HMCL22311 Clinical Diagnostics Techniques

ENDEAVOUR COLLEGE OF NATURAL HEALTH

HMCL22311 Clinical Diagnostics Techniques

Case Study 2

Name: Alkira Wode

Student ID: 257115

Date: 11/12/2022

Tutor: Raelene Clark

Q1.

1. Hirsutism

Hirsutism is characterised by the presence of excess terminal hair displaying male traits in women (Spritzer et al., 2016). Presenting areas of hirsutism growth include upper lip, sides of the face, chin, shoulders, upper abdomen and upper back (Sachdeva., 2010). This is caused by the excessive production of androgen hormones that are secreted by the adrenal glands or ovaries and produced in the hair follicles (Barbieri, MD., 2021). The most common aetiology of hirsutism is Polycystic ovary syndrome (PCOS) (Spritzer et al., 2016). As seen in the physical examination, the client is presenting with terminal hair covering the chin, side of the face and upper lip region indicating hirsutism.

2. Acne

Dermatologic manifestations are often experienced by women with PCOS including acne and acanthosis nigricans (Chuan and Chang., 2010). One of the most cutaneous manifestations of PCOS is acne facial acne lesions which present themselves in up to 50% also in the upper back, chest and next areas (Shalini Gainder and Sharma., 2019). This is due to the ovaries producing more androgen hormones resulting in the production of more oil in the skin (Caporuscio, Pharma.D., 2020) This increase in sebum production creating irregular follicular epithelial cells to shed causing the formation of comedones (Shalini Gainder and Sharma., 2019). The Propionibacterium acne causes the expansion of these follicles leading to inflammation and additional formation of cysts, nodules, papules, pustules and scarring (Shalini Gainder and Sharma., 2019). As seen in the physical examination the client is presenting with inflamed acne in the formation of papules and pustules on the face and neck indicating PCOS.

3. Acanthosis nigricans

Acanthosis nigricans are dry, dark patches of skin appearing anywhere on the body but usually seen on the back of the neck and other areas like the groin, inside thigh and underneath the breasts and is reported in 5% of women with PCOS. This occurs due to the proliferation of fibroblasts and keratinocytes caused from the increased binding of serum insulin to the insulin growth factor1 (IGF-1) display features including hyperkeratosis, papillomatosis and acanthosis with or without hyperpigmentation receptors on the skins surface (Shalini Gainder and Sharma., 2019). As seen in the physical examination the client is presendting acanthosis nigricans present on the back of the neck indicating manifestations of PCOS.

4. Abdominal Obesity

Obesity is a common characteristic of PCOS and 40-80% of women who are diagnosed with PCOS present with being overweight and show abdominal obesity (Carmina et al., 2007). PCOS is a genetic condition heightened by obesity with many mechanisms contributing to the effects of weight gain and development of obesity (Barber et al., 2019). Lifestyle and environmental factors contribute to the obesity development in PCOS which heightens the abnormalities associated with metabolic and reproductive mechanisms (Sam., 2007). Mechanisms including the effects on insulin resistance enhancing hyperandrogenism and steroidogenesis provide explanations for the close relationship between body weight and the intensity of the hyperandrogenic features of PCOS (Barber et al., 2019). There is hypothesis that hyperandrogenemia may contribute to the progression of visceral adiposity in women with PCOS although further research still needs to be conducted (Sam., 2007). Obesity can be determined by the anthropometric examination of the waist circumference if women present with a waist circumference higher than 85cm (Mawaddatina et al.,2021). As seen in Beckys vital signs she presents with a measured waist circumference of 121cm indicating clinical obesity and PCOS.

5. Oligomenorrhea

A main characteristic of PCOS is Oligomenorrhea (Harris et al., 2017). The medical term Oligomenorrhea is defined as irregular or infrequent menstrual periods that only occur fewer than six to eight times a year (Welt, MD., 2021). PCOS can cause irregular menstrual periods due to elevated levels of the male hormone androgen and high levels of insulin disrupting the regular menstrual cycle and causing monthly ovulation to not occur (anovulation) (Barbieri. MD and Ehrmann, MD., 2021, Irregular Periods - Management & Treatment). Becky currently experiences irregular periods varying from 35 days to 4 months indicating PCOS.

Q2.

1. Test panel 3 Insulin resistance

2. Test panel 7 high androgens

3. Test Panel 5 hyperlipidaemia