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salihabduallah
Century Club
Joined: 04 Sep 2007
Posts: 120
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 Posted: Thu Oct 04, 2007 1:24 pm Post subject: Can we discuss some subject? PMS |
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| Please , any study partner to discuss essays for march 2008 exam ? |
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rpwalavalkar
Teale Fenning Administrator
Joined: 20 Jul 2006
Posts: 966
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| Posted: Fri Oct 05, 2007 2:46 pm Post subject: |
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this post has been moved to 'study buddy'. please look for replies there.
Teale - Fenning aministration
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Dr Miss. Raj Walavalkar MBBS MRCOG
TealeFenning Administrator
SR O&G Wessex Region |
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salihabduallah
Century Club
Joined: 04 Sep 2007
Posts: 120
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| Posted: Fri Oct 05, 2007 4:27 pm Post subject: |
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yes but where is every body ???
why there is no one interested in discussion !!!!!!   |
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Nick Raine-Fenning
Course Director
Joined: 27 May 2006
Posts: 1854
Location: Nottingham
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| Posted: Sat Oct 06, 2007 2:23 pm Post subject: |
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| salihabduallah wrote: | yes but where is every body ???
why there is no one interested in discussion !!!!!! |
That is a good question!
The Forum has ben quiet of late and we have had virtually no feedback since the exam which is very unusual.
Having said that salihabduallah this is only your 4th post in just over one month and two of those are in this thread! 
It is good you have started to post and all we need is a few more people to do the same and get chatting! It's as easy as that.
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"Teale Fenning Medical Education" delivering evidence-based, exam-orientated learning since 1997 |
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salihabduallah
Century Club
Joined: 04 Sep 2007
Posts: 120
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| Posted: Sat Oct 06, 2007 3:59 pm Post subject: |
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ok I will think of a subject and will insert it soon
most likely will be to the essay thread
I invite people to join me there |
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benz
Joined: 19 Mar 2007
Posts: 12
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| Posted: Fri Oct 26, 2007 6:40 am Post subject: let's discuss PMS! |
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Dear salihabduallah,
have you decided what topic we're going to discuss?
if not, let's start with PMS.
what would u like to know about her problem?
how would u come to a dx?
what are the mx options for a woman of 32yrs with PMS? |
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salihabduallah
Century Club
Joined: 04 Sep 2007
Posts: 120
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| Posted: Sat Oct 27, 2007 6:49 pm Post subject: |
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| Quote: | | what would u like to know about her problem? |
symptoms and complaint
severity / affect quality of life or not
duration
medication /if present : type / dose / effective or not
duration
her social life / relatin with family and partner
family history of pshychiatric disease or mental illness |
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salihabduallah
Century Club
Joined: 04 Sep 2007
Posts: 120
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| Posted: Sat Oct 27, 2007 6:54 pm Post subject: |
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| Quote: | | how would u come to a dx? |
by appropriate history
the previuos points
cyclical symptoms
exclusion of other pshycological disturbances
respond to drugs that supress ovulation
specific questionare can help |
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shamsa
Joined: 06 Oct 2007
Posts: 2
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| Posted: Fri Nov 09, 2007 10:30 am Post subject: Re: Can we discuss some subject? PMS |
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| salihabduallah wrote: | | Please , any study partner to discuss essays for march 2008 exam ? |
Sure, I am interested in discussing essays with you and will get back tommorrow on PMS. |
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salihabduallah
Century Club
Joined: 04 Sep 2007
Posts: 120
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| Posted: Fri Nov 09, 2007 1:22 pm Post subject: |
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| I prefer if you participate at essay forum please. |
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shamsa
Joined: 06 Oct 2007
Posts: 2
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| Posted: Mon Nov 12, 2007 4:37 pm Post subject: |
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| salihabduallah wrote: | | I prefer if you participate at essay forum please. |
Yes, ofcourse I meant the forum and not the personal contact. Any how you made me laugh. Now, Nick in regard to the PMS question following is the answer for correction.
(a) How will you evaluate her complaint? 7
Her evaluation will be based on the cyclical occurrence of the symptoms in the luteal phase of the menstural cycle. The symptoms could be Physical, psycological and behavioural,not related to organic disease, of varying degree.
Physical symptoms such as breast tenderness and swelling, bloating, oedema, weight gain, migrain, headaches and pelvic discomfort .Psycological symptoms include Anxiety, tiredness,irritability, tension, depression and loss of libido and sleep. where as behavioural change are absenteenism from work, hospital admissions and suicidal or criminal behaviour. These are, however, less common occurrences.
(b) What simple measures may be helpful? 6
Reassurance that many women suffer from PMS to a certain degree. Advising healthy life style such as avoidance of alcohol and smoking, reducing caffiene intake. Dietry intake such as taking low fat diet and adding minerals and vitamines have not been proven to be beneficial. Where as exercise like yoga and behavioural therapies like hypnosis and acupunture have been shown to be effective in alleviating PMS symptoms.As exercise releases natural endorphins and keep the mood elevated.
(c) Discuss more complex treatment? 7
There are various treatment options available for Premenstural syndrome.
The treatment of choice will depend upon the patient's desire and the presence of contraindications for particular option.
Estrogen has proven to be beneficial in eliminating the symptoms but unopposed estrogen can cause endometrial hyperplasia and cancer. Therefore, combined estrogen progesterone is the first option in the treatment of PMS,in the absence of any contraindicaton. In case of contraindication to cocp, alternatively,estrogen can be given in the form of transdermal patch, implants or gel with local progesterone in the form of LNS IUS.
There is no proven benefit of progesterones in the treatment of PMS.
Danazol is effective in alleviating symptoms but has potential musculinizing effects and altetred lipid profile and can not be given for more than 6 months.
GnRH anlogue is another effective therapy but result in hypoestogenic state by causing suppression of ovarian activity.Side effects include vasomotor and atrophic symptoms and osteoporosis. Addback therapy with tibilone or HRT required to counteract these effects.
Selective serotonin reuptake inhibitors have been found to be most effective option in improvement of the symptoms of PMS.
TAH+BSO is the most effective option as final resort in severly affected women, who donot respond to the treatment and who donot desire future pregnancy. |
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