Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GYN > Menstrual disorders > Flashcards

Menstrual disorders Flashcards

1
Q

PMDD differs from PMS how

A

PMDD more severe and usually mood sxs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how to treat PMS

A 
pain mngmt 
OCP
diet- low Na low Caffeine, 
exercise
 NSAIDS,
SSRI for mood sxs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ddx for PMS

A

hypothyroidism
depression
PMDD
anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

labs for momma with PMS depression sxs

A 
UPT
CBC
TSH
CHEM7
HROMONES
SX chart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

tx options for depression exacerbated by menses

A

SSRI
continuous therapy
counseling
behavioral, exercise, rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

tests for irregular menses in 15 yo

A 
CBC-
factor V
PTT
von willibrands 
testosterone  (PCOS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

irregular menses 15 yo ddx

A 
anovulatory cycles 
PCOS
thyroid
pregnancy
thyroid disorder
bleeding disorder
pituitary or adrenal disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

labs for irregular menses

A

CBC
TSH, PROLACTIN, DHEA-S, INSULIN
CHEM 7
PT/PTT, additional coag tests if indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

tx for anovulatory cycle

A

can do really low dose bc pill if don’t need contraception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what tests would you run for a pt with migraines associated with recent BC

A

cbc
tsh
chem7

need to check BP (if increasing and hx of CVD not a good idea to be taking estrogen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what causes migraines associated with hormones

A

withdrawl of estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fatigue and HA assoc with menses ddx

A

hypothyroid
anemia
neuro

UPREG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

32 yo c/o PMS

fatigue
sad lonely irritable

A

Rule out thyroid disorders, anemia, blood sugar, etc.

Rule out thyroid disorders, anemia, blood sugar, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

the best screening test if you suspect premature ovarian failure

A

. Serum FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

when would you not check hormone levels in a pt complaining of PMS

A

Do not check hormone levels if pt on OCP/HRT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

if having sxs all month long

A

dx is mild depression with exacerbation during menses

tx options
SSRI
therapy
bx therapy exercise rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

when do you follow up with SSRI

A

f/u in 4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

if suspect perimenopausal want to get these tests

A

May do FSH, LH, estradiol if suspect perimenopausal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

15 yo w/ irregular menses 3-4x normal cycles and now heavy bleeding or spotting

A

need to know how heavy is heavy bleeding

is she sexually active

Anovulatory cycles
PCOS
Pregnancy 
Thyroid disorder
Bleeding disorder
Pituitary or adrenal disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

screening for bleeding disorders

A

PT & PTT as screening for bleeding disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

. Often bleeding disorders in females present

A

. Often bleeding disorders in females present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

LABS with irregular 15yo

A 
CBC
TSH
prolactin
DHEA-S, insulin (if indicated)
Chem 7 panel (fasting)
PT / PTT, additional coag tests if indicated
UPT
GC/Chlamydia?  Other sti testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

pill warning sign

A

ACHES

abdominal -blood clot, vomiting, cramping, weakness

chest pain-blood clot in lung or heart
hear attack

HA-stoke

eye problems-stoke

leg pain -inflammartion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Tx for 16 yo that can be on bc

A

Can out on birth control to normalize cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

21 yo
Returns for refill and states she has been getting more migraines than before starting the pill. H/o migraines, but they seem to be worse recently.

A 
Menstrual migraines
Tension ha
Depression/anxiety
Anemia
Cerebrovascular complication of OCP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

DX testing

A 
Diary of migraines
Consider labs if indicated by h&p
Cbc
Tsh
Chem 7 (fasting)
27
Q

TX for menstrual migraines

A 
Discontinue or change OCP
Consider alternative birth control method
NSAID
Triptan-day before off week
Supportive therapy
28
Q

menstrual migraines is the result of

A

Estrogen withraw

29
Q

37 yo with amenorrhea x2mos w/ 8 mos of irregularity

ddx

A

pregnancy

Anovulatory cycles

Premature ovarian failure /

perimenopause

Hypothyroidism

Prolactinoma

Pcos

endometriosis

30
Q

dx tests

A

upt
Tsh, prl, fsh, testosterone/dhea-s (if indicated)
Chem 7 (fasting)
Cbc

31
Q

DUB is a dx of exclusion, can be caused by

A

fibroids, polyps, hormone imbalance, uterine cancer, etc

32
Q

49 yo woman with hx of breast cancer and hot flashes

A

was her breast cancer estrogen receptive?

33
Q

what are non hormonal therapy for menopausal sxs

A

Ssri/snri
Clonidine
Pregabalin
Cbt, hypnosis

34
Q

______ cells of corpus luteum begin producing progesterone

A

Granulosa cells –> progesterone

35
Q

oligomenorrhea

A
  1. Irregular cycles lasting longer than 34 days
36
Q

polymenorrhea

A

<25 days

37
Q

when should you measure serum progesterone

A

Measurement of the serum progesterone concentration in the mid-luteal phase,

18-24 days after menses or 7 days before next menses is expected

38
Q

when should you measure FSH

A

Measurement of an early follicular phase serum FSH level on Day 3 of the menstrual cycle is used as a marker for ovarian reserve in older or infertile women

39
Q

highest probability of conception is with

A

Highest probability of conception is with intercourse 1-2 days prior to ovulation

40
Q

when does a rise LH occur

A

Rise in LH occurs about 36 hours prior to ovulation

41
Q

most common etiology of primary amenorrhea

A

Chromosomal abnormalities causing gonadal dysgenesis (50%)

42
Q

other causes of primary amenorrhea

A

Hypothalamic hypogonadism including functional hypothalamic amenorrhea (20%)

Absence of the uterus, cervix and/or vagina, müllerian agenesis (15%)

Transverse vaginal septum / imperforate hymen (5%)

Pituitary disease (5%)

43
Q

evaluation of primary menorrhea dx tests

A

a. Presence or absence of breast development (Tanner staging)
b. Presence or absence of the vagina, uterus, cervix, and ovaries
c. FSH serum level

44
Q

MCC if

A

pregnancy #1

	Ovarian disease (40%)
	Hypothalamic dysfunction (35%)

. Pituitary disease (19%)

. Uterine disease (5%)

45
Q

High FSH, LH: Dx = Ovarian Failure

A

i. ≥40 yrs: Menopause
ii. <40 yrs: Premature menopause
1. Karyotype if <30 yrs

46
Q

if you have a low FSH and LH

A

Normal/Low FSH, LH: Dx = Central Failure

Evaluate pituitary: MRI brain

Rx estrogen replacement

If pregnancy desired, induce ovulation

47
Q

elevated DHEAS

A

adrenal tumor

PCOS

48
Q

Elevated testosterone

A

PCOS

ovarian tumor

49
Q

progesterone challenge in a patient with amenorrhea

A

Withdrawal bleed: anovulation

No withdrawal bleed: check FSH, LH

50
Q

when do menstrual migraines occur

A

2 days prior to 3 days after onset of menses

51
Q

prometherin

A

progesterone

52
Q

premarin

A

estrogen

53
Q

theory behind menstraul migraines

A

: estrogen stimulates nitric oxide release which affects the vasculature leading to migraine

Progesterone concentration has no significant effect

54
Q

NSAID recommendation for menstrual migraines

A
  1. Taken 5-7 days prior to onset of menses, continue until 1-2 days after onset
55
Q

triptan recommendation for menstrual migraines

A
  1. Taken 2-3 days prior to anticipated onset of migraine
56
Q

Mastodynia occurs when, relieved with what

A

Occurs in luteal phase; relieved with menses

Most often assoc with fibrocystic changes of breast.

57
Q

mastodonia is the result of….

what is the Tx 1st and 2nd line

A

Due to high gonadotropin levels

there fore is relieved with danazol
androgen inhibitor of GnRH

OCP MOST useful and commonly

Tamoxifen, bromocriptine may be used off-label and with caution

58
Q

PMS sxs must occur during this phase of the menstrual cycle

A

Symptoms must occur in the luteal phase

May be related to decreased levels of prostaglandins

59
Q

menstrual migraine tx

A

1 - using monophasic pills (or monophasic ethinyl estradiol doses)
only one inactive pill week a few times a year, rather than monthly (ie. “Seasonale”)
main problem is breakthrough bleeding

2 - using OCP for BCM uses approx 20 mcg of EE in OCP day 1-21, then day 22-28 use 0.9 mg conjugated estrogens (Premarin)

3 - using low dose estrogen during the time when HA would normally occur
also GnRH agonists - but not FDA approved and high cost and side effects

60
Q

OTC FOR MILD PMS

A

Mild diurectic
Analgesics
Prostaglandin inhibitors
Antihistamines

61
Q

The only diuretic that has been shown in studies to alleviate fluid retention and breast tenderness associated with PMS

A

spironolactone

62
Q

RX for pMS SSRI

A

Sarafem (fluoxetine) 20mg po qd
Zoloft 25-50mg po qd
Celexa 20mg po qd

63
Q

when would you administer SSRI for PMS

A

Tx during last 2 weeks of cycle or given few days before anticipated start of symptoms. Efficacy for intermittent tx similar to continuous tx

64
Q

conditions that may worsen with the menstrual cycle

A 
Migraine
Depression
Seizures
Irritable Bowel Syndrome
Asthma
Chronic Fatigue Syndrome
Allergies

GYN (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions