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16 Cards in this Set
- Front
- Back
What is the primary feature of PMS that helps in its diagnosis?
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Cyclical occurence of symptoms
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What are the most common SOMATIC symptoms of PMS?
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-Bloating
-Constipation/diarrhea -Headache -Fatigue -Breast swelling and pain |
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What are the most common EMOTIONAL symptoms of PMS?
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-Irritability
-Changes in libido -Hostility -Anxiety -Depression |
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What are the most common BEHAVIORAL symptoms of PMS?
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-Food cravings
-Loss of concentration -Loss of motor skills -Sensitivity to noise |
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What phase of the female reproductive cycle does PMS seem to be related to? Why?
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Luteal phase - because estradiol levels are much higher than progesterone
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Why would lower progesterone levels be related to anxiety and irritability?
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Progesterone seems to have a sedating effect on the CNS
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What drug withdrawal do symptoms of PMS in some patients mimic? Why?
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Opiate withdrawal - because of lower endorphin levels
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What can alleviate PMS in this subset of patients?
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Exercise - releases endorphins
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How is PMS diagnosed?
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Patient keeps a diary of key symptoms and at which part of the cycle they occur in.
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What is necessary to confirm the diagnosis of PMS?
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Absence of symptoms in the FOLLICULAR phase, but presence in the LUTEAL phase
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What is the 1st step in treating PMS?
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Educate the patient and reassure her that there likely is a physiologic explanation for her symptoms
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What dietary recommondations are given for PMS?
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-More fresh foods
-Less processed |
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What should be advised in addition to dietary recommendations?
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Exercise
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What medications can help PMS?
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Meds to induce anovulation
-OCPs -Danazol -GnRH agonists (last 2 are medical oophorectomy) |
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What 2 additional meds help with pain in PMS?
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-NSAIDs
-Progesterone - vag suppository or oral micronized |
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What diuretics can be given to reduce bloating and swelling in PMS?
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-Spironolactone
-HCTZ with K+ suplementation -HCTZ w/ Triamterene (Dyazide) |