In your Case Study Analysis related to the scenario provided, explain the following:
1.The factors that affect fertility (STDs).
- Why inflammatory markers rise in STD/PID.
- Why infection happens. Also, explain the causes of a systemic reaction.
A 32-year-old female presents to the ED with a chief complaint of fever, chills, nausea, vomiting, and vaginal discharge. She states these symptoms started about 3 days ago, but she thought she had the flu. She has begun to have LLQ pain and notes bilateral lower back pain. She denies dysuria, foul-smelling urine, or frequency. States she is married and has sexual intercourse with her husband. PMH negative.
Labs: CBC-WBC 18, Hgb 16, Hct 44, Plat 325, Neuts & Lymphs, sed rate 46 mm/hr., C-reactive protein 67 mg/L CMP wnl
Vital signs T 103.2 F Pulse 120 Resp 22 and PaO2
99% on room air. Cardio-respiratory exam WNL with the exception of tachycardia but no murmurs, rubs, clicks, or gallops. Abdominal exam + for LLQ pain on deep palpation but no rebound or rigidity. Pelvic exam demonstrates copious foul-smelling green drainage with reddened cervix and + bilateral adnexal tenderness. + chandelier sign. Wet prep in ER + clue cells and gram stain in ER + gram negative diplococci.
While a set of frameworks complement and build on each other, the delineation of the concept focuses heavily on vertical versus horizontal dimensions in a time-sliced fashion. That is, time dimension in accountability has not been of primary importance. However, it is worth noting that the time dimension is closely interrelated with a series of conceptual distinctions made in previous literature, and it may cover complementary aspects of the question concerning two sequential lines represented by administrative responsibility versus political accountability. First, the positioning of accountability actors depends on the time dimension. Civil servants usually have longer terms to serve the public interest over the long term. At the same time, they are responsible to the elected representatives of the public who tend to have “a limited time horizon” and “prefer policies that yield tangible benefits for constituents in the near term” (Posner, 2004: 137). For this reason, the priorities expressed by elected officials may be far more related to short-term issues and temporal problems instead of long-term solutions, whereas the long-lasting forms of civil service personnel would prioritize sustainable solutions to secure a long-term perspective of the citizens, both current and in the future. Second, the time frame is essential to distinguishing between two main streams of accountability. Accountability mechanisms focus predominantly on retroactive accountability for the past outcomes, while accountability as a virtue takes a proactive approach to ensuring ethical behaviors in the future. The timeline is also useful to distinguishing between ex ante accountability of the decision-making process leading up to the decision and ex post accountability where the results available from the decision already taken or where questions of compliance are identified and addressed. In other words, ex ante accountability refers to being accountable for the decision before an administrator act, while ex post accountability is suggestive of situations where administrators are accountable for the outcome of their decisions. For example, the focus of traditional bureaucratic administration is very much>GET ANSWER