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TEALE FENNING
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Nick Raine-Fenning
Course Director
Joined: 27 May 2006
Posts: 1854
Location: Nottingham
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 Posted: Mon Feb 26, 2007 5:44 pm Post subject: Premenstrual syndrome |
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You are asked to see a 34-year woman who is having increasing emotional and behavioural problems related to her periods.
What further information would you want to ascertain? (6 marks)
What tests would be worthwhile? (5 marks)
How would you manage her? (9 marks)
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Last edited by Nick Raine-Fenning on Thu Mar 15, 2007 1:37 pm; edited 1 time in total |
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vani s
Century Club
Joined: 20 Jan 2007
Posts: 141
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| Posted: Mon Mar 05, 2007 9:26 am Post subject: Re: Premenstrual syndrome |
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| Nick Raine-Fenning wrote: | You are asked to see a 34-year woman who is having increasing emotional and behavioural problems related to her periods.
What further information would you want to ascertain? (6 marks)
-preexisting or new
-cyclic or not..any baseline prob ?
-how severe
-what symptoms- physical or only emotional
-social life, family and work? stress?single, maried , divorced?child?
-?any prev treatment ?any benefit from it
What tests would be worthwhile? (5 marks)
diary of symptoms for 2-3 months... noting in detail baseline and changes during periods...
Nick are 5 marks just for this????????????
How would you manage her? (9 marks)
reassurance
aromatherapy, massage, relaxation
fruit of chaste tree..
evening primrose oil for breast symptoms
vit A, E , Mg, etc ect. controversial role
cognitive behavioral therapy
medical
I line SSRI very effective
COCP inhibit ovulation
transdermal E + LNG IUS (contraception + no reg pills)
GnRha good effect, but long term use reqd so ...
danazol... same , more side effects
Prog no use... harmful
surgical:
very severe: can consider oopherectomy, after GnRHa trial and counselling about premature menopause n symptoms. |
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Abik
Century Club
Joined: 15 Jan 2007
Posts: 243
Location: Poole
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| Posted: Mon Mar 05, 2007 9:32 am Post subject: |
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Excellent answer Vani - very helpful, thanks
I guess the second question may have marks for negatives?
ie progesterone levels not helpful
hormone levels in general not helpful
and a thorough desription of the diary and what you would see.
for the third bit -
surgery only if considering hysterectomy for other reasons |
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