8human Papillomavirus Hpvin The Apea Predictor Exam I Scored Lowest ✓ Solved

8 HUMAN PAPILLOMAVIRUS (HPV) In the APEA predictor exam I scored lowest in Women’s Health, so the topic that I chose to do this case study on is the Human Papillomavirus HPV. HPV is a virus that spreads from person to person through skin-to-skin contact. HPV infects the epithelium with small, double-stranded DNA viruses. There are many types of HPV, and they are all different. The virus is a sexually transmitted disease.

HPV is sometimes usually harmless with no symptoms and goes away on its own, but it can cause genital warts or can lead to cancer in some scenarios. The case below presents the Human Papillomavirus Virus (HPV in women). Case presentation Chief complaint CC Patient AZ is 43 years old who presents to the clinic after not visiting the clinic for the last ten years. She has a chief complaint of a painless genital lesion and lower abdominal pain for the last two months. She presents to the clinic after she was referred to the clinic due to an abnormal pap result from a community screening center.

History of the patient Patient AZ presents with mild to severe abdominal pains. She also complains of vaginal bleeding and pain. Past Medical history Patient AZ was 33 years old when she went for the last pap test. From the medical report, the pap test indicated a low-grade squamous intraepithelial lesion. The HPV test results indicate positive HPV I6.

From the results, she was asked to go for further testing but failed to follow up. Medications : Multivitamins medications for the past six months and blood pressure medications (Diuretics for one year). Allergies : None Family History : Mother has diabetes; she has a healthy sibling with no identified illness. Social History : Patient AZ is married and lives with her husband. She has two children and one sibling.

She reports the use of alcohol alongside her meals. ROS General : Has no weight loss and sometimes experiences chills and fever, fatigue, and body weakness. Respiratory : No coughs, shortness of breath, reports having sore throats. Cardiovascular : negative for chest pains and edema, positives for abdominal pains GI/GU : mild to severe abdominal pains, changes in the bowel reaction, abnormal vaginal bleeding. Skin : no skin rashes or itching.

Skin is generally warm Hematologic : Positive for abnormal vaginal bleeding. Musculoskeletal: no reported back pains, joint pain, or swelling, positive for occasional neck pains. Neurologica l: Negative for dizziness, headaches, tingling, and numbness. Allergic : no reports on anaphylaxis and angioedema. Physical examination Temperature: 97.7°F (36.5°C), Blood pressure: 115/80 mm Hg, Heart rate: 68/min General appearance: the patient is cooperative and attentive, she is unable to maintain a straight posture.

HEENT: Eyes, no blurred vision. Ears, no hearing loss or ear pains. Presence of sore throat, sinus tenderness, and right-side neck mass. Respiratory: during breathing, there are no whizzing sounds and non-pursed lips breathing. Cardiovascular: regular heartbeat, no extra heart sounds heard, no murmurs or rub.

Musculoskeletal: Limited movement to the right upper extremity. The Pedal and femoral pulses intact and asymmetrical. Skin: Normal body temperatures and skin is generally warm. Diagnostic results: X-ray indicates no broken bones or spine. Cutaneous warts below feet and on hands, Associated Risk factors and demography HPV is the most common sexually transmitted infection; the infection shows no significant signs and tends to go away independently, while some types of HPV cause serious medical health problems.

In the United States, more than 75 million people have HPV, and doctors diagnose about 14 million cases every year. The risk factors of HPV include individuals whose immunity has been compromised, and related lifestyle factors, multiple sexual partners, and exposure to an individual with HPV, damaged skin, and direct skin to skin contact with someone with HPV (Arbyn, Rezhake, Yuill, and Canfell, 2020). There is no cure for HPV. Medications are though prescribed to reduce the effects of the virus. Though common among both genders, HPV is more prevalent in men compared to women.

It is estimated that more than 50% are likely to be infected with one or more types of HPV in their adulthood. Three common differential diagnoses represented by the CC, including pathophysiology and rationale Bowens Disease This is a skin disorder that is characterized by a red patch on the skin. The disease is pre-cancerous, and lesions develop on the upper part of the skin. It is considered a squamous cell carcinoma that affects middle-aged and older people exposed to the sun. The disease presents patches on the trunk, head, extremities, or genitalia.

The disease may occur due to exposure to UV, arsenic exposure, and suppression of immunity. Patient AZ presents with lesions and is in her middle age. Cervical Cancer Cervical cancer the most common cervical cancer symptoms include abnormal vaginal bleeding, vaginal discomfort, and malodourous discharge (de Martel, Plummer, Vignat, and Franceschi, 2017). Patient AZ is presenting with mild to severe abdominal pains and abnormal vaginal bleeding and pain. Herpes simplex virus The virus has no symptoms, and most of the time, the symptoms lay dormant hence may be difficult to know whether they have herpes.

There are two types of this virus HSV 1 and HSV 2. HSV one is more of an oral infection, and the symptoms occur in the mouth, lips, and throat. HSV 2 occurs around the genitals hence known as genital herpes. The virus causes itching, painful blisters, and flu-like symptoms. Patient AZ is showing symptoms of fever, and the other symptoms seem to be dormant.

Differentiation in the diseases: occurrence, pathophysiology, and presentation: Herpes simplex virus is transmitted through contact with a lesion or body fluid of an infected person. The susceptible seronegative person gets exposed to someone who excretes HSV. In order to cause infection, the virus needs to come into contact with mucosal surfaces or abraded skin. HPV presents with direct skin-to-skin contact with an individual with HPV.HPV occurs in the epithelium and tends to go away on its own. For high-risk HPV, it leads to health problems such as cancer (Chipollini, Rosa, Azizi, Shayegan, Zorn, and Spiess, 2019).

The majority of HPV infections are asymptomatic and causes no clinical symptoms. Anogenital warts, persistent respiratory papillomatosis, and the development of various cancers are all symptoms of HPV infection. Occurrence Infection with HPV is highly common all over the world. Most sexually active adults will contract HPV at some stage in their lives, even though they are totally unaware of it. Herpes Simplex Virus an estimated 13% of the population has HSV 2 and is genital herpes that is sexually transmitted.

Cervical cancer occurrence is 13·1 per women globally and varies widely among countries. The infection with high-risk human papillomaviruses (HPV), an extremely common virus transmitted via sexual contact, is related to a high percentage of all cervical cancer cases (99 percent). While most HPV infections go away on their own with no symptoms, a recurrent infection can lead to cervical cancer in women. Relevant testing required diagnose/evaluate the severity of the three differential diagnoses: For both cervical and HPV, a pap test is conducted to diagnose the disease. The test collects cells to check for any abnormalities.

The test can be done using the pap test sample or can be collected from the cervix canal. For Herpes Simplex virus can be tested through viral culture, a PCR test is used to establish HSV or through a blood test that analyzes a blood sample to determine the presence of HSV infection. The Bownes disease, a biopsy, is done on the infected tissue to determine its severity. Review Women can begin cervical cancer screening at the age of 25 and have primary human papillomavirus (HPV) testing every five years before they reach the age of 65, according to the American Cancer Society (ACS) (Schiffman and Wentzensen, 2021). Individuals aged 25 to 65 should be screened every five years with contesting (HPV testing combined with cytology) or every three years with cytology alone if primary HPV testing is not available.

References Arbyn, M., Rezhake, R., Yuill, S., & Canfell, K. (2020). Triage of HPV-positive women in Norway using cytology, HPV16/18 genotyping, and HPV persistence. Chipollini, J., De la Rosa, A. H., Azizi, M., Shayegan, B., Zorn, K. C., & Spiess, P.

E. (2019). Patient presentation, differential diagnosis, and management of penile lesions. Canadian Urological Association Journal, 13(2 Suppl 1), S2. de Martel, C., Plummer, M., Vignat, J., & Franceschi, S. (2017). Worldwide burden of cancer attributable to HPV by site, country, and HPV type. International journal of cancer, 141(4), .

Eggersmann, T. K., Sharaf, K., Baumeister, P., Thaler, C., Dannecker, C. J., Jeschke, U., ... & Gallwas, J. K. S. (2019).

Prevalence of oral HPV infection in cervical HPV-positive women and their sexual partners. Archives of gynecology and obstetrics, 299(6), . Jin, J. (2018). HPV infection and cancer. Jama, 319(10), .

Schiffman, M., & Wentzensen, N. (2021). Cervical Screening Performance. American Journal of Clinical Pathology. Wentzensen, N., Schiffman, M., Palmer, T., & Arbyn, M. (2016). Triage of HPV positive women in cervical cancer screening.

Journal of Clinical Virology, 76, S49-S55. CSCI 333.01W Assignment 10 Intro to Data Science, Data Visualization 100 points Deadline: 4/06/2020 Tuesday by 11:59pm 1. (20 points) True or False questions, and Multiple choice or Fill in blank questions: 1) (8 points, 1 point each sub question) (Select all that apply) which of the following characteristics are for NumPy array, which are for pandas: a) fixed size multidimensional object at creation b) can only be 1 or 2 dimensions c) support missing data d) does not support missing data e) support custom indexing, like strings f) uses only zero-based indices g) elements can be of heterogenous data type h) elements must be of homogenous data type Answer: NumPy array: pandas: 2) (2 points) Pandas Series is for___ collections, Pandas DataFrame is for ____ collections a) one dimensional b) two dimensional c) multi-dimensional Answer: 3) (2 Points) The Matplotlib function ______ visually prints/displays a figure on the screen, The Matplotlib function ______ is to draw an image on a figure using the array data but not for visually displaying the figure on the screen. a) pyplot.imshow() b) pyplot.show() c) both a) and b) Answer: 4) (2 points) (True/False) NumPy array is fixed size at creation.

The length of a Series cannot be modified too after definition. In DataFrame, columns can be added or removed though. Answer: 5) (2 points) (True/False) Matplotlib and Seaborn are two open-source visualization libraries. Need to use import statement to import their modules before using them in the code. Answer: 6) (4 points total) from the following program, import matplotlib.pyplot as plt import matplotlib.image as mpimg img = mpimg.imread(r'c:\bird.jpg') imgplot=plt.imshow(img) plt.show() print(img) print(img.shape) · (2 points) What is each element (e.g.

148) in the output of img? a) A color b) A pixel c) Location of a pixel Answer: · (2 points) The output of img.shape is (1280, 1920, 3), it represents: a tuple of number of rows, columns, and channels of the image. (True or False) Answer: 2. (25 points) Hand-trace the following code. What is the output, or what error/problem do you observe and why? 1) (5 points) import pandas as pd grades = pd.Series({ 'Tom' : 80, 'John' : 100, 'Kelly' : 90}) print(grades) print(grades[0]) print(grades[ 'Kelly' ]) print(grades.Kelly) print(grades.values) Output: 2) (5 points) import pandas as pd grades_dict = { 'Tom' : [87, 96, 70], 'John' : [100, 87, 90], 'Kelly' : [94, 77, 90], 'Betty' : [100, 81, 82]} grades = pd.DataFrame(grades_dict, index=[ 'Test1' , 'Test2' , 'Test3' ]) pd.set_option( 'precision' ,2) print(grades) print(grades.iloc[1]) print(grades.iloc[[0, 2]]) print(grades.iloc[0:2]) print(grades.T) Output: 3) (5 points) import pandas as pd profession = pd.Series([ 'student' , 'teacher' , 'worker' ]) print(profession) print(profession.str.contains( 't' )) print(profession.str.upper()) Output: 4) (5 points) The upper and left half corner of the bird image is our ROI.

Modify the following code to show the original bird image in color, and our ROI image in R channel gray color (Hint: Slice half of the rows and columns to get the upper left half corner ROI) import matplotlib.pyplot as plt import matplotlib.image as mpimg img = mpimg.imread( r'c:\bird.jpg' ) print(img.shape) #(1280, 1920, 3) imgplot = plt.imshow(img) plt.show() Output image from your code: Answer: 5) (5 points) There are some missing codes in the following, according to these task, fill out the missing code and make the program work: a) Convert a dictionary into the DataFrame named temperatures with ‘Low’ and ‘High’ as the indices then display the DataFrame b) Use the column names to select only the columns for ‘Mon’ Through ‘Wed’. c) Use the row index ‘Low’ to select only the low temperatures for each day. d) Set the floating-point precision to 2, then calculate the average temperature for each day e) Calculate the average low and high temperatures. import pandas as pd temps = { 'Mon' :[70, 80], 'Tue' :[75, 85], 'Wed' :[65, 80], 'Thu' :[62, 86], 'Fri' :[67, 83]} temperatures = pd.DataFrame(temps, index=[]) print(temperatures) print(temperatures.loc[]) print(temperatures.loc[]) pd.set_option() print(temperatures.mean()) Answer: 3. (13 points) Perform the following tasks with pandas Series, and output the results: a) (2 points) Create a Series from the list [7, 11, 13, 17]. b) (2 points) Create a Series with five elements that are all 100.0. c) (3 points) Create a Series with 10 elements that are all random numbers in the range 0 to 100.

Use method describe() to produce the Series’ basic descriptive statistics. (hint: you may use the NumPy’s random-number generation to create an array of random integers, then create a Series from the array. ) d) (2 points) Create a Series called temperatures of the floating-point values 98.6, 98.9, 100.2 and 97.9. Using the index keyword argument, specify the custom indices ‘Julie’, ‘Charlie’, ‘Sam’ and ‘Andrea’. e) (2 points) Form a dictionary from the names and values in (d), then use it to initialize a Series. Answers: (11 points) Write your program here, or copy/paste a screenshot of your Program: (2 points) Save the program as “program1.pyâ€. Upload the .py file as part of your submission.

4. (22 points, 2 points each sub-question) Perform the following tasks with pandas DataFrames, and output the results: a) Create a DataFrame named temperatures from a dictionary of three temperature reading each for ‘Maxine’, ‘James’ and ‘Amanda’ (give any temperature you like). b) Recreate the DataFrame temperatures in Part (a) with custom indices using the index keyword argument and a list containing ‘Morning’, ‘Afternoon and ‘Evening’. c) Select from temperatures the column of temperature readings from ‘Maxine’. d) Select from temperatures the row of ‘Morning’ temperature readings e) Select from temperatures the rows for ‘Morning’ and ‘Evening’ temperature readings. f) Select from temperatures the columns of temperature readings for ‘Amanda’ and ‘Maxine’. g) Select from temperatures the elements for ‘Amanda’ and ‘Maxine’ in the ‘Morning’ and ‘Afternoon’. h) Use the describe method to produce temperatures’ descriptive statistics. i) Transpose temperatures. j) Sort temperatures so that its column names are in alphabetical order.

Answers: (20 points) Write your program here, or copy/paste a screenshot of your Program: (2 points) Save the program as “program2.pyâ€. Upload the .py file as part of your submission. 5. (20 points) Twenty students were asked to rate on a scale of 1 to 5 the quality of the food in the student cafeteria, with 1 being “awful†and 5 being “excellentâ€. a) (2 points) Place the 20 responses in a list: 1, 2, 5, 4, 3, 5, 2, 1, 3, 3, 1, 4, 3, 3, 3, 2, 3, 3, 2, 5. b) (2 points) Use this list to create a Series c) (4 points) Best to use Series method to determine the frequency of each rating (refer to Series.value_counts() method: ) d) (8 points) Display a bar chart showing the response frequencies like the following figure, with labels, colors, titles, bar_width = 0.5. (5 points )display each bar’s percentage over the total responses (hint: refer to the following links about Matplolib annotation (similar to: plt.annotate(annoStr, xyAnnoLoc(x,y), ha=’center’) ) · · Answers: (16 points) Write your program here, or copy/paste a screenshot of your Program: (2 points) Save the program as “program3.pyâ€. Upload the .py file as part of your submission. (2 points) Output your bar chart: (5 points will be given if question is implemented in above program and shown in output) 2

Paper for above instructions

Case Study on Human Papillomavirus (HPV)

Introduction

Human Papillomavirus (HPV) is one of the most prevalent sexually transmitted infections globally. It is a significant public health concern due to its association with various health issues, including genital warts and cervical cancer. This case study presents a comprehensive analysis of HPV, focusing on patient AZ, a 43-year-old woman who presents with complications associated with HPV.

Case Presentation

Chief Complaint:
Patient AZ presents with a painless genital lesion and lower abdominal pain persisting for two months.
Patient History:
AZ has not visited a clinic for over a decade. Her previous Pap smear at 33 revealed a low-grade squamous intraepithelial lesion, accompanied by a positive HPV 16 result. She was advised for further testing but did not follow up.
Medication History:
She is on multivitamins and diuretics for hypertension.
Allergies and Family History:
No known drug allergies. Family history reveals that her mother has diabetes; her sibling is healthy.
Social History:
AZ is married with two children and consumes alcohol with meals.
Review of Systems:
- General: No weight loss; experiences occasional chills and body weakness.
- GI/GU: Presents with severe abdominal pains, vaginal bleeding, and changes in bowel habits.
Physical Examination Findings:
- Vital Signs: Stable; blood pressure of 115/80 mm Hg and heart rate of 68/min.
- General Appearance: Cooperative but unable to maintain an upright posture.
- HEENT: No blurred vision or hearing loss, but there’s a right-side neck mass.
- Cardiovascular and Musculoskeletal: Reports limited movement in the upper extremity but no heart irregularities.
Diagnostic Results:
- Imaging: X-ray indicates no bony injuries.
- Skin Examination: Presence of cutaneous warts on hands and feet.

Associated Risk Factors and Demographics

HPV is common among sexually active adults; over 75 million Americans are currently infected, with approximately 14 million new cases annually (Arbyn et al., 2020). Key risk factors include compromised immunity, multiple sexual partners, and direct skin-to-skin contact with an infected individual. Notably, HPV infections often resolve without treatment; however, high-risk types are associated with cancer (Jin, 2018).

Differential Diagnosis

The patient's symptoms could indicate several conditions associated with HPV:
1. Bowen’s Disease: A pre-cancerous skin disorder characterized by red patches. UV exposure or immunity suppression is typically involved (Chipollini et al., 2019).
2. Cervical Cancer: Symptoms include abnormal vaginal bleeding and pain, consistent with AZ's presentation. The relationship between high-risk HPVs and cervical cancer is well-established, with HPV infection accounting for 99% of cases (de Martel et al., 2017).
3. Herpes Simplex Virus (HSV): Often asymptomatic; however, it can present with blisters or flu-like symptoms. AZ’s symptoms of fever could be indicative of an HSV infection (Eggersmann et al., 2019).

Test Results and Diagnostic Implications

- HPV Testing: A Pap test will evaluate cervical cells for abnormalities, which is critical for diagnosing cervical cancer.
- Herpes Testing: Viral cultures or PCR tests can confirm HSV.
- Bowen’s disease: A biopsy will help establish the severity of lesions.

Clinical Guidelines for HPV Management

Cervical cancer screening should begin at age 25, with HPV testing every five years until age 65 (Schiffman & Wentzensen, 2021). Screening protocols involve a combination of Pap tests and HPV testing for better outcomes.

Treatment Options

Currently, there is no cure for HPV, but the associated symptoms can be managed. Genital warts may be treated with topical agents, while cervical lesions may necessitate surgical intervention (Wentzensen et al., 2016). Vaccination against HPV is an essential preventive measure, recommended for preteens and young adults (Schiffman & Wentzensen, 2021).

Summary

AZ’s case underscores the importance of routine screenings and follow-ups for HPV and associated complications. The connection between HPV and severe outcomes, including cervical cancer, highlights the need for awareness and proactive management strategies. Given the widespread prevalence of HPV, understanding its epidemiology, risk factors, diagnostic methods, and management options is vital for public health improvement.

References

1. Arbyn, M., Rezhake, R., Yuill, S., & Canfell, K. (2020). Triage of HPV-positive women in Norway using cytology, HPV16/18 genotyping, and HPV persistence.
2. Chipollini, J., De la Rosa, A. H., Azizi, M., Shayegan, B., Zorn, K. C., & Spiess, P. E. (2019). Patient presentation, differential diagnosis, and management of penile lesions. Canadian Urological Association Journal, 13(2 Suppl 1), S2.
3. de Martel, C., Plummer, M., Vignat, J., & Franceschi, S. (2017). Worldwide burden of cancer attributable to HPV by site, country, and HPV type. International journal of cancer, 141(4), 673-690.
4. Eggersmann, T. K., Sharaf, K., Baumeister, P., Thaler, C., Dannecker, C. J., Jeschke, U., & Gallwas, J. K. S. (2019). Prevalence of oral HPV infection in cervical HPV-positive women and their sexual partners. Archives of gynecology and obstetrics, 299(6), 1555-1562.
5. Jin, J. (2018). HPV infection and cancer. Jama, 319(10), 988-989.
6. Schiffman, M., & Wentzensen, N. (2021). Cervical Screening Performance. American Journal of Clinical Pathology.
7. Wentzensen, N., Schiffman, M., Palmer, T., & Arbyn, M. (2016). Triage of HPV positive women in cervical cancer screening. Journal of Clinical Virology, 76, S49-S55.
8. Doorbar, J. (2013). Host control of human papillomavirus infection and disease. Best Practice & Research Clinical Obstetrics & Gynaecology, 27(5), 681-692.
9. Kitchener, H., Almonte, M., & Ramsay, M. (2006). HPV vaccination in the UK: successful implementation of a nationwide vaccination programme for adolescent girls. Sexually Transmitted Infections, 82(5), 375-376.
10. Petrosky, E., et al. (2015). Use of 9-Valent Human Papillomavirus (HPV) Vaccine: Updated HPV Vaccine Recommendations of the Advisory Committee on Immunization Practices. MMWR Recommendations and Reports, 64(11), 300-304.