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Final Exam: NU664D/ NU 664D (NEW 2025/ 2026 Update) Review| 100% Correct- Regis
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MRIl canl detect Answer: obstructivel abnormalities
laparoscopyl orderedl when Answer: initiall measuresl havel notl improvedl symptoms,l secondaryl dysmenorrhea,l painl affectingl dailyl activityl
Primaryl amenorrhea:l definition Answer: absencel ofl mensesl byl 15 l withl normall growthl andl secondaryl sexl characteristicsl ORl absencel ofl mensesl withl completel absencel ofl secondaryl sexl characteristicsl byl 13
secondaryl amenorrheal defintion
Answer: absencel ofl mensesl forl morel thanl 3 l monthsl inl al girll whol cyclingl regularlyl ORl 6 - monthl absencel inl al girll whol previouslyl hadl irregularl cycles
secondaryl amenorrheal causes Answer: pregnancy/lactation perimenopausel orl menopause PCOSl - l hyperandrogenism hypothyroidl (sometimesl hyperthyroid) Pituitaryl dysfunctionl - l hyperprolactinemial froml tumor/injury,l medications,l cocaine hypothalamicl amenorrheal (eatingl disorder,l weightl lossl underl normall BMI) Primaryl ovarianl insufficiencyl - l physiologicl menopausel inl womenl <l 40
primaryl amenorrheal causes Answer: imperforatel hymen,l gonadall dysgenesisl (Turnor),l mullerianl agenesisl (absencel ofl uterus/vagina),l physiologicl delay,l endocrinel disordersl (PCOS,l hyperprolactinemia,l thyroidl disorders)
primaryl dysmenorrheal sxs Answer: crampy,l achy,l dull, beginsl beforel mensesl andl persistsl forl 24 - 48 l hours associatedl withl - l n/v,l fatigue,l dizziness,l diarrhea,l anxiety,l headache
secondaryl dysmenorrheal defintion
Answer: exercisel - l increasesl endorphinsl andl suppressesl prostaglandinl release,l shuntsl bloodl awayl froml uterus,l reducel pelvicl congestionl andl pain dietl - l reducel saltyl foods,l increasel fiberl andl freshl fruits/vegetablesl andl waterl (naturall diuretics) headingl padsl orl warml bathsl tol decreasel musclel spasms weightl loss
obesityl andl estrogen Answer: increasesl amountl ofl estrogenl impactsl howl heavyl someonel isl bleeding increasesl riskl forl breastl andl uterinel cancer canl causel irregularl cycles
medicationl forl dysmenorreha Answer: NSAIDSl - l analgesicl effectl andl decreasel volumel ofl menstruall flowl 70%l havel moderatel tol completel reliefl ofl painfull cramping
alterativel optionsl forl dysmenorrhea Answer: vitaminl B,l acupuncture
dysmenorrheal - l secondl linel tx Answer:
COCl - l suppressl ovulation,l reducingl amountl ofl prostaglandinl producedl byl endometriall lining 90%l effective canl takel inl continuousl orl extendedl cyclesl (withdrawall bleedingl indicatedl everyl 3 l months)
Bestl txl forl endometriosis-relatedl dysmenorrhea Answer: depo,l Nexplanon,l hormonall iud
Estrogenl contraindications Answer: activel thrombophlebitis,l venousl thromboembolicl disorder acutel orl chronicl obstructivel liverl disease,l elevatedl liverl enzymes breastl cancer undiagnosedl genitall bleeding womenl >l 35 l whol smoke knownl orl suspectedl pregnancy arteriall thrombosis/ischemicl heartl disease HTN Migrainesl withl visuall aural (increasedl riskl forl ischemicl stroke)
Mechanisml ofl actionl forl mifepristonel (abortion) Answer: inhibitl progesteronel receptors,l antagonizingl endometriall andl myometriall effects atl highl dosesl leadsl tol contractions,l inducingl activityl intl hel myometrium
Riskl factorsl associatedl withl bloodl clots Answer: DVT,l PE
DVTl symptoms Answer: unilaterall painl withl acutel onset,l swelling,l warmth/redness,l +l Homan'sl sign,l palpablel venousl cord
PEl symptoms Answer: unilaterall chestl pain,l anxiety,l restlessness,l dyspnea,l cyanosis,l tachypnea,l tachycardia,l diminishedl breathl soundsl overl affectedl area
Safel HTNl medicationsl inl pregnancy Answer: methyldopa,l betal blockersl (labetalol),l CCBl (nifedipine)
elevatedl FSH/LHl withl al lowl estradioll indicates Answer: primaryl ovarianl insufficiency
lowl FSH/LHl andl estradioll indicate Answer: hyponatremicl hypogonadism
low-normall FSH/LHl andl estradioll indicate Answer: hypothalamicl amenorrhea
irregularl menstruall cycle,l obesity,l hirsuitism,l acne,l male-patternl hairl loss Answer: seruml androgen,l seruml testosterone,l prolactin,l serum17-hydroxyprogesterone,l fastingl glucose
Asl indicatedl labsl forl AUB Answer: GC/CH,l wetl mount,l UA,l UPT
whenl tol orderl pelvicl USl forl AUB Answer: abnormall examl finding
endometriall stripl inl al postmenopausall bleedingl womanl shouldl bel lessl than Answer: 5mml (.5cm)
ifl endometriall stipel >l (.5cm)l 5mml inl al postmenopausall bleedingl patientl whatl dxl tooll isl next Answer: endometriall biopsy
normall endometriall thicknessl withl nol complaintsl ofl abnormall bleeding Answer: 1.1cml (11mm)
C/Ol dysmenorrhea,l prematurel spotting,l painfull defecation,l dyspareunial - l youl suspectl endometriosisl - l howl tol havel definitivel dx Answer: directl visualizationl throughl laparoscopyl withl biopsy
labsl orderl tol dxl andl r/ol causesl ofl abnormall uterinel bleeidng Answer: thyroid,l CBC,l UPT,l prolactin
Hypothyroidl indicatedl byl whichl labs Answer: elevatedl TSH,l lowl T3,l lowl T