Misc. - 4 Flashcards
Nomenclature around premenstrual dysphoria?
Premenstrual symptoms
Premenstrual syndrome
Premenstrual Dysphoric Disorder
Normal premenstrual symptoms are usually……. !
mild and transient
Normal premenstrual symptoms include
Minor mood change
Physical discomfort (e.g. bloating)
Premenstrualy syndrome refers to
Mild to moderate symptoms including
Emotional, physical and cognitive changes
not impairing
when do premenstrual syndrome (PMS) is thought to happen?
during luteal phase
how does PMS changes to PMDD?
when symptoms cause impairment in daily functioning + one affective symptom (mood lability, depression or anxiety)
Prevalence of normal PM symptoms?
60-80%
Prevalence of PMS?
20-40% (mild to moderate)
Prevalence of PMDD?
1-8% (moderate to severe)
The term Premenstrual Tention Synrome in ICD 11?
-idiopathic
— changes in environmental, metabolic or behavioural during luteal phase of menstrual cycle
—–>impairing cyclic emotional, physical adn behaviours symptoms
criteria for PMTS in ICD 11?
at least specific clyclic association with luteal phase and impairment
Management of PMDD/PMTD?
Combined oral contraceptives (COC)
SSRI
CBT
COC in Rx PMDD/PMTD
drospirenone and ethinylestradiol
SSRI in Rx PMDD/PMTD
Only if affective symptom present
either continue or on during luteal ph.
why could PMDD be result of?
Heightened sensitivity to cyclinical variationin reproductive hormones
Onset in PMDD?
about 1 week before menses
Criteria for PMDD in ICD-11?
1- hx of PMD
2- majority of menses within past year
3- Pattern of mood, somatic and cognitive symptoms
4-Temporal link for symptoms & luteal
5-At least 2 symptomatic cycles
6-AT LEAST ONE AFFECTIVE SYMPTOMS
RISK FOR PMD?
OBESITY
CIGARRETE SMOKING
PREV. TRAUMA
Treatments with strong evidence in PMD?
SSRI
COC
GnRH
CBT &DBT
surgical Rx for PMDD?
bilateral salpingo-oophorectormy w/ or w/out hysterectomy
how long erection should last in priapism?
More than 4 hours
&
Unrelated to sexual dysfunction
example of meds that cause priapism
antidepressant
&
Antipsychotics
how meds cause priapism?
disturb the balance between sympathetic & parasympathetic input to penile or clitoral vasculature
which antipsychotics known to cause priapism?
chlorpromazine