her menses lasts for 4-5 days, and she has 28-day cycles. For the first 2-3 days of her menses she states that she has very bad cramping. The cramps have occurred since menarche and seem to have worsened in the past year. They have been so bad at times that she has missed school and has not been able to participate in her after-school sports. She has been taking acetaminophen and over-the-counter "menstrual cramp" pills without adequate relief. She has no significant medical history, takes no medications regularly, and is not sexually active. Her examination is normal. You assess the problem as primary dysmenorrhea and prescribe diclofenac to be used on an as-needed basis. Questions 1. What are the therapeutic effects of nonsteroidal anti-inflammatory drugs (NSAIDs)? 2. What is the mechanism of the anti-inflammatory action of NSAIDs? 3. Explain the clinical correlation between the disease and the chosen drug.
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- NSAIDs, such as diclofenac, have several therapeutic effects, including: - Analgesic (pain-relieving) effects. - Anti-inflammatory effects. - Antipyretic (fever-reducing) effects. Show moreā¦
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1. Which of Cathy's signs and symptoms are common to both pelvic inflammatory disease and appendicitis? Why is it important to rule out appendicitis? 2. What signs and symptoms support the diagnosis of PID? 3. Suppose Cathy says that in spite of her "wildness" in college, she just wants to "get it all out of my system, and then settle down and have kids after I graduate." As her physician, what would you tell her about the relevance of her present behavior to her family plans? 4. Why are a Pap smear and an HIV test conducted? 5. Why do Cathy's signs and symptoms rule out cervical, endometrial, and ovarian cancer? 6. Erica, a 17-year-old female, is a member of her high school swim team. She visits her physician because she has missed her last two menstrual periods. Laboratory tests are negative for HCG. Based on this limited information, speculate about the cause of Erica's amenorrhea. What treatment, if any, would you recommend? 7. Twenty-eight-year-old Brenda visits her gynecologist complaining of irregular menstruation, back pain, and pain during intercourse. Which of the following signs would suggest that Brenda is suffering from polycystic ovary disease? a. elevated serum LH concentrations b. elevated serum HCG concentration c. mucopurulent discharge d. rebound tenderness e. dyschezia 8. Andrea, a 32-year-old female, visits her nurse practitioner complaining of constipation, pelvic pain, and dysmenorrhea. Within the last 6 months, Andrea's sister has been diagnosed with endometriosis. Laparoscopy reveals two regions of ectopic endometrial tissue on Andrea's ovaries. Since Andrea does not intend to have any children, she decides to take a GnRH agonist in an attempt to treat the disorder without resorting to surgery. Explain how this medication would help alleviate the signs and symptoms of this disorder. 9. Why is maintaining an acidic pH in the hymen important in treating vaginitis? 10. A 15-year-old girl misses 3 days of school due to severe menstrual cramps before her mother takes her to a gynecologist. If you were the gynecologist, what issues would you discuss with the girl while taking her history? Suppose the gynecologist tells the girl simply to use a heating pad and analgesics, wait it out for another day or two, and return to school when she feels better. What do you think the diagnosis is?
Supreeta N.
3. Suppose Cathy says that in spite of her "wildness" in college, she just wants to "get it all out of my system, and then settle down and have kids after I graduate." As her physician, what would you tell her about the relevance of her present behavior to her family plans? 5. Why do Cathy's signs and symptoms rule out cervical, endometrial, and ovarian cancer? 6. Erica, a 17-year-old female, is a member of her high school swim team. She visits her physician because she has missed her last two menstrual periods. Laboratory tests are negative for HCG. Based on this limited information, speculate about the cause of Erica's amenorrhea. What treatment, if any, would you recommend? 7. Twenty-eight-year-old Brenda visits her gynecologist complaining of irregular menstruation, back pain, and pain during intercourse. Which of the following signs would suggest that Brenda is suffering from polycystic ovary disease? a. elevated serum LH concentrations b. elevated serum HCG concentration c. mucopurulent discharge d. rebound tenderness e. dyschezia 8. Andrea, a 32-year-old female, visits her nurse practitioner complaining of constipation, pelvic pain, and dysmenorrhea. Within the last 6 months, Andrea's sister has been diagnosed with endometriosis. Laparoscopy reveals two regions of ectopic endometrial tissue on Andrea's ovaries. Since Andrea does not intend to have any children, she decides to take a GnRH agonist in an attempt to treat the disorder without resorting to surgery. Explain how this medication would help alleviate the signs and symptoms of this disorder.
Sri K.
Alicia, a 29-year-old female, complained of cramping in the abdomen with severe, dull, aching pain. She has been generally healthy and has no other health concerns or physical findings by her health clinician. A laparoscopic exam was ordered and revealed the presence of ectopic endometrial tissue on the outside of the uterine wall, ovaries, and even some on the lower loops of the intestinal tract. Alicia was prescribed a lengthy course of oral Danazol or Danocrine (a synthetic androgen that inhibits gonadotropins) 800 mg/day to suppress the growth of abnormal endometrial tissue and provide symptomatic relief. Danazol is described in the literature as a "GnRH (Gonadotropin Releasing Hormone) agonist". What is an "agonist" and what is its purpose for Alicia's treatment?
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