NSG 5003 Assignment: Disorders of the Female Reproductive System

NSG 5003 Assignment: Disorders of the Female Reproductive System

NSG 5003 Assignment  Disorders of the Female Reproductive System

A 30-year-old female presents with amenorrhea for 6 months. Prior to this she had periods of dysmenorrhea and irregular cycles. Discuss the pathophysiology of amenorrhea and possible causes. What might the prior irregular cycles and dysmenorrhea mean in terms of the pathophysiology of the disorder?

• The most common cause of amenorrhea in adolescents are hypothalamic disorders and is known as hypothalamic amenorrhea.
• During the initial 2-3 years after the onset of menarche, the HPO axis is still under development. Immature HPO axis may lead to anovulatory cycles which can cause abnormalities in menstrual cycles.
• The most common cause of amenorrhea after 2-3 years of onset of puberty include eating disorders, excessive exercise, medications, and psychosocial stress.^[6][7]
• Leptin plays an important role in energy consumption, body composition, food intake along with sexual maturation and reproductive improvement.
  • It is assumed that leptin plays a role in the development of hypothalamic amenorrhea.
  • Leptin receptors are in close relationship with hypothalamus and it is postulated that leptin regulates GnRH production and secretion.
  • Patients with anorexia nervosa or excessive exercise have amenorrhea from down-regulation of leptin receptors, which can be elevated by refeeding.^[8][9][10]
  • Leptin level in cachexic patients will increase after gaining appropriate weight in patients without amenorrhea, but will remain low in patients with amenorrhea.

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• It has been observed that leptin levels in amenorrheic athletes are low as compared to non-athletes women or athletes with regular menses.^[13][14]
• Administration of recombinant leptin for 3 months in women with conditions such as hypothalamic amenorrhea, excessive exercises or weight loss has been associated with an increased level of LH, FSH, and estradiol leading to ovulatory cycles.^[15]
• Antipsychotic drugs and other medications that have an inhibitory effect on dopamine D2 receptor lead to an increased level of prolactin. Higher levels of prolactin suppress pulsatile GnRH secretion and block positive feedback of estradiol on hypothalamus, leading to disruption of HPO axis.^[16]
• Stress and strenuous activities like other metabolic or cardiovascular responses are regulated through corticotropin releasing hormone (CRH), secreted by paraventricular nuclei of hypothalamus. CRH induce the release of β-endorphin, an endogenous opioid. Both CRH and β-endorphin suppress GnRH release. On the other hand, glucocorticoids suppress LH production from pituitary and also estrogen/progesterone from ovaries.^[17]
• Kallmann syndrome, a genetic disorder caused by KAL gene mutation, has disturbance in migration of olfactory nerves along with GnRH neurons. Lack of GnRH leads to absence of secondary sexual characteristics and amenorrhea.^[18]Grading Rubric
  

  Performance Category	100% or highest level of performance 100% 16 points	Very good or high level of performance 88% 14 points	Acceptable level of performance 81% 13 points	Inadequate demonstration of expectations 68% 11 points	Deficient level of performance 56% 9 points	Failing level of performance 55% or less 0 points
  Total Points Possible= 50	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
  Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic topics.	Presentation of information was exceptional and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was good, but was superficial in places and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was minimally demonstrated in all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in one of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in two of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in three or more of the following elements Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
  	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
  Application of Course Knowledge Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations	Presentation of information was exceptional and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was good, but was superficial in places and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was minimally demonstrated in the all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in one of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from and scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in two of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in three of the following elements Applies principles, knowledge and information and scholarly resources to the required topic. Applies facts, principles or concepts learned scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.
  	10 Points	9 Points			6 Points	0 Points
  Interactive Dialogue Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic.	Demonstrated all of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 3 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.			Demonstrated 2 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 1 or less of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.
  	8 Points	7 Points	6 Points	5 Points	4 Points	0 Points
  Grammar, Syntax, APA Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error.	The following was present: 0-3 errors in APA format AND Responses have 0-3 grammatical, spelling or punctuation errors AND Writing style is generally clear, focused on topic,and facilitates communication.	The following was present: 4-6 errors in APA format. AND/OR Responses have 4-5 grammatical, spelling or punctuation errors AND/OR Writing style is somewhat focused on topic.	The following was present: 7-9 errors in APA format. AND/OR Responses have 6-7 grammatical, spelling or punctuation errors AND/OR Writing style is slightly focused on topic making discussion difficult to understand.	The following was present: 10- 12 errors in APA format AND/OR Responses have 8-9 grammatical, spelling and punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand.	The following was present: 13 – 15 errors in APA format AND/OR Responses have 8-10 grammatical, spelling or punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand. AND/OR The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.	The following was present: 16 to greater errors in APA format. AND/OR Responses have more than 10 grammatical, spelling or punctuation errors. AND/OR Writing style does not facilitate communication
  	0 Points Deducted					5 Points Lost
  Participation Requirements	Demonstrated the following: Initial, peer, and faculty postings were made on 3 separate days					Failed to demonstrate the following: Initial, peer, and faculty postings were made on 3 separate days
  	0 Points Lost					5 Points Lost
  Due Date Requirements	Demonstrated all of the following: The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.					Demonstrates one or less of the following. The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.