Mass extending halfway between the symphysis pubis and umbilicus deviated to the right of the midline.

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Sep 29, 2022


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Choose the case study below for your report and include the following:
A thorough understanding of the topic
A critical assessment of all questions
At least two differential diagnoses, if applicable
At least two pharmacologic treatment modalities, if applicable
A well-developed treatment plan
A thorough patient education plan
The body of your paper needs to be 3-4 pages long. This does NOT include the title page and reference page. Papers that are more than 4 pages long will not be accepted. You must reference a minimum of two scholarly sources on your paper.
Use current APA format to style your paper and to cite your sources. Integrate your sources into the paragraphs and use internal citations pointing to evidence in the literature and supporting your ideas.
Case Study #3: Gynecologic Abnormalities
Mrs. Jones, a 42-year-old, G3P3, presents with a history of abnormal bleeding and pelvic pain.
She was well until approximately age 35, when she began developing dysmenorrhea and
progressive menorrhagia. The dysmenorrhea was not fully relieved by NSAIDs. Over the next
several years, the dysmenorrhea and menorrhagia became more severe. She then developed
intermenstrual bleeding and spotting as well as pelvic pain, which she describes as a constant
feeling of pressure. She also complains of urinary frequency. Her past GYN history is negative.
Her surgical history includes 3 C-sections and a bilateral tubal ligation at age 30. Her past
medical history is unremarkable.
Her physical exam reveals a well-developed, well-nourished woman in no distress. Vital signs
and general physical exam are unremarkable. Her abdominal exam reveals an irregular-sized
mass extending halfway between the symphysis pubis and umbilicus deviated to the right of the
midline. The vagina and cervix appear normal on inspection. However, the cervix palpates firm.
The uterus is markedly enlarged and irregular, especially on the right side. The adnexae are not
Labs drawn: Hgb. 10.3 Hct. 31.2%. Indices are hypochromic, microcytic. Serum ferritin
confirms mild iron deficiency anemia. Pap test is negative and an ultrasound reveals multiple
large intramural fibroids, filling the pelvis and extending into the lower abdomen. The ovaries
are not visualized.
1. What are the likely causes for the mass?
2. What are your differential diagnoses? What is your final diagnosis?
3. What is the prevalence of leiomyoma in different populations of women?
4. Discuss the appropriate management of women with fibroids.
5. What are the indications for hysterectomy in women with fibroids?
6. What are nonsurgical treatment options for women with fibroids


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