(Latest ) Primary Care of
the Childbearing and Childrearing
Family Practicum | 100% Correct
Questions with Answers –
Chamberlain
Question:
Female reproductive cycle and menstruation
Answer:
Normal Menstrual cycle:
Frequency: Every 24 - 38 days
Regularity: +/- 2 - 20 days
Duration: 3 - 8 days
Quantity: 5 - 80 mL (roughly 3 - 6 pads per day)
,Question:
Mittelschmerz pain
Answer:
§ Some women experience pain, commonly known as "mittelschmerz"
(German for "middle pain"), during ovulation. Over 40% of women
experience this midcycle pain, which may occur monthly.
§ Pain varies in intensity and is often felt on the same side as the
developing follicle near the ovaries.
§ Mittelschmerz coincides with the peak in plasma luteinizing hormone (LH)
levels during follicular enlargement.
§ Elevated LH levels are thought to increase ovarian smooth muscle
contractility producing pain. Mittelschmerz does not require medical
intervention and can be useful in predicting optimal fertility.
§ Women who experience sudden and severe pain that does not improve
with time or gets worse should seek medical attention, as a more serious
condition may exist.
,Question:
Amenorrhea
Answer:
the absence of a menstrual period and is classified as primary or
secondary.
§ Primary amenorrhea is a failure of the initiation of menses by age 14 in
the absence of puberty or by 16 years of age regardless of the
development of secondary sexual characteristics.
§ Causes of primary Amenorrhea: turner syndrome, Kallmann Syndrome,
obstructed vagina, uterine dysplasia, eating disorders, excessive exercise
§ Causes of secondary Amenorrhea: pregnancy, contraception,
antidepressants, chemotherapy, PCOS, premature ovarian failure,
hypothyroidism
§ If menarche has not occurred by age 13 and there is no onset of
puberty, primary amenorrhea should be investigated. Secondary
amenorrhea is the cessation of menses after it has begun or menses that
have been absent for greater than 3 months.
§ Appropriate diagnostic tests for amenorrhea may include follicle
stimulating hormone (FSH), luteinizing (LH), testosterone, and prolactin.
For primary amenorrhea, genetic karyotyping is appropriate
o Differential Diagnoses
▪ Pregnancy (always r/o first)
▪ Hypothalamic causes: Stress, eating disorders, weight loss, exercise.
▪ Pituitary causes: Prolactinoma, pituitary infarction, medications
(antipsychotics).
▪ Ovarian causes: PCOS, premature ovarian insufficiency, Turner
syndrome.
, ▪ Outflow tract causes: Müllerian agenesis, imperforate hymen,
Asherman's syndrome.
▪ Thyroid disorders: Hypo- or hyperthyroidism.
Measure FSH/LH:
• ↑ FSH/LH → ovarian failure.
• ↓ FSH/LH → hypothalamic/pituitary cause.
Imaging:
• Pelvic ultrasound → uterine anomalies or ovarian pathology.
• MRI brain → pituitary lesion (if prolactin elevated or LH/FSH
low).
Question:
Dysmenorrhea
Answer:
characterized by uterine pain, often described as a dull cramping ache, that
is experienced around the time of menses.
§ The pain may occur with menses or precede menses by 1 to 3 days.
§ Pain tends to peak 24 hours after the onset of menses and subside after
2 to 3 days.
the term dysmenorrhea is reserved for women whose pain prevents or
interferes with normal activity and requires medication.
o Physical Assessment Findings
▪ Primary: