-
8/2/2019 Reproductive workshop 2 (Patient Assessment)
1/3
Authors notes:
Dysmenorrhoea is painful menstral cramps, and it is divided into
two categories:
Primary dysmenorrhoeao No underlying causeo More common
Secondary dysmenorrhoeao Dysmenorrhoea is a symptom due to an
underlying problemo Endometriosis (extra endometrium growing where
it shouldnt be, most common
cause), inflammation of the fallopian tubes, fibroids (growths
in the uterus)
The pain tends to be caused by cells which become hypoxic due to
vasoconstriction induced by
uterine prostaglandin release.
Questions:
Briefly summarise the current opinion on the use of oral
contraceptives for the treatment of
dysmenorrhoea
Solid evidence is lacking However, data suggests low dose or
combined oral contraceptives may be effective in
reducing pain
Does any specific NSAID have a superior action (or advantage)
over other NSAIDs for the
treatment of primary dysmenorrhoea?
Not really Longer answer: not really for the readily available
drugs. It appears anti-COX-2 activity is
more effective, but those are hard to come by.
List seven circumstances that women could commonly experience
thrush from:
1. Antibiotic treatment2. Diabetes3. Pregnancy4. Inflammatory
skin conditions (eczema or dermatitis)5. Immunosuppressed
patients6. Tight clothing which encourages excessive sweating7.
Poor hygiene?
What details must be recorded in the pharmacy when selling any
oral/vaginal thrush
preparations?
They are Pharmacist Only medications, so you need to ask
for:
Name Address Phone number
List five symptoms that may indicate a case of cystitis
1. Dysuriaa. Painful urination
-
8/2/2019 Reproductive workshop 2 (Patient Assessment)
2/3
2. Change in urinary frequency3. Urgency4. Nocturia
a. Need to wake up to urinate at night5. Haematuria
a. Blood in the urineb. Caution: can also indicate cancers.
Refer this patientOther, less common ones:
Smaller volumes of urine Pain can worsen at the end Low back
pain
Briefly discuss the role of cranberry products for the
prevention of cystitis
Some protection benefits have been shown Although it might not
work 100%, it doesnt have any adverse effects, so why not?
Give four different examples of people/conditions that should be
referred to their GP if presenting
to you with symptoms of cystitis
If male Children under 16 Diabetes Duration longer than 7 days
Elderly women Immunocompromised patients Pregnancy Vaginal
discharge (indicates vaginal infection instead, see doctor for
antibiotics) Signs of infection (fever, nausea, vomiting, flank
pain etc.)
Differential diagnosis for vaginal discharge:
Normal Candidiasis Trichomoniasis Bacterial vaginitis
Colour Clear/white Yellowish/white Green-yellow White
Consistency Thin Cottage cheese Frothy Thin
Odour None Little Bad smelling Fishy
Redness/itching None Most Most Not usually
Therefore:
Candidiasiso Itchingo Yellow/white, thick dischargeo Itchingo
BUT: Generally no bad odours
Trichomoniasiso Green-yellow, frothy dischargeo Itchingo Bad
smelling
Bacterial vaginitiso White, fishy discharge
-
8/2/2019 Reproductive workshop 2 (Patient Assessment)
3/3
o BUT is thin and doesnt itch
