NURS 6501 Knowledge Check Neurological and Musculoskeletal Disorders

Sample Answer for NURS 6501 Knowledge Check Neurological and Musculoskeletal Disorders Included After Question

In this exercise, you will complete a 5-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

Stroke
Multiple sclerosis
Transient Ischemic Attack
Myasthenia gravis
Headache
Seizure disorders
Head injury
Spinal cord injury
Inflammatory diseases of the musculoskeletal system
Osteoporosis
Osteopenia
Bursitis
Tendinitis
Gout
Lyme Disease
Spondylosis
Fractures
Parkinson’s
Alzheimer’s

Three basic bone-formations:

Osteoblasts
Osteocytes
Osteoclasts

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

BY DAY 7 OF WEEK 7

Complete the Knowledge Check by Day 7 of Week 7.

A Sample Answer For the Assignment: NURS 6501 Knowledge Check Neurological and Musculoskeletal Disorders

Title: NURS 6501 Knowledge Check Neurological and Musculoskeletal Disorders

It is no coincidence that the neurological system and the musculoskeletal system share both anatomical, physiological, and functional connectivity. This structure-function relationship between the neuronal and muscular topology is responsible for influencing the disease process, the pathogenesis, presentation, diagnostic formulation, and treatment of both systems. Therefore, an understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment and helps in educating the affected patients. This paper provides an account of the interplay between the neurological and the musculoskeletal system, how the racial and ethnic variables impact the physiological functioning, and how these processes interact to affect the patient.

Pathophysiologic Processes That Would Account for The Patient Presenting These Symptoms

Conspicuously, the patient has a history of hypertension and smoking that form the basis of his clinical symptoms including left-sided weakness of both the upper and lower limbs and a mild left facial droop. These features suggest a stroke. Hypertension is a well-established cause of stroke through various mechanisms that include acceleration of the arteriosclerotic process in the cerebral arteries thus increasing the risk of stenosis, embolism, and consequently infarction. Furthermore, high intravascular pressure within the cerebral arteries leads to considerable damage to the endothelial lining and alteration of the smooth muscle function (Wajngarten & Silva, 2019). This endothelial damage and altered blood cell-endothelium interaction lead to the formation of local thrombi, ischemia, and cerebral infarction whereas smooth muscle cell degeneration leads to intracerebral hemorrhages.

NURS 6501 Knowledge Check Neurological and Musculoskeletal Disorders

Smoking on the other hand is associated with an increased risk of developing a stroke. According to Pan et al. (2019) smokers have an increased risk of overall stroke compared with nonsmokers, with a pooled odds ratio of 1.61 (95% CI: 1.34–1.93). Tobacco smoke contains a lot of chemicals that include nicotine, carbon monoxide, and cyanide among many others. These chemicals increase the risk of developing atherosclerosis, platelet aggregation, hypertension, low levels of high-density cholesterol, and high levels of low-density cholesterol. A complex and multifactorial interaction of the abovementioned factors leads to impaired vascular function resulting in both cardiovascular compromise and cerebral embolism and infarction.

Racial/Ethnic Variables That May Impact Physiological Functioning

Generally, evidence shows that a racial disparity exists in the presentation of this physiological process, affecting more blacks as compared to whites. According to a study by Howard et al. (2019), the black individuals aged between 45 and 64 years had a 3-fold increase of developing stroke as compared with the whites. Black individuals have a higher preponderance of stroke because of their high risk to develop metabolic conditions such as diabetes mellitus, hypertension, obesity, hypercholesterolemia, and smoking (Tong et al., 2021).

How These Processes Interact to Affect the Patient

Neurological and musculoskeletal processes work hand in hand. Every movement the body makes requires communication between the brain and the muscles. Consequently, a pathologic process affecting the neurological process can lead to musculoskeletal manifestations such as hemiplegia, muscle spasms, muscle atrophy, and muscle pain among others. For instance, chronic musculoskeletal pain is principally considered a nervous system disorder as a result of nervous system plasticity (George & Bishop, 2018). Similarly, several factors such as smoking, hypertension, aging, and racial variables impact these physiologic systems resulting in an inherent complexity of interactions that affect patient functioning.

Conclusion

Musculoskeletal and neurological systems are correlated. Nurses must assess both systems at a given point for effective diagnosis and treatment. It is also elemental to educate the patient concerning modifiable risk factors such as smoking and hypertension that result in occurrences that limit the functioning of the musculoskeletal and neurological systems.

References

George, S. Z., & Bishop, M. D. (2018). Chronic musculoskeletal pain is a nervous system disorder… now what? Physical Therapy, 98(4), 209–213. https://doi.org/10.1093/ptj/pzy002

Howard, V. J., Madsen, T. E., Kleindorfer, D. O., Judd, S. E., Rhodes, J. D., Soliman, E. Z., Kissela, B. M., Safford, M. M., Moy, C. S., McClure, L. A., Howard, G., & Cushman, M. (2019). Sex and race differences in the association of incident ischemic stroke with risk factors. JAMA Neurology, 76(2), 179–186. https://doi.org/10.1001/jamaneurol.2018.3862

Pan, B., Jin, X., Jun, L., Qiu, S., Zheng, Q., & Pan, M. (2019). The relationship between smoking and stroke: A meta-analysis: A meta-analysis. Medicine, 98(12), e14872. https://doi.org/10.1097/MD.0000000000014872

Tong, X., Schieb, L., George, M. G., Gillespie, C., Merritt, R. K., & Yang, Q. (2021). Racial/ethnic and geographic variations in long-term survival among Medicare beneficiaries after acute ischemic stroke. Preventing Chronic Disease, 18(200242), E15. https://doi.org/10.5888/pcd18.200242

Wajngarten, M., & Silva, G. S. (2019). Hypertension and stroke: Update on treatment. European Cardiology, 14(2), 111–115. https://doi.org/10.15420/ecr.2019.11.1

Week 7: Concepts of Neurological and Musculoskeletal Disorders – Part 1

Anatomists often use the analogy of a house to explain the human body, with skeletal systems, respiratory systems, and circulatory systems represented as a home’s framing structure, ventilation, and piping, respectively. Such analogies further emphasize the point that relationships between systems can result in complications when issues arise in one system.

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With hundreds of diseases that can impact the brain, spine, and nerves, neurological disorders represent a complicated array of issues that present significant health concerns. Disorders such as strokes and Parkinson’s disease not only affect the nervous system, however; they can have secondary impacts in other areas, especially the musculoskeletal system. NURS 6501 Knowledge Check Neurological and Musculoskeletal Disorders

This week, you examine fundamental concepts of neurological disorders. You explore common disorders that impact these systems and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.
Learning Objectives

Students will:

Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

Required Readings (click to expand/reduce)

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: the biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

Chapter 15: Structure and Function of the Neurologic System
Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function (stop at Sleep); Summary Review
Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function (start at Acute confusional states and delirium) (stop at Alterations in neuromotor functions); (Parkinson’s Disease); Summary Review NURS 6501 Knowledge Check Neurological and Musculoskeletal Disorders
Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction (stop at Degenerative disorders of the spine); (start at Cerebrovascular disorders) (stop at Tumors of the central nervous system); Summary Review
Chapter 44: Structure and Function of the Musculoskeletal System (stop at Components of muscle function); Summary Review
Chapter 45: Alterations of Musculoskeletal Function (stop at Bone tumors); (start at Disorders of joints); Summary Review
Chapter 47: Structure, Function, and Disorders of the Integument (section on Lyme Disease)

Chin, L. S. (2018). Spinal cord injuries. Retrieved from https://emedicine.medscape.com/article/793582-overview#a4

Required Media (click to expand/reduce)

Module 5 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 5 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check and your Assignment. (3m) NURS 6501 Knowledge Check Neurological and Musculoskeletal Disorders

Khan Academy. (2019b). Ischemic stroke . Retrieved from https://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/stroke/v/ischemic-stroke

Note: The approximate length of the media program is 8 minutes.

NURS 6501 Knowledge Check Neurological and Musculoskeletal Disorders Osmosis.org. (2019, June 12). Osteoporosis – causes, symptoms, diagnosis, treatment, pathology [Video file]. Retrieved from https://www.youtube.com/watch?v=jUQ_tt_zJDo

Note: The approximate length of the media program is 9 minutes.

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 15, 16, 18, and sections of Chapters 44 and 45 that relate to the neurological and musculoskeletal systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Scenario 2: Osteoporosis

A 78-year-old female was out walking her small dog when her dog suddenly tried to chase a rabbit and made her fall. She attempted to try and break her fall by putting her hand out and she landed on her outstretched hand. She immediately felt severe pain in her right wrist and noticed her wrist looked deformed. Her neighbor saw the fall and brought the woman to the local ER for evaluation. Radiographs revealed a Colles’ fracture (distal radius with dorsal displacement of fragments) as well as radiographic evidence of osteoporosis. A closed reduction of the fracture was successful, and she was placed in a posterior splint with ace bandage wrap and instructed to see an orthopedist for follow up.

Question:

Discuss what is osteoporosis and how does it develop pathologically?

Your Answer:

Osteoporosis is a chronic metabolic disorder that presents with bone loss, causing a decreased bone density and increasing the risk of fracture. The commonly affected bones are the spine, hip, and wrist. Osteoporosis is diagnosed in a patient with a T-score at or below −2.5 (Akkawi & Zmerly, 2018). Common osteoporosis manifestations are loss of height, back pain with bending, lifting, or stooping, and fractures. Osteoporosis develops when bone resorption exceeds bone building, resulting in decreased bone mineral density (BMD). BMD decreases more rapidly in postmenopausal females due to decreased serum estrogen levels. Estrogen helps in preventing bone loss.

Reference

Akkawi, I., & Zmerly, H. (2018). Osteoporosis: Current Concepts. Joints, 6(2), 122–127. https://doi.org/10.1055/s-0038-1660790

A Sample Answer 4 For the Assignment: NURS 6501 Knowledge Check Neurological and Musculoskeletal Disorders

Title: NURS 6501 Knowledge Check Neurological and Musculoskeletal Disorders

Scenario 3: Rheumatoid Arthritis

A 48-year-old woman presents with a five-month history of generalized joint pain, stiffness, and swelling, especially in her hands. She states that these symptoms have made it difficult to grasp objects and has made caring for her grandchildren problematic. She admits to increased fatigue, but she thought it was due to her stressful job.

FH: Grandmothers had “crippling” arthritis.

PE: remarkable for bilateral ulnar deviation of her hands as well as soft, boggy proximal interphalangeal joints. The metatarsals of both of her feet also exhibited swelling and warmth.

Diagnosis: rheumatoid arthritis.

Question:

The pt. had various symptoms, explain how these factors are associated with RA and what is the difference between RA and OA?

Your Answer:

RA is a chronic, gradual, systemic inflammatory autoimmune disorder affecting synovial joints. It is characterized by inflammation of connective tissue in the synovial joint. It is a systemic disease that affects the body system and usually involves several joints and other tissues. Rheumatoid factors (RFs) are formed and attack healthy tissues, particularly synovium, causing inflammation (Scherer et al., 2020). The disease then involves the articular cartilage, joint capsule, and surrounding ligaments and tendons. This explains the patient’s symptoms of generalized joint pain, stiffness, and swelling, in her hands as well as boggy proximal interphalangeal joints and swelling and warmth of the metatarsals in her feet also exhibited swelling and warmth.

Osteoarthritis (OA) presents with deep joint pain secondary to extensive joint use. It manifests with a reduced range of motion (ROM) in affected joints and Heberden nodes. Joint stiffness in OA occurs during rest, and it also has joint stiffness in the morning that lasts less than 30 minutes (Yunus et al., 2020). On the other hand, RA presents with morning joint stiffness lasting more than an hour. RA presents with systemic symptoms, like a low-grade fever, anorexia, fatigue, and weight loss, which do not occur in OA.

References

Scherer, H. U., Häupl, T., & Burmester, G. R. (2020). The etiology of rheumatoid arthritis. Journal of autoimmunity, 110, 102400. https://doi.org/10.1016/j.jaut.2019.102400

Yunus, M., Nordin, A., & Kamal, H. (2020). Pathophysiological Perspective of Osteoarthritis. Medicina (Kaunas, Lithuania), 56(11), 614. https://doi.org/10.3390/medicina56110614

A Sample Answer For the Assignment: NURS 6501 Knowledge Check Neurological and Musculoskeletal Disorders

Title: NURS 6501 Knowledge Check Neurological and Musculoskeletal Disorders

Scenario5: Multiple Sclerosis (MS)

A 28-year-old obese, female presents today with complaints for several weeks of vision problems (blurry) and difficulty with concentration and focusing. She is an administrative para-legal for a law firm and notes her symptoms have become worse over the course of the addition of more attorneys and demands for work. Today, she noticed that her symptoms were worse and were accompanied by some fine tremors in her hands. She has been having difficulty concentrating and has difficulty voiding. She went to the optometrist who recommended reading glasses with small prism to correct double vision. She admits to some weakness as well. No other complaints of fevers, chills, URI or UTI

PMH: non-contributory

PE: CN-IV palsy. The fundoscopic exam reveals edema of right optic nerve causing optic neuritis. Positive nystagmus on positional maneuvers. There are left visual field deficits. There was short term memory loss with listing of familiar objects.

DIAGNOSIS: multiple sclerosis (MS).

Question:

Describe what is MS and how did it cause the above patient’s symptoms?

Your Answer:

MS is a chronic demyelinating disorder of the central nervous system (CNS). It is an autoimmune disorder that affects the myelin sheath and CNS conduction pathway. It is characterized by central areas of inflammation, demyelination, proliferation and activation of glial cells, and degeneration caused by immune-mediated attacks (Fernández et al., 2020). The clinical manifestations of MS include muscle weakness and spasticity, intention tremors, fatigue, inability to direct or limit movement, reduced sensitivity to pain, paresthesia, and decreased motor coordination. In addition, MS is characterized by changes in peripheral vision, reduced visual and hearing acuity, bowel and bladder dysfunction, altered sexual function, and cognitive changes.

Optic nerve and brainstem involvement can be attributed to the patient’s vision problems with blurred vision. The difficulty in voiding is due to a loss of neural control. Besides, demyelination in the cerebral cortex causes difficulties in concentration and focusing, which are present in the patient (Fernández et al., 2020). Demyelination in the cerebellum causes imbalance, incoordination, vertigo, and tremors, which explains the patient’s fine hand tremors and weakness. The difficulty in voiding can be attributed to the involvement of the spinal cord because the peripheral and spinal connections control the voiding reflex (Preziosi et al., 2018).

References

Fernández, Ó., Costa-Frossard, L., Martínez-Ginés, M., Montero, P., Prieto, J. M., & Ramió, L. (2020). The Broad Concept of “Spasticity-Plus Syndrome” in Multiple Sclerosis: A Possible New Concept in the Management of Multiple Sclerosis Symptoms. Frontiers in neurology, 11, 152. https://doi.org/10.3389/fneur.2020.00152

Preziosi, G., Gordon-Dixon, A., & Emmanuel, A. (2018). Neurogenic bowel dysfunction in patients with multiple sclerosis: prevalence, impact, and management strategies. Degenerative neurological and neuromuscular disease, 8, 79–90. https://doi.org/10.2147/DNND.S138835

Knowledge Check: Neurological and Musculoskeletal Disorders

In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:
Stroke
Multiple sclerosis
Transient Ischemic Attack
Myasthenia gravis
Headache
Seizure disorders
Head injury
Spinal cord injury
Inflammatory diseases of the musculoskeletal system
Osteoporosis
Osteopenia
Bursitis
Tendinitis
Gout
Lyme Disease
Spondylosis
Fractures
Parkinson’s
Alzheimer’s

Three basic bone-formations:

Osteoblasts
Osteocytes
Osteoclasts

Photo Credit: Getty Images/Science Photo Libra

Complete the Knowledge Check By Day 7 of Week 7

To complete this Knowledge Check:

Module 5 Knowledge Check

Next Week

To go to the next week:

Week 8

Question 1

1 out of 1 points

Correct

Muscle protein that stores oxygen is called:
Selected Answer:
Correct

Myoglobin
Answers:

Epiphysis

Correct

Myoglobin

Hyaluronate

Diaphysis

Question 2

1 out of 1 points

Correct

Lipogranuloma of oil-secreting gland of the eyelid best describes a:
Selected Answer:
Correct

Chalazion
Answers:

Keratitis

Blepharitis

Correct

Chalazion

Entropion
Question 3

1 out of 1 points

Correct

Neurons need insulin in order to take in glucose.
Selected Answer:
Correct

False
Answers:

True

Correct

False
Question 4

1 out of 1 points

Correct

Damage to an upper motor neuron will cause muscle ________________________
Selected Answer:
Correct

spasticity
Answers:
Correct

spasticity

flaccidity

tremor

paralysis
Question 5

0 out of 1 points

Incorrect

Damage to the cerebellum will cause what symptoms?
Selected Answer:
Incorrect

resting tremor and ataxic gait
Answers:

resting tremor and ataxic gait

resting tremor and shuffling gait

Correct

intention tremor and ataxic gait

intention tremor and shuffling gait
Question 6

0 out of 1 points

Incorrect

Which substances inhibit bone re absorption?
Selected Answer:
Incorrect

Prostaglandin E2 (PGE2) and tumor necrosis factor-a (TNF-a)
Answers:
Correct

Osteoprotegerin (OPG) and estrogen

Prostaglandin E2 (PGE2) and tumor necrosis factor-a (TNF-a)

Osteoprotegerin (OPG) and t umor necrosis factor-a (TNF-a)

Prostaglandin E2 (PGE2) and estrogen
Question 7

1 out of 1 points

Correct

A neuron extension that carries impulses toward the cell body is called:
Selected Answer:
Correct

Dendrite
Answers:

Axon

Correct

Dendrite

Limbic

Myelin
Question 8

1 out of 1 points

Correct

Venous bleeding around the brain can cause a(n):

Selected Answer:
Correct

subdural hematoma
Answers:
Correct

subdural hematoma

epidural hematoma

intracerebral hematoma

cerebellar infarct
Question 9

1 out of 1 points

Correct

Inflammation in small fluid-filled sacs located between tendons, muscles, and bony prominences is called?
Selected Answer:
Correct

Bursitis
Answers:

Septic joint

Epicondylitis

Correct

Bursitis

Nonunion
Question 10

1 out of 1 points

Correct

Cranial nerves III, IV, and VI are necessary for normal movement of the:
Selected Answer:
Correct

eye
Answers:

cheeks

lips

tongue

Correct

eye
Question 11

1 out of 1 points

Correct

Characteristics of rheumatoid arthritis include:
Selected Answer:
Correct

Severe joint deformities and autoimmune disease
Answers:
Correct

Severe joint deformities and autoimmune disease

Subchondral bone sclerosis and loss of articular cartilage

Joint pain relieved by rest and joint stiffness for first hour after awakening

Subchondral bone sclerosis and joint stiffness for first hour after awakening
Question 12

1 out of 1 points

Correct

What brain structure is responsible for the thermoregulation and heat production in the body?
Selected Answer:
Correct

hypothalamus
Answers:
Correct

hypothalamus

thalamus

cerebellum

pons
Question 13

1 out of 1 points

Correct

Damage to a lower motor neuron will cause muscle ________________________
Selected Answer:
Correct

flaccidity
Answers:

spasticity

Correct

flaccidity

tremor

paralysis
Question 14

1 out of 1 points

Correct

Inflammation of the eyelid is best described as:
Selected Answer:
Correct

Blepharitis
Answers:

Keratitis

Correct

Blepharitis

Chalazion

Entropion
Question 15

0 out of 1 points

Incorrect

Impaired recognition of tactile, visual, or auditory stimuli is called:
Selected Answer:
Incorrect

Athetosis
Answers:

Athetosis

Apraxia

Aphasia

Correct

Agnosia
Question 16

1 out of 1 points

Correct

Which of the following conditions are have an autoimmune cause?
Selected Answer:
Correct

Lichen planus and lupus erythematosus
Answers:
Correct

Lichen planus and lupus erythematosus

Erysipelas and impetigo

Tinea pedis and candidiasis

Erysipelas and candidiasis
Question 17

1 out of 1 points

Correct

Which of the following conditions are have a bacterial cause?
Selected Answer:
Correct

Erysipelas and impetigo
Answers:

Lichen planus and lupus erythematosus

Correct

Erysipelas and impetigo

Tinea pedis and candidiasis

Erysipelas and candidiasis
Question 18

0 out of 1 points

Incorrect

Characteristics of osteoarthritis include:
Selected Answer:
Incorrect

Joint pain relieved by rest and joint stiffness for first hour after awakening
Answers:

Severe joint deformities and autoimmune disease

Correct

Subchondral bone sclerosis and loss of articular cartilage

Joint pain relieved by rest and joint stiffness for first hour after awakening

Subchondral bone sclerosis and joint stiffness for first hour after awakening
Question 19

1 out of 1 points

Correct

Inflammation of a tendon where it attaches to a bone is called?
Selected Answer:
Correct

Epicondylitis
Answers:

Septic joint

Correct

Epicondylitis

Bursitis

Nonunion
Question 20

1 out of 1 points

Correct

Changes in the pupils are useful to evaluate the function of what area of the brain?
Selected Answer:
Correct

brainstem
Answers:

grey matter

corticol

Correct

brainstem

white matter

Wednesday, August 18, 2021 8:08:11 AM EDT

Question 1

Needs Grading

A 28-year-old woman presents to the clinic with a chief complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarche at 12 years of age. She began to develop dark, coarse facial hair when she was 14 years of age, but her parents did not seek treatment or medical opinion at that time. The symptoms worsened after she gained weight in college. She got married 3 years ago and has been trying to get pregnant for the last 2 years without success. Height 66 inches and weight 198. BMI 32 kg.m². Moderate hirsutism without virilization noted. Laboratory data reveal CMP within normal limits (WNL), CBC with manual differential (WNL), TSH 0.9 IU/L SI units (normal 0.4-4.0 IU/L SI units), a total testosterone of 65 ng/dl (normal 2.4-47 ng/dl), and glycated hemoglobin level of 6.1% (normal value ≤5.6%). Based on this information, the APRN diagnoses the patient with polycystic ovarian syndrome (PCOS) and refers her to the Women’s Health APRN for further workup and management.

Question 1 of 2:

What is the pathogenesis of PCOS?

Selected Answer:	There is a direct correlation between the pathophysiology of PCOS, the action of LH, predisposition to hyperandrogenism, and insulin resistance. A common theory that explains the pathogenesis of PCOS highlights that, resistance to insulin usually suppresses the synthesis of globulin, a sex-binding hormone, increasing the synthesis of ovarian and adrenal androgens which increases the levels of androgens, aggravating hyperandrogenism. Although the main characteristic feature of PCOS is a hyperandrogenic state, in most cases, hyperinsulinemia, glucose intolerance and insulin resistance run parallel exacerbating the hyperandrogenic state, worsening the symptoms and signs of PCOS.
Correct Answer:	The pathogenesis of PCOS has been linked to altered luteinizing hormone (LH) action, insulin resistance, and a possible predisposition to hyperandrogenism. One theory maintains that underlying insulin resistance exacerbates hyperandrogenism by suppressing synthesis of sex hormone–binding globulin and increasing adrenal and ovarian synthesis of androgens, thereby increasing androgen levels. These androgens then lead to irregular menses and physical manifestations of hyperandrogenism. The hyperandrogenic state is a cardinal feature of PCOS but glucose intolerance/insulin resistance and hyperinsulinemia often run parallel to and markedly aggravate the hyperandrogenic state, thus contributing to the severity of signs and symptoms of PCOS.
Response Feedback:	[None Given]

Question 2

Needs Grading

Question 2 of 2:

How does PCOS affect a woman’s fertility or infertility?

Selected Answer:	The main cause of infertility in women with PCOS are problems in ovulation. Ovulation may be hindered by increased production of testosterone or failure of ovarian follicles to mature. When hormones fail to balance, an individual may experience irregular ovulation and menstruation. Since the main characteristic feature in the pathology of PCOS is a hyperandrogenic state, in excess, androgens affect the growth of follicles while insulin suppresses apoptosis which declines follicular growth. There are also dysfunctions that occur in the development of ovarian follicles. In other instances, inappropriate secretion of gonadotropin triggers the start of a vicious cycle which perpetuates anovulation.
Correct Answer:	Ovulation problems are usually the primary cause of infertility in women with PCOS. Ovulation may not occur due to an increase in testosterone production or because follicles on the ovaries do not mature. Due to unbalanced hormones, ovulation and menstruation can be irregular. A hyperandrogenic state is a cardinal feature in the pathogenesis of PCOS. Excessive androgens affect follicular growth, and insulin affects follicular decline by suppressing apoptosis and enabling follicle to persist. There is dysfunction in ovarian follicle development. Inappropriate gonadotropin secretion triggers the beginning of a vicious cycle that perpetuates anovulation.
Response Feedback:	[None Given]