Paulson - Menopause

Question 1

abnormal menstrual length

Answer 1

< 2 days or > 7 days

Question 2

abnormal menstrual flow

Answer 2

>80 mL

Question 3

abnormal length of cycle

Answer 3

<21 days

>35 days

Question 4

congenital d.o of reproductive system

underdeveloped, malfunctioning

Answer 4

gonadal dysgenesis/turner’s syndrome

Question 5

4 causes of primary amenorrhea

Answer 5

ovarian dysfxn

pituitary dysfxn

hypothalamic dysfxn

outflow obstruction

Question 6

ex of outflow tract obstruction

Answer 6

imperforate hymen

Question 7

does outflow tract obstruction cause lifelong amenorrhea

Answer 7

no

most other primary amenorrheas do

Question 8

cessation of previously regular menses for 3 months or previously irregular menses for 6 months

Answer 8

secondary amenorrhea

Question 9

causes of secondary amenorrhea

Answer 9

pregnancy

PCOS

meds → depo

DM

hyper/hypo thyroidism

surgery

Question 10

cause of secondary pregnancy she really wants us to know

Answer 10

pregnancy

Question 11

1st step in work up for primary and secondary amenorrhea

Answer 11

pregnancy test

Question 12

mc endocrinopathy in females

Answer 12

PCOS

Question 13

pharm for PCOS

Answer 13

OCAs

metformin

Question 14

4 screening tests to consider for PCOS

Answer 14

lipids

bp

OSA

DPN

Question 15

5 meds that cause amenorrhea

Answer 15

antihistamines

antihypertensives

antipsychotics

antidepressants

opiates

all the a’s and an o

Question 16

female athlete triad

Answer 16

eating d.o

low bone mineral density

amenorrhea

Question 17

mc pituitary tumor

Answer 17

prolactinoma

Question 18

pain w. ovulation

Answer 18

mittleschmerz

Question 19

primary dysmenorrhea is caused by

Answer 19

prostaglandin E2 in menstrual fluid

Question 20

secondary dysmenorrhea is caused by

Answer 20

pathologic causes → ex endometriosis

Question 21

how is pain in secondary dysmenorrhea different form primary

Answer 21

it lasts longer than menstrual cycle

Question 22

tx for dysmenorrhea

Answer 22

NSAIDs →

ibuprofen, naproxen, diclofenac

Question 23

2 tx for AUB that cause infertility

Answer 23

hysterectomy

endometrial ablation

Question 24

acute tx for heavy menstrual bleeding in adolescent

Answer 24

estrogen IV or PO

Question 25

maintenance therapy for AUB in adolescent

Answer 25

OCAs

injectable progesterone

levonorgestrel IUD

Question 26

management of acute abnormal uterine bleeding in nonpregnant reproductive aged woman

Answer 26

refer to OB or ER