PMS and PMDD

Question 1

Diagnostic steps: What question should you ask to determine if it is PMS?

Answer 1

Do your symptoms change across your cycle?

if yes or unsure -> PSST (premenstrual symptoms screening tool)

Question 2

If the PSST score suggests moderate to severe changes begin tracking for at least ___ cycles of daily symptoms.

Answer 2

2

Question 3

PMS is applicable if at least 2 symptoms. 1 _____ and 1 _____ symptom.

Answer 3

somatic - bloating, breast tenderness, headache, joint or muscle pain, swelling of extremities, weight gain
affective - angry, anxiety, confusion, depression, irritability, social withdrawal.

Question 4

PMDD is applicable if at least ___ or more symptoms are moderate to severe in the ____ phase and the remit to minimal to absent by ______?

Answer 4

PMDD is applicable if at least 5 or more symptoms are moderate to severe in the luteal phase and the remit to minimal to absent by end of menses

Question 5

What is PME?

Answer 5

Premenstrual excerbation - applicable if chronic symptoms become worse before or during menses.

Question 6

PMS diagnostic considerations: (AMCNN)
AT LEAST _____
MUST _____
CONFIRM _____
NOT _____
NOT____

Answer 6

AT LEAST 2 symptoms 1 affective and 1 somatic
MUST show distress or impairment
CONFIRM with daily rating across at least 2 cycles
NOT an exacerbation of another disorder
NOT attributable to effect of a medical condition, substance, or medication

Question 7

PMDD diagnostic considerations

Answer 7

AT LEAST : 5 total symptoms 1 emotion symptom

Rest are the same as PMS

Question 8

etiology of PMS and PMDD?

Answer 8

unknown and likely multifactoral - abnormla sensitivity to normal hormonal changes is a leading theory.

Question 9

improvement of symptoms is usually seen within ____ cycles?

Answer 9

2-3

Question 10

treatment is usually considered effective when?

Answer 10

50% reduction of luteal phase symptoms, or the difference b/t follicular and luteal phase symptoms decreased 30%

Question 11

T/F: PMS and PMDD tend to recur after stopping treatmnt

Answer 11

true

Question 12

3 main differentials to look for?

note: symptoms are where there is cross over

Answer 12

anemia - fatigue, tachycardia, palpitations

primary hypothyroidism - weight gain, fatigue, depression, weakness, constipation, muscle cramps, headaches, myalgias

Major depressive disorder - dysphoria, anhedonia, appetite changes, insomnia or hypersomnia, fatigue, worthlessness, concentration/memory

Question 13

what is the carolina premenstrual assessment scoring system (C-PASS)

Answer 13

diagnostic algorithm for making the DSM-5 diagnosis of PMDD using 2 cycles

Question 14

what ist he most accurate way to diagnosis PMS And PMDD?

Answer 14

prospective questionnaire. Pt’s tend to overestimate cyclic nature of symptoms, tracking is important.