Patient Assessment Female 3

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Patient Assessment Female 3
2013-11-29 12:29:03
Patient Assessment Female
Patient Assessment Female 3
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  1. The first occurrence of Primary Dysmenorrhea occurs at what point?
    Within the first 3 years of menses
  2. The prevalence of Primary Dysmenorrhea decreases with ___________.
    Age or after Childbirth
  3. What is the MOA for Primary Dysmenorrhea?
    Release of prostaglandins and leukotrienes into the menstrual fluid leading to inflammation and painful vasoconstriction
  4. Is Primary Dysmenorrhea uncommon?
  5. Is Primary Dysmenorrhea considered a serious problem?
  6. What is used to treat primary Dysmenorrhea?
    Oral contraceptives, diet, NSAIDs and exercise
  7. What is secondary Dysmenorrhea?
    Dysmenorrhea with a significant underlying pathology
  8. What can cause secondary Dysmenorrhea?
    IUD complications, PID, Ovarian cysts, Uterine fibroids, endometriosis
  9. When is the Onset of Secondary Dysmenorrhea?
    Any age, most likely over 25
  10. How is Secondary Dysmenorrhea treated?
    By treating the underlying pathology
  11. What are the signs and symptoms of Primary Dysmenorrhea?
    Pain begins with onset of menses and peaks on first day, lower abdominal or suprapubic cramping, Pain with N and V, fever, HA and lightheadedness, pain radiates to back or thighs, stops with menses
  12. What dietary changes can be used to treat Dysmennorhea?
    Decrease Sodium, Caffeine and Fat
  13. Why is exercise a treatment for Dysmenorrhea?
    Suppresses prostaglandin release, increases endorphins, shunts blood from the uterus and decreases stress
  14. Define Premenstrual syndrome:
    Broad term for a number of behavioral and somatic symptoms occurring during the late luteal phase of the menstrual cycle and disappearing after the onset of menses
  15. What is the etiology of PMS?
  16. Estrogen peaks before or after ovulation?
  17. Progesterone peaks before or after ovulation?
  18. The first phase of the menstrual cycle, which includes menstruation and the development of the follicle, prior to ovulation is called what?
    Follicular phase
  19. The second half of the menstrual cycle that occurs after ovulation is called what?
    Luteal phase
  20. What is the incidence of PMS?
    90% of all women, 40% of childbearing age have significant disruptive systems and 3-5% have severe impairment
  21. What psychological complaints are common with PMS?
    Anxiety, Irritability, Depression/sadness/hopelessness, tension, mood swings, crying and difficulty concentrating
  22. What physical complains are common with PMS?
    Acne, abdominal bloating/cramping, backache, breast tenderness, HA, Constipation/diarrhea, N/V, weight gain
  23. What is Premenstrual Dysphoric Disorder?
    Severe subtype of PMS (5% of most severe PMS)
  24. What percent of women have Premenstrual Dysphoric Disorder?
  25. The symptoms of Premenstrual Dysphoric Disorder are similar to what?
    Major depressive disorder
  26. Premenstrual Dysphoric Disorder suffers are 14 times more likely to have what?
    Major depressive disorder
  27. Why is it difficult to diagnose PMS?
    100 symptoms associated, not lab test
  28. How is PMS usually diagnosed?
    Charting of symptoms that appear/change during luteal phase and disappear in follicular phase
  29. What are the first line treatments for PMS?
    Regular sleep, caffeine restriction, Exercise, Smoking and alcohol cessation, low intake of fats and sodium, stress management, outdoor activities, light therapy, acupuncture
  30. (True/False) Midol contains caffeine.
    True 2 Midol caplets = 1 cup of coffee
  31. What are the pharmacologic treatments for PMS?
    Antidepressants, NSAIDs and Diuretics
  32. What antidepressants may be prescribed for PMS (per FDA)?
    SSRIs: Fluoxetine (Prozac), Sertraline (Zoloft) and Paroxetine (Paxil) (TCAs and SNRIs can also be sued)
  33. Do SSRIs need to be continuously administered for PMS?
    No can administer only during Leuteal phase
  34. What does PAP smear stand for?
    Papanicolaou Smear
  35. On what schedule should PAP smears be performed?
    Yearly after 18