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Chapter 49. Menstruation-Related Disorders

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The medical management of _______________ should result in the relief of pelvic pain, an improved quality of life, and a reduction in related lost school/work days.

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A. Amenorrhea

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B. Anovulatory bleeding

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C. Dysmenorrhea

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D. Menorrhagia

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E. Polycystic ovary syndrome

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Regardless of the cause of amenorrhea, which of the following lifestyle interventions is most appropriate?

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A. Increase the level of exercise

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B. Increase the intake of dietary calcium and vitamin D

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C. Decrease the intake of alcohol

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D. Decrease the level of exercise

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E. Transition to a gluten-free diet

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The primary goal of estrogen therapy in amenorrhea is to improve the patient’s bone health. A progestin is added to:

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A. Augment estrogen’s effects on bone

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B. Improve overall quality of life

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C. Prevent endometrial hyperplasia

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D. Restore fertility

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E. Counter estrogen’s negative effects on lipids

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A 35-year-old woman presents with complaints of increasingly heavy menses that last approximately 7 days per month. A CBC shows a 2 g/dL (20 g/L; 1.24 mmol/L) drop in hemoglobin over the past 15 months. A Pap smear and endometrial biopsy are performed, and are both negative. Her past medical history is significant for a deep vein thrombosis 3 years ago secondary to her oral contraceptive. Which of the following is most appropriate first-line therapy for this patient?

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A. A combination oral contraceptive with 50 mcg of ethinyl estradiol plus desogestrel

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B. Mefenamic acid 500 mg by mouth followed by 250 mg by mouth four times daily during menses

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C. Levonorgestrel IUD releasing 20 mcg of levonorgestrel daily

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D. Medroxyprogesterone acetate 10 mg by mouth on days 5 through 26 of the menstrual cycle

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E. Acetaminophen 650 mg by mouth four times daily

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Which of the following treatments for dysmenorrhea results in the most rapid symptom improvement?

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A. Acetaminophen

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B. Levonorgestrel IUD

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