Need response to a peers discussion post
Prompt
Select two different students/topics and discuss the condition encompassing clinical experiences and critique the post.
In your
response, it is important to be respectful, make your response
meaningful, and express yourself clearly. It is a best practice to
not use unsupported personal opinions, generalizations or language that
might be viewed as offensive to others. If you are trying to extend a
discussion, consider using probing questions. If providing a
disagreement to a peer post remain respectful, considerate, and maintain
an academic tone.
Respond to this post
A 40-year-old has an endometrial biopsy report: benign endometrial hyperplasia.
Explain the diagnosis.
An
enlargement of the endometrial glands and stroma (the tissue lining the
uterus) is a condition known as benign (not cancerous) endometrial
hyperplasia. This disease is often brought on by an excess of
endometrial cells due to an imbalance in the progesterone and estrogen
levels. The most common causes of the illness are elevated estrogen
exposure and a relative progesterone insufficiency, sometimes known as
“unopposed estrogen” (Singh et al., 2024). In the event of atypical forms, it can progress to endometrial cancer if therapy is not received (Singh et al., 2024). Symptoms may include abnormal menstrual flow (Singh et al., 2024).
Which cells are implicated in this diagnosis? Compare and contrast atrophy vs. hyperplasia.
The
endometrial glandular cells and the uterine lining’s stromal cells are
the main cells implicated in benign endometrial hyperplasia. When
progestins do not resist estrogenic stimulation of the endometrium,
proliferative glandular epithelial alterations or hyperplasia result (Singh et al., 2024). Atrophy is the shrinkage of an organ or tissue caused by a reduction in the size and quantity of cells. Skeletal
muscle atrophy is defined by weakening, contracting, and decreasing
muscle mass and fiber cross-sectional area (Yin et al., 2021). The
volume of an organ or tissue diminishes as cells shrink or die (Yin et
al., 2021). When
an organ or tissue has more cells than it can support, it becomes
larger, a condition known as hyperplasia. It is induced by a rise in
functional demand or by hormone stimulation (Singh et al., 2024). Examples
include endometrial hyperplasia brought on by an increase of estrogen
and benign prostatic hyperplasia (BPH). Without affecting cell size,
cell proliferation causes an increase in tissue or organ volume (Singh et al., 2024).
How does dysplasia differ from hyperplasia?
One
condition that is commonly thought to be a precursor to cancer is
dysplasia, which is defined by abnormal cell growth and development
inside tissues (Bakarman et al., 2023). There are cell irregularities in
terms of size, shape, and arrangement. The cellular architecture is
being disrupted. May be curable, but if the underlying cause is left
untreated, there is a greater chance that it may worsen and eventually
become malignant (cancer) (Bakarman et al., 2023). The
growth of cells that are not malignant or neoplastic is called
hyperplasia. Despite having more of them, the cells nonetheless look
normal. usually reversible if the trigger is removed, such as an
imbalance in hormones (Singh et al., 2024).
Does hyperplasia lead to neoplasia? Defend your answer.
Without
treatment, hyperplasia can lead to neoplasia. There is an increased
chance that some forms of hyperplasia, particularly those containing
atypical cells (such as atypical endometrial hyperplasia), will develop
into neoplasia. Endometrial hyperplasia carries a considerable risk of
progressing to endometrial carcinoma if it becomes atypical (Singh et
al., 2024). According to recent meta-analyses, about 33% of people with
atypical endometrial hyperplasia also have endometrial cancer
concurrently (Singh et al., 2024). According to the same study, the
annual risk of cancer progression for individuals with atypical
endometrial hyperplasia was estimated to be 8.2% if left untreated, and
2.6% for those without the condition (Singh et al., 2024). Therefore,
women with atypical endometrial hyperplasia have a higher risk of
developing endometrial cancer as compared to those without such
hyperplasia.
Part 2
A
40-year-old obese woman was undergoing menopause and noticed abnormal
bleeding during urination within my clinical experience. Within clinical
experiences patients with endometrial hyperplasia present symptoms such
as abnormal bleeding from the uterus. Abnormal uterine bleeding (such
as from irregular postmenopausal bleeding or ongoing or recurrent
bleeding) are symptoms that need medical attention to rule out
endometrial cancer (Singh et al., 2024). Some risk factors include
obesity, diabetes, or polycystic ovarian syndrome (Singh et al., 2024).
To confirm the diagnosis, an endometrial biopsy may be performed during
the pelvic exam. Treatments for endometrial hyperplasia include
progestins, combined oral contraceptives, weight management, and
exercise to balance hormones. Regular follow-ups need to be done to rule
out cancer. Educating patients about endometrial hyperplasia risks and
benefits of treatment and surgical options (such as hysterectomy) is
essential to prevent atypical hyperplasia, optimal management, and
positive outcomes.
References
Bakarman,
K., Alsiddiky, A. M., Zamzam, M., Alzain, K. O., Alhuzaimi, F. S.,
& Rafiq, Z. (2023). Developmental Dysplasia of the Hip (DDH):
Etiology, Diagnosis, and Management. Cureus, 15(8), e43207. https://doi.org/10.7759/cureus.43207
Singh, G., Cue, L., & Puckett, Y. (2024). Endometrial Hyperplasia. In StatPearls. StatPearls Publishing.
Yin,
L., Li, N., Jia, W., Wang, N., Liang, M., Yang, X., & Du, G.
(2021). Skeletal muscle atrophy: From mechanisms to treatments. Pharmacological research, 172, 105807. https://doi.org/10.1016/j.phrs.2021.105807
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