Module 1 BBB Practice Questions Flashcards
Why do adolescence have more irregular menses?
Their HPO axis is underdeveloped. It may be 1-2 years before their period is regular.
When would we be using Tanner staging?
When a teen/adolescent or parent asks if they are normal or concerned about their development.
When should testing begin for an adolescent that has not started their menstrual cycle?
At age 13 without any sex characteristics or age 15 with characteristics but no menarche.
Does the evidence support routine pelvic exams?
The evidence does not support routine pelvic exams as screening tests. It is not recommended without symptoms or concerns during a well exam.
There are a few organizations that recommend against routine pelvic exam, but ACOG doesn’t recommend for or against. What should you as the provider do?
Use shared decision-making!
If a patient is not getting a routine pelvic exam, what should the time be used for?
Health maintenance. I.E. discussing diet, exercise, safety, vaccinations, stress levels, etc.
Which patient needs a speculum exam?
A) Sexually active teen who wants contraception
B) Virginal teen who has dysmenorrhea
C) 32-year old who is due for a cervical screening
D) 45-year old who is here for a well visit, but is up to date on PAP
E) 18-year old with a new sexual partner but no abnormal discharge or dyspareunia
C
Your patient reports a menstrual cycle that lasts 34 days and is very regular. When do they typically ovulate?
Day 20
When the BBT rises, does this mean you are fertile?
No, it indicates that ovulation has happened
What causes primary dysmenorrhea?
Prostaglandins and an absence of pathology
How can we differentiate between primary and secondary dysmenorrhea?
Age-more likely to be primary if close in age to menarche
Symptoms: Change in symptom pattern may indicate secondary
Describe the symptoms of primary dysmenorrhea.
Abdominal cramping, GI symptoms, Back pain, leg pain,
What is first line management for primary dysmenorrhea?
-NSAIDs 2-3 days before the period starts-decreases the level of prostaglandins and the amount of bleeding
-Heat, aerobic exercise 30m 3 times a week (can decrease by up to 80%)
-CHC
**Review table in chapter 25
When in the menstrual cycle does PMS/PMDD occur?
The luteal phase, the week before the period starts
If someone didn’t ovulate, would you expect them to have PMS symptoms?
No