Lower Abdominal Pain Essay

Excerpt from Essay :

Lower Abdominal Pain

Patient: Patient is a 30-year-old female presenting with lower abdominal pain, beginning approximately 48-hour previous to her exam. Over the last few days, her pain has increased, and she reports vaginal bleeding that is scanty. She did have a normal menstrual period that ending two-weeks prior, and she indicates this was normal and lasted about 4 days. She is Gravida 2, Para -0, Miscarriage -- 2, and has been attempting to conceive with her husband. In addition, she denies dysuria or urinary frequency.

Vaginal bleeding after sex; inflammation of cervix from friction during sex, usually harmless and clear up quickly. It is possible that the issue could be something more serious (cervical dysplasia or cancer), but more likely inadequate lubrication or foreplay, possibly injury to the uterine lining. Vaginitis is another possible cause, all of which require a vaginal examination (Mayo Clinic, 2014).

Pseydocyesis (False pregnancy). This is based on psychological issues of trying to conceive, previous period, and vaginal bleeding. This could be something as simple as vaginal irritation from excessive intercourse, it could also be a false pregnancy or other irritation of the vaginal linings (Daines).

2) We do not know the patient's weight or BMI. In addition, exercise level and nutirional assessment have not been performed. Therefore, Amenorrhea secondary to athletics, anorexia or bulimia are possible conclusions. Considering this particular patient's age and gender (a female adolescent), extreme weight loss and/or cachectic state is one of the causes of amenorrhea (Dains, et al., 2012)

3. Polycystic Ovary Syndrome -- one of the most common causes of amenorrhea -- approximately 20% of cases of secondary or primary amenorrhea attributed to PCOS. This is a condition in which there are various imbalances of the female sex hormones, leading to menstrual changes, potential cysts, or other irritations (Adams, 2002.

4. Amenorrhea secondary to hypothyroidism. Once pregnancy is ruled out, the next indicated step would be to check TSH and prolactin levels for hypothyroidism and hyperprolactinemia as the indications for these as the etiology are high (Adams, 2002)

5. Amenorrhea secondary to hyperprolactinemia. An imbalance of high levels of prolactin in the blood that can not only change issues within lactation, but also hormonal imbalances in the reproductive system that may result in bleeding or discomfort (Master-Hunter, 2006).

Assessment Issues/Diagnostic testing:

1) Serum HCG: First, any sort of pregnancy must be ruled out using laboratory testing (primary, secondary…

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