exam 2 menstruation related disorders pp

Question 1

absence of menses

Answer 1

amenorrhea

Question 2

prolonged menstrual bleeding (>7 days) or cyclic, heavy bleeding (>80ml per cycle)

Answer 2

abnormal uterine bleeding

Question 3

pelvic pain, cramping

Answer 3

dysmenorrhea

Question 4

physical and emotional symptoms that occur during the week before the cycle

Answer 4

PMS

Question 5

severe symptoms of depression irritability, and stress starting the week before menses and resolves within a few days

Answer 5

PMDD

Question 6

infertility, osteopenia, osteoporosis

Answer 6

amenorrhea

Question 7

iron deficiency anemia

Answer 7

abnormal uterine bleeding

Question 8

increased risk for polyps, endometrial hyperplasia and carcinoma

Answer 8

anovulatory bleeding

Question 9

fourfold increases risk for type 2 diabetes and nonalcoholic fatty liver disease, sleep apnea, dyslipidemia

Answer 9

PCOS

Question 10

interference with school and/or work

Answer 10

dysmenorrhea

Question 11

treatment consideration

Answer 11

age
comorbid conditions
desire for fertility

Question 12

amenorrhea treatment goals

Answer 12

ensure normal puberty is occurring
restore normal cycle
preserve bone density
prevent bone loss, improve QOL, restore ovulation

Question 13

abnormal uterine bleeding treatment goals

Answer 13

minimize disruption of QOL
decrease bleeding
prevent or correct iron deficiency
reduce need for surgery

Question 14

anovulatory bleeding treatment goals

Answer 14

stop acute bleeding
restore natural cycle of growth and shedding
prevent osteoporosis and infertility

Question 15

dysmenorrhea treatment goals

Answer 15

reduce pain
improve QOL and missed work/school

Question 16

PMS/PMDD treatment goals

Answer 16

alleviate the presenting symptoms and improve QOL

Question 17

severe and rare ADE of estrogen

Answer 17

sever abdominal pain (mesenteric or pelvic vein thrombosis)
chest pain (heart attack or PE)
HA (storke)
eye problems (blood clot in eye)
swelling or leg pain (DVT)

Question 18

estrogen ADE

Answer 18

breast enlargement and tenderness
bloating
nausea
GI upset
HA
edema
thromboembolism (risk increases with smoking)

Question 19

progesterone ADE

Answer 19

edema
anorexia
depression
insomnia
weight gain or loss
elevated LDL
reduced HDL

Question 20

progestin only ADE

Answer 20

HA
irregular bleeding
weight gain
mood changes

Question 21

endometriosis non pharm

Answer 21

acupuncture
PT
avoid caffeine, alcohol, smoking
heating pads and hot water bottles on lower back and abdomen
massaging lower back and abdomen
regular exercise

Question 22

GnRH agonists

Answer 22

suppress estrogen effects by down regulation go GnRH receptors
leads to medical menopause
reduces endometrial tissue
only use for 6 months
cannot use in pregnancy

Question 23

GnRH antagonist

Answer 23

block GnZRH receptors
suppress FSH and LH secretion

Question 24

PMS

Answer 24

at least 1 symptom present during the 5 days before menses in the last 3 cycles

Question 25

PMDD

Answer 25

at least 5 symptoms are present for 2 cycles 1 symptom must be: lability, irritability, depressed mood, or anxiety 1 symptom must interfere with work and/or social relationships symptoms must not be an exacerbation of underlying psychiatric disorder