week 4 quiz Flashcards
A naturopathic doctor has 4 female patients, all of whom are coming for help with dysmenorrhea. Their characteristics are as follows:
AM, a 15-year-old with a BMI of 18
BN, a 25-year-old non-smoker
CO, a 35-year-old who also reports shorter menstrual cycles
DP, a 45-year-old whose periods started at age 13
Which of these patients is most likely to have primary dysmenorrhea?
Question 1 Answer
a.
CO
b.
AM
c.
BN
d.
DP
b.
AM
A 32-year-old patient presents to the clinic with a history of cyclic pelvic pain that intensifies during menstruation and is associated with deep dyspareunia and dyschezia. On physical examination, you notice a retroverted uterus and palpable adnexal masses.
Which of the following diagnostic evaluations is most appropriate for this patient?
Question 2 Answer
a.
Utilize transvaginal ultrasonography and, if indicated, magnetic resonance imaging to investigate for ovarian and bowel endometriomas
b.
Proceed with urinalysis and cystoscopy with hydrodistension and biopsy to assess for bladder wall mucosal irritation
c.
Perform urine tests to exclude pregnancy or infectious causes, which are common considerations in reproductive-age individuals
d.
Conduct saline microscopy of vaginal fluid to evaluate for signs of infection and microscopic examination of discharge
a.
Utilize transvaginal ultrasonography and, if indicated, magnetic resonance imaging to investigate for ovarian and bowel endometriomas
A 28-year-old woman with a history of severe dysmenorrhea presents to her naturopathic doctor. Her symptoms have been poorly controlled with over-the-counter nonsteroidal anti-inflammatory drugs, and she reports significant interference with her daily activities. She expresses a desire for a holistic approach to her care.
Which of the following interprofessional team strategies is most appropriate for managing her dysmenorrhea?
Question 3 Answer
a.
Focusing on enhancing this patient’s pain management through the prescription of stronger analgesics before consideration of non-pharmacological options, by referring her to her family doctor
b.
Arranging a referral to a gynecologist for evaluation and consideration of hormonal therapy, as suggested by clinical practice guidelines
c.
Working with the patient to develop a comprehensive treatment plan that includes a gynecologist for medical management, a pharmacist for tailored medication counseling, and a pelvic physical therapist for non-pharmacological interventions
d.
Reassuring the patient that they have come to the right place to pursue alternative medicine techniques, such as acupuncture or herbal supplements, which can now be pursued without pharmacological interventions
c.
Working with the patient to develop a comprehensive treatment plan that includes a gynecologist for medical management, a pharmacist for tailored medication counseling, and a pelvic physical therapist for non-pharmacological interventions
A 24-year-old sexually-active female presents to your clinic with a history of severe cramping pain during her menstrual periods that has not been relieved by over-the-counter pain medications or oral contraceptives. The pain, described as a dull, throbbing sensation in the lower abdomen, typically begins a day before her menses and lasts for two days. She reports no recent changes in menstrual flow or systemic symptoms. Physical and pelvic examinations are unremarkable, and a urine pregnancy test is negative.
Given her inadequate response to over-the-counter medications, what is the most appropriate next step in management?
Question 4 Answer
a.
Advise lifestyle modifications and book a reassessment after three months
b.
Arrange a prescription for oral contraceptives and book a reassessment in six months.
c.
Refer for immediate laparoscopy to evaluate for endometriosis
d.
Order a complete blood count and conduct laboratory testing for sexually transmitted infections
d.
Order a complete blood count and conduct laboratory testing for sexually transmitted infections
A 25-year-old woman with a long-standing history of primary dysmenorrhea consults her physician about her concern for future complications related to her condition. She experiences severe menstrual cramps each month, which disrupt her work schedule. However, her pelvic examinations have consistently been normal.
What is the most appropriate information regarding the prognosis and potential complications of her condition?
Question 5 Answer
a.
There is progressive risk of secondary issues such as pelvic organ prolapse
b.
Development of significant underlying pelvic pathologies is common
c.
Typically, there is improvement in symptoms with age or post-childbirth
d.
Persistent symptoms are likely, increasing the risk of chronic pelvic conditions
c.
Typically, there is improvement in symptoms with age or post-childbirth
