a. What is the diagnosis for the patient and Is this a diagnosis with a ‘cure’? b. The tissue in itself is considered benign, but it is invasive. Suggest a reason as to how that could be contributing to the intense pain felt by the patient. c. Adhesions between the organs make the space ‘rigid’. How is that related to the discomfort during defecation and the pain during intercourse

Human Heredity: Principles and Issues (MindTap Course List)
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a.

What is the diagnosis for the patient and Is this a diagnosis with a ‘cure’?

b.

The tissue in itself is considered benign, but it is invasive. Suggest a reason as to how that could be contributing to the intense pain felt by the patient.

c.

Adhesions between the organs make the space ‘rigid’. How is that related to the discomfort during defecation and the pain during intercourse

The Reproductive Systems
© Cinemanikor/Shutterstock.com
Case 105:
A 21-year-old female goes to her PCP because of issues with her menses. The patient has been experiencing severe
pelvic and abdominal pain, which, at times, is so debilitating that she has not been able to move from a fetal posi-
tion on her bed. She is in University, and the issue has been disrupting her studies, and all other aspects of her life.
In taking the medical history, the following primary symptoms are of note:
- When menses occurs, it is extremely painful with intense cramping that is not abated by nonsteroidal anti-
inflammatory drugs such as ibuprofen.
- Cramping occurs for 2 of the 4 weeks of the menstrual cycle, 1 week either side of the first day of menses.
- She experiences pain during intercourse.
- There is pronounced discomfort with bowel movements, and so the patient has been using stool softeners to
make stool very ease to pass.
- She has near-constant lower back and pelvic pain in the form of a dull ache.
- Menses involves very heavy bleeding (the patient notes she uses at least 6 Tampax Ultra tampons a day, which
are designed to absorb 15–18 g of menstrual blood each).
- Some bleeding/spotting can occur in between menses.
A pelvic examination established that there is no abnormality of the cervix and vagina that could be contributing to
the condition, and blood test findings are negative for indicators of infection, although the complete blood count
confirms severe anemia with deficiencies in ferritin, folate, and vitamin B12-
Uterus
Enlarged ovary
Aberrant tissue
Adhesions to rectum
Aberrant tissue within
the fallopian tube leading
to extensive distension.
183
© Dr. Najeeb Layyous/Science Photo Library
Transcribed Image Text:The Reproductive Systems © Cinemanikor/Shutterstock.com Case 105: A 21-year-old female goes to her PCP because of issues with her menses. The patient has been experiencing severe pelvic and abdominal pain, which, at times, is so debilitating that she has not been able to move from a fetal posi- tion on her bed. She is in University, and the issue has been disrupting her studies, and all other aspects of her life. In taking the medical history, the following primary symptoms are of note: - When menses occurs, it is extremely painful with intense cramping that is not abated by nonsteroidal anti- inflammatory drugs such as ibuprofen. - Cramping occurs for 2 of the 4 weeks of the menstrual cycle, 1 week either side of the first day of menses. - She experiences pain during intercourse. - There is pronounced discomfort with bowel movements, and so the patient has been using stool softeners to make stool very ease to pass. - She has near-constant lower back and pelvic pain in the form of a dull ache. - Menses involves very heavy bleeding (the patient notes she uses at least 6 Tampax Ultra tampons a day, which are designed to absorb 15–18 g of menstrual blood each). - Some bleeding/spotting can occur in between menses. A pelvic examination established that there is no abnormality of the cervix and vagina that could be contributing to the condition, and blood test findings are negative for indicators of infection, although the complete blood count confirms severe anemia with deficiencies in ferritin, folate, and vitamin B12- Uterus Enlarged ovary Aberrant tissue Adhesions to rectum Aberrant tissue within the fallopian tube leading to extensive distension. 183 © Dr. Najeeb Layyous/Science Photo Library
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