Assignment: Advanced Pathophysiology
Assignment: Advanced Pathophysiology
The scenario concerns a 60-year-old man who has developed urinary incontinence and frequency from chemotherapy and radiotherapy used to treat prostate cancer. He also has a constant low back and hip pain that began a month ago. On DRE, he has an enlarged and nodular prostate. Mild degenerative changes are evident on the L5 spine, with an evident cystic mass adjacent to the spine. The purpose of this assignment is to discuss STDs, prostatitis, and anemia and how they could relate to the patient’s case.
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Factors That Affect Fertility
The common STDs associated with infertility are chlamydia, syphilis, and gonorrhea. Chlamydia and gonorrhea can cause epididymitis, an inflammation of the tube behind the testicles which stores and transports sperm. Severe and untreated cases of epididymitis can lead to infertility (Tsevat et al., 2018). Besides, syphilis can cause epididymitis and erectile dysfunction, which significantly affects a man’s fertility. Other STDs like Genital Herpes have been found to contribute to a low sperm count, which lowers the fertility level.
[elementor-template id="165244"]Inflammatory Markers Rise in STD/PID
Inflammatory markers like C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and cytokines are usually elevated in STD, suggesting the presence of inflammation. Mwatelah et al. (2019) explain that STDs are characterized by genital inflammation, which contributes to increased levels of inflammatory cytokines highly associated with increased protease activity. Thus, males with chlamydia, active syphilis, and gonorrhea are likely to have elevated inflammatory markers.
Prostatitis and Infection
Prostatitis occurs following bacterial infection of the prostate gland, leaving it inflamed. Bacterial prostatitis typically occurs alongside urethritis or a lower urinary tract infection. Microbes get to the prostate through the bloodstream or the urethra. The common pathogens are E.coli, Proteus, Enterobacter, and group D streptococci (Huang et al., 2022). In addition, the pathogens can enter the systemic circulation resulting in a systemic infection that causes fever, chills, and malaise. The patient in the case study may develop prostatitis if pathogens are inoculated during therapy and reach the prostate gland.
Splenectomy In ITP
Splenectomy is an effective treatment approach for steroid-refractory or dependent ITP. It entails removing the spleen, the primary organ for producing autoantibodies and clearing platelets. Consequently, it has a higher durable response rate than other ITP therapies. A patient diagnosed with ITP would be recommended to have a splenectomy if they have an active lifestyle and wish to be free from daily medication and frequent monitoring (Chaturvedi et al., 2018). Besides, those with fulminant ITP without an adequate response to medical treatment can have a splenectomy.
Anemia
Anemia is a hematologic condition characterized by decreased red blood cells (RBC) and hemoglobin (Hb). Anemia is categorized as per the mean corpuscular volume (MCV) size into macrocytic or microcytic. When the MCV is increased, the RBC is larger than normal (macrocytic), common in megaloblastic anemias. On the other hand, a decreased MCV results in the RBC being smaller than normal (microcytic), common in iron deficiency anemia.
Conclusion
STDs in males can cause epididymitis and low sperm count, which affect fertility. The genital inflammation in STDs results in increased inflammatory markers like cytokines. The patient can develop prostatitis if pathogens enter the patient’s prostate gland during therapy, and systemic infection can occur if the pathogens enter the systemic circulation.
References
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
Huang, L., LaBonte, M. J., Craig, S. G., Finn, S. P., & Allott, E. H. (2022). Inflammation and Prostate Cancer: A Multidisciplinary Approach to Identifying Opportunities for Treatment and Prevention. Cancers, 14(6), 1367. https://doi.org/10.3390/cancers14061367
Mwatelah, R., McKinnon, L. R., Baxter, C., Abdool Karim, Q., & Abdool Karim, S. S. (2019). Mechanisms of sexually transmitted infection-induced inflammation in women: implications for HIV risk. Journal of the International AIDS Society, p. 22 Suppl 6(Suppl Suppl 6), e25346. https://doi.org/10.1002/jia2.25346
Tsevat, D. G., Wiesenfeld, H. C., Parks, C., & Peipert, J. F. (2018). Sexually transmitted diseases and infertility. American Journal of Obstetrics and Gynecology, 216(1), 1–9. https://doi.org/10.1016/j.ajog.2016.08.008
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