Assignment: In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (Below is a list of questions that will need to be addressed within your paper. Not all will apply to scenario. You will need to address all of the questions even if they are not directly related to the scenario):

Assignment: In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (Below is a list of questions that will need to be addressed within your paper. Not all will apply to scenario. You will need to address all of the questions even if they are not directly related to the scenario):

Assignment: In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (Below is a list of questions that will need to be addressed within your paper. Not all will apply to scenario. You will need to address all of the questions even if they are not directly related to the scenario):

Keep in mind that if you use the work of another you must cite the reference. There is also a case study that will need to be reviewed and followed up with a one to two page paper.

In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (Below is a list of questions that will need to be addressed within your paper. Not all will apply to scenario. You will need to address all of the questions even if they are not directly related to the scenario):

The factors that affect fertility (STDs).

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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).

Case Scenario:

A 14-year-old female is brought to the urgent care by her mother, who states that the girl has had an abnormal number of bruises and “funny looking red splotches” on her legs. These bruises were first noticed about 2 weeks ago and are not related to trauma. PMH not remarkable and she takes no medications. The mother does state the girl is recovering from a “bad case of mono” and was on bedrest at home for the past 3 weeks. The girl noticed that her gums were slightly bleeding when she brushed her teeth that morning.

Labs at urgent care demonstrated normal hgb and hct with normal WBC differential. Platelet count of 100,000/mm3 was the only abnormal finding. The staff also noticed that the venipuncture site oozed for a few minutes after pressure was released. The doctor at urgent care referred the patient and her mother to the ED for a complete work-up of the low platelet count, including a peripheral blood smear for suspected immune thrombocytopenia purpura.

Must include a title and reference page.

Must include a minimum of 4 references.

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Case Study

The factors that affect fertility (STDs).

STDs like Chlamydia and gonorrhea silently cause female infertility. Chlamydial and gonorrheal infections in females spread to the upper genital tract including the uterus and fallopian tubes, causing pelvic inflammatory disease (PID). PID is linked with damage to the fallopian tubes and uterus, leading to chronic pain, infertility, and ectopic pregnancy (Liu et al., 2022). STDs also cause male infertility. Goulart et al. (2020) explain that STDs alter the male reproductive system physiology causing impairment in semen in parameters like motility, morphology, concentration, and number. This leads to an estimated 15% of male infertility incidences.

Why inflammatory markers rise in STD/PID.

Inflammatory markers, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) significantly rise in STDs and PID.  PID is characterized by inflammation of the upper genital organs. The rise in inflammatory markers indicates an inflammatory process occurring in the pelvic region. Mitchell et al. (2021) explain that STDs like chlamydia and gonorrhea cause an infection in the reproductive organs, causing inflammation and tissue damage, which lead to a rise in CRP and ESR. The inflammatory markers also rise due to the body’s immune response when the body’s immune system reacts to the STI infection by releasing inflammatory markers to fight the pathogens.

Why prostatitis and infection happen.

Acute Prostatitis occurs through ascending urethral infection. This happens when bacteria ascend from the external urethral meatus to the prostate. The bacteria can also flow back from contaminated urine to the ejaculatory and prostate duct following transurethral manipulations like catheterization and cystoscopy (Xiong et al., 2020). In addition, bacteria can be directly implanted during a prostate biopsy causing infection of the prostate.  A systemic reaction occurs when the bacteria causing prostatitis spreads to other body organs via the bloodstream or lymphatic system (Xiong et al., 2020). This results in systemic symptoms like fever, chills, vomiting, and generalized body weakness or malaise.

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

ITP is an acquired thrombocytopenia diagnosed based on a platelet count < 100 × 10^9/L. It is associated with the destruction of platelets by the immune system (Chaturvedi et al., 2018). A patient would need a splenectomy following a diagnosis of ITP if they fail to attain a stable and adequate platelet count after corticosteroid therapy. Splenectomy is used to eliminate the primary site of platelet clearance and production of autoantibodies and has the highest rate of durable response. The patient in the case study has a very low platelet count of 100,000/mm3, which may necessitate a splenectomy if corticosteroid therapy is ineffective.

Anemia and the different kinds of anemia (i.e., micro and macrocytic).

Anemia is characterized by an RBC count and a hemoglobin level below the normal range. Anemia is differentiated into macrocytic, microcytic, and normocytic anemia depending on the RBCs size (Busaleh et al., 2021). Macrocytic anemia is an MCV>100 fl and occurs in Vitamin B12 and Folate deficiency. Microcytic anemia is an MCV<80 fl and is seen in Iron deficiency, Thalassemias, and Anemia of chronic disease. Lastly, in normocytic anemia, the MCV is 80-100 fl and is seen in patients with renal failure and Aplastic anemia.

References

Busaleh, F., Alasmakh, O. A., Almohammedsaleh, F., Almutairi, M. F., Al Najjar, J. S., & Alabdulatif, A. (2021). Microcytic Anemia Hiding Vitamin B12 Deficiency Anemia. Cureus, 13(12), e20741. https://doi.org/10.7759/cureus.20741

Chaturvedi, S., Arnold, D. M., & McCrae, K. R. (2018). Splenectomy for immune thrombocytopenia: down but not out. Blood, 131(11), 1172–1182. https://doi.org/10.1182/blood-2017-09-742353

Goulart, A. C. X., Farnezi, H. C. M., França, J. P. B. M., Santos, A. D., Ramos, M. G., & Penna, M. L. F. (2020). HIV, HPV and Chlamydia trachomatis: impacts on male fertility. JBRA assisted reproduction, 24(4), 492–497. https://doi.org/10.5935/1518-0557.20200020

Liu, L., Li, C., Sun, X., Liu, J., Zheng, H., Yang, B., … & Wang, C. (2022). Chlamydia infection, PID, and infertility: further evidence from a case–control study in China. BMC Women’s Health, 22(1), 1-9. https://doi.org/10.1186/s12905-022-01874-z

Mitchell, C. M., Anyalechi, G. E., Cohen, C. R., Haggerty, C. L., Manhart, L. E., & Hillier, S. L. (2021). Etiology and diagnosis of pelvic inflammatory disease: looking beyond gonorrhea and chlamydia. The Journal of infectious diseases, 224(Supplement_2), S29-S35. https://doi.org/10.1093/infdis/jiab067

Xiong, S., Liu, X., Deng, W., Zhou, Z., Li, Y., Tu, Y., Chen, L., Wang, G., & Fu, B. (2020). Pharmacological Interventions for Bacterial Prostatitis. Frontiers in pharmacology, 11, 504. https://doi.org/10.3389/fphar.2020.00504