WOMEN'S HEALTH FINAL REVIEW NSG 6430 QUESTIONS WITH
CORRECT ANSWERS LATEST UPDATE 2024 A+
GUARANTEED
1. Primary amenorrhea: absence of menses: by age 15 years
often secondary to: dysfunction in the hypothalamus, pituitary, ovaries (hpo axis),
uterus, or vagina
2. Dysmenorrhea: painful cramping: associated with menstruation caused by
spasmodic uterine contractions
most common gyn problem: in adolescents & adult females history: is
key!!!
primary versus secondary
3. Primary dysmenorrhea: absence of pelvic pathology: cause: excessive
prostaglandins
onset: in adolescence
pain: starts 1-2 days prior to onset of menses or with menses, resolving over 12-
72 hours
associated: with nausea, diarrhea, dizziness, fatigue, ha, back pain
improves: with nsaids, hormonal contraceptives, age & parity
4. Secondary dysmenorrhea: presence of pelvic pathology: onset: usually
after age 25 years
abnormal uterine bleeding (aub) variable
sx: n, v, d, back pain
,dyspareunia: (esp. W/endometriosis)
symptoms: often worsen over time
causes: endometriosis, fibroids, infection/pid, adenomyosis, etc.
5. Dysmenorrhea management: get a good history: (medical & menstrual)
physical exam: to identify a cause
pelvic exam: may defer if young, non-sexually active adolescents with mild
symptoms
consider pelvic us: to look for adnexal masses, fibroids, other pelvic pathology
if secondary, address underlying cause.
6. Dysmenorrhea non-pharm management: heat: to lower abdomen = oral
analgesics
exercise: improves symptoms
7. Dysmenorrhea pharm management: nsaids: 80-86% efficacy o start at onset
of menses for x 1-2+ days
o If no relief, consider starting 1-2+ days before
combination hormonal contraceptives (chc)
consider both, if no relief with nsaids
intrauterine contraceptive (iuc): hormonal
o Mirena or skyla (smaller) with levonorgestrel
if no relief, consider secondary cause
8. Abnormal uterine bleeding (aub): comprehensive, focused history
many causes: palm-coein classification consider differential by age & history
post-menopausal: o any bleeding beyond 12 months since lmp o even "1 drop of
blood" is concerning o must refer to obgyn to r/o cancer
9. Classification/differential: palm-coein: structural
, P
Polyps:
> 30 years
A
adenomyosis:
> 30
L
Leiomyoma/fibroids: >
30
M
Malignancy/hyperplasia:
> 40 (obesity, dm, pcos, > 50 yr)
Non structural
C
Coagulopathy:
any age
O
Ovulatory dysfunction:
Any age
E
CORRECT ANSWERS LATEST UPDATE 2024 A+
GUARANTEED
1. Primary amenorrhea: absence of menses: by age 15 years
often secondary to: dysfunction in the hypothalamus, pituitary, ovaries (hpo axis),
uterus, or vagina
2. Dysmenorrhea: painful cramping: associated with menstruation caused by
spasmodic uterine contractions
most common gyn problem: in adolescents & adult females history: is
key!!!
primary versus secondary
3. Primary dysmenorrhea: absence of pelvic pathology: cause: excessive
prostaglandins
onset: in adolescence
pain: starts 1-2 days prior to onset of menses or with menses, resolving over 12-
72 hours
associated: with nausea, diarrhea, dizziness, fatigue, ha, back pain
improves: with nsaids, hormonal contraceptives, age & parity
4. Secondary dysmenorrhea: presence of pelvic pathology: onset: usually
after age 25 years
abnormal uterine bleeding (aub) variable
sx: n, v, d, back pain
,dyspareunia: (esp. W/endometriosis)
symptoms: often worsen over time
causes: endometriosis, fibroids, infection/pid, adenomyosis, etc.
5. Dysmenorrhea management: get a good history: (medical & menstrual)
physical exam: to identify a cause
pelvic exam: may defer if young, non-sexually active adolescents with mild
symptoms
consider pelvic us: to look for adnexal masses, fibroids, other pelvic pathology
if secondary, address underlying cause.
6. Dysmenorrhea non-pharm management: heat: to lower abdomen = oral
analgesics
exercise: improves symptoms
7. Dysmenorrhea pharm management: nsaids: 80-86% efficacy o start at onset
of menses for x 1-2+ days
o If no relief, consider starting 1-2+ days before
combination hormonal contraceptives (chc)
consider both, if no relief with nsaids
intrauterine contraceptive (iuc): hormonal
o Mirena or skyla (smaller) with levonorgestrel
if no relief, consider secondary cause
8. Abnormal uterine bleeding (aub): comprehensive, focused history
many causes: palm-coein classification consider differential by age & history
post-menopausal: o any bleeding beyond 12 months since lmp o even "1 drop of
blood" is concerning o must refer to obgyn to r/o cancer
9. Classification/differential: palm-coein: structural
, P
Polyps:
> 30 years
A
adenomyosis:
> 30
L
Leiomyoma/fibroids: >
30
M
Malignancy/hyperplasia:
> 40 (obesity, dm, pcos, > 50 yr)
Non structural
C
Coagulopathy:
any age
O
Ovulatory dysfunction:
Any age
E
