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Chapter 49. Menstruation-Related Disorders

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.

A. Amenorrhea

B. Anovulatory bleeding

C. Dysmenorrhea

D. Menorrhagia

E. Polycystic ovary syndrome

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

A. Increase the level of exercise

B. Increase the intake of dietary calcium and vitamin D

C. Decrease the intake of alcohol

D. Decrease the level of exercise

E. Transition to a gluten-free diet

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

A. Augment estrogen’s effects on bone

B. Improve overall quality of life

C. Prevent endometrial hyperplasia

D. Restore fertility

E. Counter estrogen’s negative effects on lipids

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?

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

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

C. Levonorgestrel IUD releasing 20 mcg of levonorgestrel daily

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

E. Acetaminophen 650 mg by mouth four times daily

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

A. Acetaminophen

B. Levonorgestrel IUD

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