Module 1 BBB Practice Questions Flashcards

1
Q

Why do adolescence have more irregular menses?

A

Their HPO axis is underdeveloped. It may be 1-2 years before their period is regular.

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2
Q

When would we be using Tanner staging?

A

When a teen/adolescent or parent asks if they are normal or concerned about their development.

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3
Q

When should testing begin for an adolescent that has not started their menstrual cycle?

A

At age 13 without any sex characteristics or age 15 with characteristics but no menarche.

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4
Q

Does the evidence support routine pelvic exams?

A

The evidence does not support routine pelvic exams as screening tests. It is not recommended without symptoms or concerns during a well exam.

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5
Q

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?

A

Use shared decision-making!

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6
Q

If a patient is not getting a routine pelvic exam, what should the time be used for?

A

Health maintenance. I.E. discussing diet, exercise, safety, vaccinations, stress levels, etc.

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7
Q

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

A

C

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8
Q

Your patient reports a menstrual cycle that lasts 34 days and is very regular. When do they typically ovulate?

A

Day 20

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9
Q

When the BBT rises, does this mean you are fertile?

A

No, it indicates that ovulation has happened

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10
Q

What causes primary dysmenorrhea?

A

Prostaglandins and an absence of pathology

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11
Q

How can we differentiate between primary and secondary dysmenorrhea?

A

Age-more likely to be primary if close in age to menarche
Symptoms: Change in symptom pattern may indicate secondary

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12
Q

Describe the symptoms of primary dysmenorrhea.

A

Abdominal cramping, GI symptoms, Back pain, leg pain,

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13
Q

What is first line management for primary dysmenorrhea?

A

-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

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14
Q

When in the menstrual cycle does PMS/PMDD occur?

A

The luteal phase, the week before the period starts

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15
Q

If someone didn’t ovulate, would you expect them to have PMS symptoms?

A

No

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16
Q

How can we differentiate PMS from depression?

A

The timing of the symptoms. They will be fine most of the time and then struggle right before their cycle.

17
Q

How can we differentiate PMS from PMDD?

A

The severity of symptoms.

PMS: they are coping but want something to be done.
PMDD: they are not functioning. Ex. suicidal, homicidal

18
Q

A patient presents to you with symptoms of PMS, what will help us determine how to care for this patient?

A

Daily record of symptoms for 2 months AND/OR ask what symptoms bother them the most

19
Q

What management options do we have for PMS?

A

-SSRI: often the first line. Can take daily or on the first day of symptoms until the menstrual cycle begins
-CBT
-Exercise
-Adequate sleep
-Supplements: Ca, tumeric,