The patient, a 28-year-old woman, has been sexually active with multiple partners since she was 14 years old. She is now married and wants to have children. She has intermittent breakouts of vulvar ulcers/sores but no other complaints. Her pelvic examination during a routine visit with her gynecologist was normal. She had a lump in her left breast.
Studies Results Sexually transmitted infections (STIs), p. 756
Herpes simplex test, p. 731 Positive for herpes simplex virus-2 (HSV-2) (normal: negative) No change in serology 4 weeks later Cytomegalovirus, p. 200 No antibodies detected Chlamydia, p. 722 No antibodies detected Gonorrhea, p. 761 Culture negative Syphilis serology, p. 473 No antibodies detected Pap smear, p. 743 Adequacy of specimen Adequate Category Epithelial abnormality Epithelial cell abnormalities Squamous, atypical cells Human papillomavirus (HPV) testing, p. 745 Positive for HPV 16 Breast sonogram, p. 871 Benign fibroadenoma
The patient was informed of her test results. Her herpes titers indicated that the disease was rather chronic, not acute. No treatment was recommended. Because of her age, mammograms were contraindicated. A breast ultrasound indicated the lesion was not cancerous. A fibroadenoma is common in this age-group. Because of her positive HPV results and suspicious Pap smear, further evaluation was recommended.
Studies Results Colposcopy, p. 595 Several suspicious areas Biopsy Squamous cell carcinoma Cervical cone biopsy, p. 720 Invasive squamous cell carcinoma Hysteroscopy, p. 614 No extension to the endocervical canal or uterus Pelvic ultrasound, p. 887 No extension of tumor beyond the cervix The patient was advised to have a radical hysterectomy. She refused because she wanted to have a family. She began psychologic counseling for guilt over her past promiscuity, which had increased her risk for cervical cancer. She became pregnant 1 year later and lost the
Case Studies 2
pregnancy during the second trimester. One year later, she developed a large pelvic mass, which represented progressive, inoperable cervical cancer. Despite radiation therapy and chemotherapy, she died at age 31 of cervical cancer.
Critical Thinking Questions
- Why was mammography contraindicated for this patient? 2. How is sexual promiscuity related to the risk for cervical cancer? APA style at least 2 reference.
The strict importance of identity springs from the Latin word ‘persona’, the cover utilized by roman theater on-screen characters. identity alludes to our attributes manners by which of reacting to individuals and things. Identity is portrayed by the consequent highlights:- it has both physical and mental parts. Its appearance as far as conduct is genuinely particular in an exceedingly given person. Its fundamental alternatives don’t just change with time. it’s dynamic inside the feeling that some of its alternatives could change on account of inward or outer situational requests. Meanings of identity While there are numerous elective hypotheses of identity, the essential advance is to know explicitly what’s implied by the term identity. The word identity itself originates from the Latin word persona, that alluded to a dramatic veil work by entertainers in order to either extend entirely unexpected jobs or camouflage their personalities. A concise definition would be that identity is made from the trademark examples of considerations, sentiments and practices that make somebody one of a kind. also identity, identity emerges from inside the individual and remains genuinely reliable all through life. Some different meanings of personality as given by a few analysts seem to be: • “Identity alludes to people’s trademark examples of thought, feeling, and conduct, close by the mental components — covered up or not — behind those examples. This definition implies among their associates in various subfields of science, those analysts United Nations organization think about personality have a novel order: to clear up entire people.” (Funder, D. C., 1997) • “Albeit no single definition is reasonable to all or any identity scholars, we will say that demeanor could be an example of nearly changeless attributes and unmistakable qualities that offer every consistency and independence to a person’s conduct.” (Feist and mongrel, 2009) Parts of disposition So what explicitly makes up an identity? As portrayed inside the definitions higher than, one would anticipate that qualities and examples of thought and feeling outline a pivotal half. some of the other essential attributes of demeanor include: Consistency – there’s commonly a conspicuous request and normality to practices. essentially, people act inside a similar manners by which or comparative manners by which in an exceedingly style of things. Mental and physiological – personality could be a mental develop, anyway examination proposes that it’s conjointly impacted by natural procedures and wishes. It impacts practices and activities – disposition doesn’t just impact anyway we will in general move and react in our condition; it conjointly makes North American nation act in bound manners by which. Numerous articulations – personality is shown in extra than just conduct. It might be found in our considerations, sentiments, close connections and diverse social communications. Speculations OF demeanor Identity contains a long history going from mathematician, Plato, Aristotle, solon and fluctuated distinctive savants and essayists. Plato Plato (427– 347 BCE) laid out the human spirit in light of the fact that the seat of personality. with regards to scholar the spirit comprises of 3 fundamental powers managing human conduct: reason, feeling, and appetence. Reason is given the simple best cost since it keeps the extra crude powers of appetence and feeling treed while feeling and especially appetence territory unit considered the “bring down interests.” Aristotle Aristotle (384– 322 BCE), one in everything about understudies and furthermore the instructor of Alexander the great, noted human spirit on the grounds that the mind. Aristotle anticipated that the mind is that the result of natural procedures. He furthermore observed the mind as and in addition a gathering of resources that he put amid a chain of command of significance. the grade school that Aristotle recognized is that the nutritive—the human living being’s fundamental drives to satisfy its real wants. This school is found in plants further as in creatures and other individuals. progressive and better school is that the tangible movement, that rationalist laid out in light of the fact that the feature of mind that translates tactile data. Creatures further as people have a tactile action school. The last and most noteworthy school is that the learned person, that logician saw as unmistakable to friends and relatives. Descartes As per René mathematician (1596– 1650), a French mastermind, human personality is that the result of the cooperation of heavenly and base powers. He saw the fundamental power behind human personality in light of the fact that the godlike soul—unadulterated, flawless, and elusive. mathematician began to clear up anyway this religious element collaborated with the material body. His perception of partner anatomical analyzation semiconductor diode him to assume he had settled this mind-body drawback. He distinguished atiny low body inside the evident focus of the mind alluded to as the epiphysis cerebri or epiphysis cerebri, accordingly named by the Greco-Roman MD Claudius I Galen (c. 130– c. two hundred CE) because of its frame helped him to remember a pine cone. Descartes(1649) arrived at the resolution that that this cone shaped endocrine organ ought to be the motivation behind contact between the spirit and furthermore the body. thinker philosophical framework, that will be that the philosophical position that 2 substances—matter and soul, or cerebrum related personality—exist severally of each unique however they associate—turned into the premier regular read inside the Christian West when the seventeenth century because of it “clarified” the presence of human caution and awareness in a generally unthinking universe. For sure, before the presence of the pc, it showed up impractical to allow for cognizance while not engaging nonmaterial thoughts. Machiavelli Niccolò Machiavelli (1469– 1527), a Florentine representative and political mastermind, trusted that demeanor is best comprehended in an exceedingly social setting. with regards to Machiavelli, people region unit essentially narcissistic, insatiable, thankless, and unforgiving. additionally, he saw 2 essential powers as process human character. the essential one is relate Italian term—virtù—which is best portrayed as a blend of inspiration, valor, and confirmation. Machiavelli alluded to as the second power Fortuna, that will be that the Latin word for luckiness. somebody may turn into a vigorous pioneer with the help of a fair portion of virtù and Fortuna. with regards to him pioneers United Nations office carry on of graciousness and a trust the fundamental integrity of humankind can consistently fall flat. This conviction is normally communicated by present day people as “decent folks end last.” There are wide range of speculations with respect to anyway disposition creates. very surprising schools of thought in science impact a few of those speculations. Type hypothesis of disposition Maybe the most punctual recognized hypothesis of demeanor is that of the Greek MD Hippocrates (c. 400 B.C.), United Nations organization described human conduct as far as 4 demeanors, each identified with a novel amusingness, or “silliness.” The cheery, or hopeful, kind was identified with blood; the apathetic kind (moderate and dormant) with mucus; the melancholic kind (dismal, discouraged) with dark bile; and furthermore the irritable (furious) kind with natural liquid. Singular personality made up our brains by the quantity of everything about four humors. Hippocrates’ framework stayed legitimate in Western Europe all through the medieval and Renaissance periods. flourishing references to the four humors is found inside the plays of dramatist, and furthermore the terms with that Hippocrates labeled the four personality sorts territory unit still in like manner use these days. the possibility of dispositions is among a spread of frameworks that impact human personality by separating it into sorts. A wide advanced (yet deductively questionable) in vogue grouping of demeanor was created inside the Nineteen Forties by William Sheldon, relate yank man of science. Sheldon arranged disposition into 3 classes upheld body types: the somebody (overwhelming and nice), individual (strong and forceful), and individual (thin and scholarly or imaginative). Attribute hypothesis of demeanor A noteworthy shortcoming of Sheldon’s morphological game plan and distinctive kind hypotheses by and large is that the segment of misrepresentation intrinsic in embeddings individuals into one class, that overlooks the undeniable reality that every disposition speaks to a novel blend of characteristics. Frameworks that address disposition as a blend of characteristics or measurements territory unit alluded to as quality speculations. Understood property scholarly Gordon Allport (1897-1967) broadly researched the manners by which amid which qualities blend to make conventional identities, recording more than 18,000 separate characteristics over a time of thirty years. He anticipated that each individual has around seven focal attributes that rule his or her conduct. Allport’s promise to building property examination extra reasonable and supportive by disentangling it had been extended by future scientists, United Nations organization discovered manners by which to bunch attributes into groups through a technique alluded to as correlational investigation. Raymond B. Cattell decreased Allport’s top to bottom rundown to sixteen essential groups of between related qualities, and Eysenck guaranteed that personality can be outline bolstered 3 fundamental elements: psychoticism (such reprobate attributes as remorselessness and dismissal of social traditions), self preoccupation extroversion, and emotionality-soundness (likewise alluded to as neuroticism). Hans Jurgen Eysenck conjointly built up a quadrant upheld crosswise over passionate steady and independent outgoing tomahawks.>