Porth's Essentials of Pathophysiology, 4e

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Disorders of the Female Genitourinary System

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3. A 30-year-old woman consults her gynecologist because of amenorrhea and inability to become pregnant. Physical examination reveals an obese woman with hirsutism. The physician tells her that she might have a condition known as polycystic ovary syndrome and that further laboratory tests are indicated. A. Among tests ordered were a fasting blood glucose and serum LH, FSH, and dehydroepiandrosterone levels. What information can these tests provide that would help in establishing a diagnosis of polycystic ovary syndrome? B. What is the probable cause of this woman’s amenorrhea, hirsutism, and failure to become pregnant? C. What type of treatment might be used to help this woman become pregnant? 4. A 45-year-old woman makes an appointment to see her physician because of a painless lump in her breast that she has discovered. A. What tests should be done to confirm the presence or absence of breast cancer? B. During the removal of breast cancer, a sentinel node biopsy is often done to determine whether the cancer has spread to the lymph nodes. Explain how this procedure is done and its value in determining lymph node spread. systemic therapy for women without detectable metastatic disease. The presence or absence of estrogen receptors in the cytoplasm of tumor cells is important in determining the selection of an agent for use in adjuvant therapy. Explain. C. After surgical removal of breast cancer, tamoxifen may be used as an adjuvant 1. Moore KL, Aqur AM, Dalley AF. Clinically Oriented Anatomy . 7th ed. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014: 98–108, 382–417. 2. Ross MH, Pawlina W. Histology: A Text and Atlas . 6th ed. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011:830–894. 3. Hall JE. Guyton & Hall Textbook of Medical Physiology . 12th ed. Philadelphia, PA: Elsevier Saunders; 2010:987–1005. 4. Rosen MP, Cedars MI. Female reproductive endocrinology and infertility. In: Gardner DG, Shoback D, eds. Greenspan’s Basic & Clinical Endocrinology . 9th ed. New York, NY: Lange Medical Books/McGraw-Hill Medical; 2011:423–475. 5. Gruber CJ, Tschugguel W, Huber J. Production and actions of estrogens. N Engl J Med. 2002;346:340–350. 6. Ellenson LH, Pirog EC. The female genital tract. In: Kumar V, Abbas AK, Fausto N, et al., eds. Robbins and Cotran Pathologic Basis of Disease . 8th ed. Philadelphia, PA: Saunders Elsevier; 2010:1005–1063.

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