Initial tests may be culdocentesis, hematocrit, a pregnancy test, a qualitative HCG blood test, a transvaginal ultrasound or pregnancy ultrasound and a white blood count test. An ectopic pregnancy can be distinguished from a normal intrauterine pregnancy through a rise in quantitative HCG levels. Declining -hCG levels is indicative of an ectopic pregnancy (Kulp & arnhart 2008). AD & C, laparoscopy and laparotomy tests will confirm the diagnosis (Chen).
An early diagnosis of ectopic pregnancy with transvaginal ultrasound scan or TVS provides the clinician with conservative options (Madani 2008). Methotrexate may be prescribed if the ectopic pregnancy is small. TVS also reduces chances of mortality. Laparoscopy can be reserved for use as treatment rather than for diagnosis (Madani).

Differential diagnosis includes appendicitis, salpingitis, ruptured corpus luteum cyst, or ovarian follicle, spontaneous or threatened abortion, ovarian torsion, and urinary tract disease (Sepilian & Wood 2009).

Treatment

An ectopic pregnancy can neither be treated nor…...

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BIBLIOGRAPHY

Aronsen, Lena. Smoking is Associated with Increased Risk of Ectopic Pregnancy.

Medical Masteral dissertation. University of Tromso, 1999

Bernstein, S.L. et al. Statement of Emergency Medicine Operations. 32: 370-381 Journal

of Nurse Practitioners: Elsevier, Inc., 2006.

Case Study: JuanitaPatient Information: Juanita Morales is a 47-year-old G5P5LC6 Hispanic female. She presents with symptoms of lower abdominal cramping, urinary leakage, and cessation of menses for 8-12 months. She is well developed and well nourished but obese (BMI 45.89). She has a negative social history for alcohol, tobacco, and recreational drugs. Her last medical exam was several years ago.SubjectiveCC (chief complaint): Lower abdominal cramping and urinary leakage, along with fatigue, for the past day.HPI: Juanita reports the abdominal cramping started several hours ago, is sharp, intermittent, and is increasing in frequency and intensity. She tried Motrin but it provided no relief. Her menses ceased 8-12 months ago. She also reports constipation, increased gas over the past several months, and a possible vaginal spotting several days ago.Current Medications: None reported.Allergies: No known drug allergies.PMH: No past medical or surgical history reported.Soc Hx: Negative for alcohol, tobacco, and recreational drugs.Fam Hx:…...

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ReferencesAhmad, A., Kumar, M., Bhoi, N. R., Badruddeen, Akhtar, J., Khan, M. I., ... & Ahmad, M. (2023). Diagnosis and management of uterine fibroids: current trends and future strategies. Journal of Basic and Clinical Physiology and Pharmacology, 34(3), 291-310.Dubbewar, A., Srivastava, A., Hiremath, R. N., Ghodke, S., Chourey, N., & Sreenivas, A. (2022). A rare case of spontaneous heterotopic pregnancy with intrauterine gestational trophoblastic neoplasia and tubal ectopic pregnancy at a remote secondary care hospital. Journal of Family Medicine and Primary Care, 11(7), 3996-3998.Martin, M. L., Halling, K., Eek, D., & Reaney, M. (2020). “Lower abdominal pains, as if I was being squeezed… in a clamp”: A Qualitative Analysis of Symptoms, Patient-Perceived Side Effects and Impacts of Ovarian Cancer. The Patient-Patient-Centered Outcomes Research, 13, 189-200.Vitale, A. M., & Lockwood, G. M. (2020). Urine Microscopy: The Burning Truth–White Blood Cells in the Urine. Urine Tests: A Case-Based Guide to Clinical Evaluation and Application, 143-166.

ectopic/heterotopic brain tissue. Extracranial brain tissue without direct connection to the brain itself may be an isolated cutaneous embryonic defect that is usually located on the occipital or parietal area of the scalp. Most of the time these are harmless and can be removed. These often are called heterotopic brain tissue or cutaneous ectopic brain tissue or (CEB).
ECTOPIC OR HETEROTOPIC BRAIN TISSUE

Extracranial brain tissue that is directly connected to the brain itself may be an isolated cutaneious embryonic defect. These are usually located on the occipital or parietal areas of the scalp. They are often called heteropic brain tissue or cutaneous ectopic brain (CEB) (Janniger 1). Most of the time these are simple defective tissue that can easily be removed from the scalp. However, there are several different types of ectopic brain tissues and some of these can be signs of underlying central nervous system problems. Each of these…...

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Works Cited

Aplasia Cutis Congenita" Available Online at  http://www.keratin.com/af/af006.shtml 

Drolet, Beth Ann & Clowry, Lawrence. "The Hair Collar Sign: Marker for Cranial Dysraphism" Pediatrics Aug 1995 Part 1 of 2 Vol. 96 Issue 2 p. 309

Drolet BA, Clowry L. Jr., McTigue MK, Esterly NB. "The Hair Collar sign: Marker for Cranial Dysraphism" Pediatrics 1995 Aug 1996 (2 pt 1): 309-13

Fuloria, Mamta M.D. & Kreiter, Shelly M.D. "The Newborn Examination: Part I" American Family Physician Jan 1, 2002 Vol. 65 No. 1 www.aafp.org/afp

Ectopic Pegnancy and the Jehovah's Witness
It is impotant to be awae of cultual and eligious beliefs within a community, especially as a health cae povide, because when dealing with patients fom within that community thee can be tensions that aise if the teatment violates a pinciple of the cultual/eligious community. This would be the case wee a membe of Jehovah's Witness community to come into the hospital with the symptom descibed in the case study in which the woman has ectopic pegnancy. Because it is a tenant of the Jehovah's Witness community to eject blood tansfusion, it is impotant that a hospital have a back-up plan fo such cases so as to be able to pactice "bloodless medicine" in ode to save the lives of patients like the 25-yea-old woman in the case scenaio (Ratcliffe, 2004). This pape will discuss the impact of teating Jehovah's Witnesses when the teatment equies…...

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references and the Right to Forgo Life-Saving Treatments. Social Theory and Practice, 41(4): 716-733.

Pelvic inflammatoy disease, a citical poblem
Occuence o ecuence of pelvic inflammatoy disease o PID has been linked to STIs such as C. tachomatis o Neisseia gonohoeae. Patient education and simplified guidelines ae needed to develop accuate diagnosis. In ode fo changes to take place, moe eseach must be done to undestand the complex natue of the disease and the most effective and cost effective method of teatment.

This pape delves into the isk factos, diagnosis pocesses, teatment, elevant psychological issues, public health implications, patient and family education, and appopiate efeal to specialty by eviewing liteatue petinent to PID. The esults of the liteatue eview show vey little in the past was done in egads to eseaching symptoms of PID and teatment efficacy. New eseach shows lowe abdominal pain as a main indicato of PID as well as C. tachomatis o Neisseia gonohoeae. The data also elaboates on the isks of…...

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references for fertility in women with pelvic inflammatory disease. Fertility and Sterility, 81(5), 1344-1350.

Sweet, R.L. (2011). Treatment of Acute Pelvic Inftammatory Disease. Infectious Diseases in Obstetrics and Gynecology, 2011(561909), 1-13.

Tepper, N.K., Steenland, M.W., Gaffield, M.E., Marchbanks, P.A., & Curtis, K.M. (2013). Retention of intrauterine devices in women who acquire pelvic inflammatory disease: a systematic review. Contraception, 5(87), 655-60. Retrieved from  http://www.ncbi.nlm.nih.gov/pubmed/23040135

Abnormal Uterine Bleeding and Issues
Reproductive Tract Diseases for human females are typically focused in the upper reproductive tract or the lower reproductive tract. The upper tract includes the fallopian tubes, ovary and uterus, while the lower reproductive tract focuses on the vagina, cervix and vulva. There are three major types of infections: endogenous, iatrogenic and sexually transmitted diseases. Endogenous diseases arise from internal cellular structures and may be bacterial, viral or genetic, usually the most common and arise from an overgrowth of organisms that are already present in the vagina; iatrogenic diseases are the result of medical or surgical treatment, and sexually transmitted diseases occur between humans as a result of sexual behavior. In addition to infections, there are congenital abnormalities, cancers and functional problems. Each infection has its own specific cause and symptoms; caused by bacteria, virus, fungi or other organisms. Indeed, some are easily treatable and cured, others…...

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Works Cited

Azim, P., et al. (2011). Evaluation of Abnormal Uterine Bleeding. Isra Medical Journal, 3(3). Retrieved November 2013, from http://121.52.154.227/Isra%20Medical%20Journal%20Volume-III%20Issue-III.pdf#page=6

Davidson, B., et al. (2012). Abnormal Uterine Bleeding During the Reproductive Years. Journal of Midwifery and Women's Health, 57(3), 248-54.

Fraser, I., et al. (2011). The FIGO Recommendations on Terminologies and Definitions for Normal and Abnormal Uterine Bleeding. Seminars in Reproductive Medicine, 29(5), 383-90.

Gray, S. (2013). Menstural Disorders. Pediatrics in Review, 34(1), 6-18.

It produced a net increase in perceived benefits of protective behavior and in self-efficacy among both males and females, and a reduction in perceived barriers to protective behavior among females. Consistent with these changes, it was also associated with a reduction in risky sexual behavior among young men and an increase in contraceptive use among young men and women (Agha, 2002, p. 67+).
Agha also noted that there was more positive change among young women than among young men, a fact that "may reflect a better ability of these adolescent sexual health interventions to address the concerns of women than of men, or a greater receptivity to such interventions among young women than among young men" (2002, p. 67+). Because of the success of this program, however, Agha suggests that means of reaching young men to the same extent are worthy of additional study, and multi-media, educational programs of long…...

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Works Cited

Agha, Sohail. "A Quasi-Experimental Study to Assess the Impact of Four Adolescent Sexual Health Interventions in Sub-Saharan Africa." International Family Planning Perspectives, vol. 28, no. 2 (2002), vol. 28, no. 2, p. 67+. Retrieved October 12, 2005 from www.questia.com.

Dijamba, Yanyi K. "Social Capital and Premarital Sexual Activity in Africa: The Case of Kinshasa, Democratic Republic of Congo." Journal Title: Archives of Sexual Behavior. 32, no. 4, (2003), 327+. Retrieved October 12, 2005 from www.questia.com.

Kiragu, Karungari and Laura Schwab Zabin. "The Health Consequences of Adolescent Sexual and Fertility Behavior in Sub-Saharan Africa." Studies in Family Planning, vol. 29, no. 2 (1998), 210+. Retrieved October 12, 2005 from www.questia.com.

Koblinsky, Marjorie A., Oona M.R. Campbell, S.D. Harlow. "Mother and more: A broader perspective on women's health." In The Health of Women: A Global Perspective. Ed. Marlene A. Koblinsky, Judith Timyan, and Jill Gay. Boulder, CO. Westview Press. (1993) Pp.33-62.

ahrq.gov/clinic/uspstfix.htm, through the National Guideline Clearinghouse at http://www.guideline.gov.
Evidence-based findings concerning chlamydia screening and treatment of PID contained in the peer-reviewed and scholarly literature.

The additional resources cited at Appendix a will also be consulted.

3. Identify a specific group of people that are being affected by the disease/condition. The screening guidelines published by the USPSTF recommend that the following specific groups of women should be routinely screened, whether or not they are pregnant, if they:

Are sexually active and aged 25 or younger;

Have more than one sexual partner, regardless of age;

Have had an STD in the past, regardless of age; and Do not use condoms consistently and correctly, regardless of age (Screening for Chlamydial infection) a. Explain any unhealthy behaviors that may be contributing to the disease/condition. Some of the unhealthy behaviors that may contribute to the incidence of PID include (1) having multiple sex partners and (2) not using condoms consistently and…...

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Works Cited

Hubacher, D., R. Lara-Ricalde, D.J. Taylor, F. Guerra-Infante and R. Guzman-Rodriguez. (2001). "Use of copper intrauterine devices and the risk of tubal infertility among nulligravid women. New England Journal of Medicine 345: 561-67 in Mckay at 259.

Klein, Rupert and Barbel Knauper. (2003). "The Role of Cognitive Avoidance of STIs for Discussing Safer Sex Practices and for Condom Use Consistency." The Canadian Journal of Human Sexuality 12(3-4): 137-138.

Macdonald, Noni E. And Robert Brunham. (1997). "The Effects of Undetected and Untreated Sexually Transmitted Diseases: Pelvic Inflammatory Disease and Ectopic Pregnancy in Canada." The Canadian Journal of Human Sexuality 6(2): 161.

Mcglynn, Elizabeth a., Eve a. Kerr, Cheryl L. Damberg and Steven M. Asch. Quality of Care for Women: A Review of Selected Clinical Conditions and Quality Indicators. Santa Monica, CA: Rand, 2000.

A newer and easy test is the OSOM Vlue, which mixes a swabbed specimen from the vagina with a reagent. The test yields sialidase activity or presence in the vaginal fluid in 10 minutes. Sialidase is produced by V pathogens (Mashburn).
pH Level

The most reliable criterion for detecting V is a pH>4.5 (Mashburn, 2007). A normal pH should, therefore, rule out V. A pH >4.5 can also indicate trichomoniasis or muco-purulent cervicitis. Vaginal inflammation more strongly suggests trichomonas or muco-purulent cervicitis, in turn associated with gonorrhea or chlamydial trachomatis (Mashburn).

The patient's pH level is 6, indicating V.

Wet Smears

These are an inexpensive and relatively easy screening procedure for the most common sexually transmitted diseases, such as V (Iglesias, Alderman & Fox, 2000). The practitioner should be appropriately trained and experienced in using this procedure. Hence, the proper protocol and quality control are needed to insure accurate diagnosis. The wet smear is…...

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BIBLIOGRAPHY

Alfonsi, G.A.; Cshlay, J., and Parker, S. (2004). What is the best approach for managing

Recurrent bacterial vaginosis? Journal of Family Practice: Dowden Health Media,

Inc. Retrieved on July 7, 2009 from  http://findarticles.com/p/articles/mi_m0689/is_8_53/ai_n6169486/?tag=content;col1 

Brown, M (2007). Treating a case of bacterial vaginosis -- case study. Health and Republic News: Health Republic. Retrieved on July 12, 2009 from  http://www.healthcarerepublic.com/res/clinical/article/572868/treating-case-bacterial-vaginosis

Against Legal Abortion
The legality of abortion has been a topic of discussion for quite some time now. Pro-life participants and pro-choice participants go head in head debating on what the right thing to do would be. Although giving women the right to choose to do with their bodies whatever it is that they would like to do with them, the health risks and the societal effects and impact that legalizing abortion would do, will outweigh any freedom of choice argument.

Women who get even one abortion in their lifetime have an increased chance of getting physical ailments and illnesses than women who have not gotten an abortion. They are 30% more likely to get an ectopic pregnancy in the future if they have gotten one abortion and four times more likely if they have gotten two or more, which by itself increases the mortality rate of a woman by 12% with…...

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References:

Monahan, M. (2006). The effects of abortion. In AbortionFacts.com. Retrieved August 15, 2011, from

Masse, S. (2011). Abortion Risks. In Ramah International. Retrieved August 15, 2011, from

Armstrong's findings additionally relate that due to previous research and the influence of perinatal loss on postpartum depression on partnered relationships. Armstrong states that differences in continued psychological stress between mothers and fathers after a subsequent birth is another area requiring further evaluation. Specifically stated is that it is necessary to evaluate "...the strength of partnered relationships during future childbearing experiences is important to identify any potential influence of the loss on couple, as well as family, outcomes. Understanding possible gender differences may help neonatal nurses and other healthcare providers to recognize couples at risk for discord." (2007)
Neonatal nurses are those who work closely with infants and parents and in the best position to make identification of depression and to pose questions about the individuals symptoms including:

1) mood;

2) appetite;

3) energy or fatigue levels;

4) ability to concentrate; and 5) as well the neonatal nurse is in the unique position to…...

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Bibliography

Gold, K.J., Dalton, V.K. And Schwenk, T.L. (2007) Hospital Care for Parents After Perinatal Death. Obstetrics and Gynecology Vol. 109. No. 5 May 2007.

Hughes, P., Turton, P., Hopper, E. And Evans, CDH (2002) Assessment of Guidelines for Good Practice in Psychosocial Care of Mothers After Stillbirth: A Cohort Study. The Lancet 2002;360:114-18.

Alexander, K.V. (2001) the One Thing You Can Never Take Away": Perinatal Bereavement Photographs. The American Journal of Maternal/Child Nursing Vol. 26(3) May/June 2001. 2001 Lippincott Williams & Wilkins, Inc.

Et al. "Psychological Responses of Women After First-Trimester Aortion." Arch Gen Psychiatry. Volume 57.8 (2000): 777-84. Lexis Nexis
Rearden, David C. "Aortion and Susequent Sustance Ause." The Journal of Drug and Alcohol Ause. Vol 26.1 (2000): 61-75. Wiley Online Lirary

Rosen, Gerald; Spitzer, Roert; McHugh, Paul. "Prolems with the post-traumatic stress disorder diagnosis and its future in DSM-V." British Journal of Psychology. Volume 192 (2008): 3-4. Hard Copy

Speckhard, Anne; Rue, Vincent. "Complicated mourning: Dynamics of impacted post aortion grief." Journal of Prenatal Psychology Health. Volume 8.1 (1993): 32

Speckhard, Anne; Rue, Vincent. "Postaortion Syndrome: An Emerging Pulic Health Concern." Journal of Social Issues. Volume 48.3 (2010): 95-119. Referenced in Government Study

Government Report

"Mental Health and Aortion." American Psychology Association. 2008. We. 25 Fe. 2012....

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bibliography with verifiable peer reviewed studies. It was simply a summery of the work, similar to some of the peer reviewed sources. Finally, the popular news article was also less accurate and more of an opinion piece and the author's bias were very obvious.

Women who see their physician two times a year for refills would see an individual cost savings of $85 per year for a total cost savings of $307 million for the population. In addition, approximately 2.1 million women would eliminate their annual gynecological visits altogether for an individual cost savings of $85 per year and a total cost savings of $178.54 million (Louis Harris and Associates 1993). Overall, the savings to women who either stop seeing their physician annually or reduce their visits to once a year would equal about $695.3 million.
Assuming the average wage rate is $12/hour and the average amount of time spent at the doctor's office is 11/2 hours (including travel time), women who currently see their physician four times a year for Oral Contraception refills would save 4.5 hours per year or$54 for a total opportunity cost savings of $44.4 million for the population. Five…...

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References

Holly Mead, IWPR/GWU Research Fellow. Making Birth Control More Accessible to Women. A Cost Benefit Analysis of Over-the-Counter Oral Conceptive. Feb, 2001. IWPR Publications.

Kate Saunders. New Mobile Clinics to carry out birth control policy in Tibet. July, 2003. Life News

China Forces Abortion, Sterilization on Tibetans Lhasa. Aug, 2000. CW News in collaboration with LSN.

Health Abortion 'part of birth control'. January, 1999. Health Latest BBC Health News.

If a driver ignored a road sign that said "Danger: Bridge Out!" and proceeded along the street, he would be labeled as an idiot by his community. If a fence had a sign on it that read, "arning: Vicious Dogs" and some adventure-seeking teens climbed that fence, no one would be surprised when they had their legs torn off by a pack of pit bulls. However, every single year 400,000 Americans die[1] from ignoring one of the most infamous warnings: The Surgeon General's warning on cigarette packages. Smoking cigarettes may seem to be a part of the definition of being an American-- everyone from the street punk rebels to the successful big business CEOs are automatically visualized with a cigarette or fat Cuban cigar hanging from their mouths. These smokers see themselves as a better person for the momentary pleasure they receive from these tobacco products, but fail to realize…...

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Works Cited.

The American Cancer Society. Who Is At Risk? "Tobacco and Cancer." 2001.

The American Heart Association. Publications and Resources. "Tobacco Smoke."

California Department of Health Services. Youth Media Network. "Effects of Secondhand Smoke." November 2001.

Emphysema Foundation For Our Right to Survive. Medical Info Pages. "About Smoking With Emphysema." January 2002.

STDs: A MAJO CONTEMPOAY PUBLIC HEALTH CONCEN
Sexually Transmitted Diseases

Given the advances in medicine and public health over the past several decades, most people might assume that the incidence and prevalence of sexually-transmitted diseases (STDs) is declining; however, the scientific evidence suggests otherwise. ecent estimates from the Centers for Disease Control and Prevention (CDC) in the United States suggest that 20 million new STD infections occur every year and cost the U.S. health care system close to $16 billion dollars annually (CDC, 2013). This is up from 12 million STD infections and $10 billion dollars annually during the mid-1990s (Zenilman, 2004). In 2011, reports of chlamydia incidence set another annual record, double from what it was just 10 years ago (CDC, 2011). To better understand the health threats facing Americans when they engage in sexual activity this report will review what is known about the most common STDs infecting the population.…...

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References

CDC. (2013). CDC Fact Sheet: Incidence, prevalence, and cost of sexually transmitted infections in the United States. Retrieved from:  http://www.cdc.gov /std/stats/STI-Estimates-Fact-Sheet-Feb-2013.pdf.

CDC. (2011). Sexually Transmitted Disease Surveillance, 2011. Altlanta, GA: Department of Health and Human Services. Retrieved from:

I. Introduction

1. Physical Effects
   

   1. Bleeding and cramping
   
   
   2. Pain in the lower abdomen or back

2. Emotional Effects
   

   1. Sadness and grief
   
   
   2. Anger and guilt

II. Body

1. Physical Effects
   

   1. Vaginal bleeding and cramping
   
   
   2. Pain in the lower abdomen or back
   
   
   3. Nausea and vomiting
   
   
   4. Diarrhea
   
   
   5. Fatigue

2. Emotional Effects
   

   1. Sadness and grief
   
   
   2. Anger and guilt
   
   
   3. Anxiety and depression
   
   
   4. Difficulty sleeping
   
   
   5. Loss of appetite

3. Other Effects
   

   1. Relationship problems
   
   
   2. Problems at work or school
   
   
   3. Financial problems

III. Conclusion

1. Physical Effects
   

   1. Most physical effects of miscarriage are temporary.
   
   
   2. However, some women may experience long-term problems, such as infertility or ectopic pregnancy.

2. Emotional Effects
   

   1. The emotional effects of....