Menstruation-related disorders, such as dysmenorrhea and premenstrual syndrome (PMS), are extremely common conditions that significantly impact quality of life. Pharmacists, guided by the knowledge gained in the Patient Care 5 “Women’s Health” module, are key in helping patients manage these symptoms, from recommending appropriate self-care with NSAIDs to understanding the role of hormonal contraceptives in treatment. This quiz will test your knowledge on the pathophysiology and management of these common women’s health issues.
1. Primary dysmenorrhea is caused by an excess of what substance in the uterine lining?
- a. Progesterone
- b. Luteinizing Hormone (LH)
- c. Prostaglandins
- d. Estrogen
Answer: c. Prostaglandins
2. What is the first-line pharmacologic treatment for primary dysmenorrhea?
- a. Opioid analgesics
- b. Acetaminophen
- c. Non-steroidal anti-inflammatory drugs (NSAIDs)
- d. Oral corticosteroids
Answer: c. Non-steroidal anti-inflammatory drugs (NSAIDs)
3. Premenstrual Syndrome (PMS) symptoms occur during which phase of the menstrual cycle?
- a. Follicular phase
- b. Ovulation
- c. Luteal phase
- d. Menstrual phase
Answer: c. Luteal phase
4. The key difference between Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) is that:
- a. PMDD involves physical symptoms, while PMS does not.
- b. PMDD is characterized by more severe mood and emotional symptoms that interfere with daily functioning.
- c. PMS is treated with SSRIs, while PMDD is not.
- d. PMDD occurs during the follicular phase.
Answer: b. PMDD is characterized by more severe mood and emotional symptoms that interfere with daily functioning.
5. Which class of medications is considered first-line for the pharmacologic treatment of moderate-to-severe PMDD?
- a. Benzodiazepines
- b. Selective Serotonin Reuptake Inhibitors (SSRIs)
- c. Beta-blockers
- d. NSAIDs
Answer: b. Selective Serotonin Reuptake Inhibitors (SSRIs)
6. The “Women’s Health” module, which covers menstrual disorders, is a specific learning module in which course?
- a. PHA5787C Patient Care 5
- b. PHA5104 Sterile Compounding
- c. PHA5703 Pharmacy Law and Ethics
- d. PHA5878C Patient Care 3
Answer: a. PHA5787C Patient Care 5
7. How do combined hormonal contraceptives (CHCs) help alleviate the symptoms of primary dysmenorrhea?
- a. By increasing prostaglandin synthesis.
- b. By inhibiting ovulation and thinning the endometrium, which reduces prostaglandin production.
- c. By acting as a potent analgesic.
- d. By increasing uterine contractions.
Answer: b. By inhibiting ovulation and thinning the endometrium, which reduces prostaglandin production.
8. For maximum efficacy in treating dysmenorrhea, when should a patient start taking their NSAID?
- a. Only when the pain becomes severe.
- b. On the first day of bleeding.
- c. 1-2 days before the expected onset of menses.
- d. After menstruation has ended.
Answer: c. 1-2 days before the expected onset of menses.
9. The term “menorrhagia” refers to:
- a. The absence of menstruation.
- b. Painful menstruation.
- c. Irregular menstruation.
- d. Heavy or prolonged menstrual bleeding.
Answer: d. Heavy or prolonged menstrual bleeding.
10. A significant complication of chronic, untreated menorrhagia is:
- a. Osteoporosis
- b. Iron-deficiency anemia
- c. Type 2 Diabetes
- d. Hypertension
Answer: b. Iron-deficiency anemia
11. The management of women’s health is a topic within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
12. Secondary amenorrhea is defined as the absence of menses for how long in a woman who was previously menstruating?
- a. 1 month
- b. 2 months
- c. More than 3-6 months
- d. 1 year
Answer: c. More than 3-6 months
13. A common cause of secondary amenorrhea is:
- a. Pregnancy
- b. Excessive exercise
- c. Low body weight / eating disorders
- d. All of the above
Answer: d. All of the above
14. The pathophysiology of primary dysmenorrhea involves uterine contractions and ischemia caused by:
- a. Prostaglandins
- b. Serotonin
- c. Dopamine
- d. Estrogen
Answer: a. Prostaglandins
15. Counseling patients on self-care for reproductive health is a key objective for student pharmacists.
- a. True
- b. False
Answer: a. True
16. Which of the following is a non-pharmacologic recommendation for PMS?
- a. Increasing caffeine and sugar intake.
- b. Limiting physical activity.
- c. Regular aerobic exercise and stress reduction.
- d. A diet high in sodium.
Answer: c. Regular aerobic exercise and stress reduction.
17. The “Reproductive Self-Care” module is part of the Patient Care I course.
- a. True
- b. False
Answer: a. True
18. Which dietary supplement has shown some benefit in treating the symptoms of PMS?
- a. Vitamin K
- b. Iron
- c. Calcium
- d. Vitamin B6
Answer: c. Calcium
19. Secondary dysmenorrhea is different from primary dysmenorrhea because it is caused by:
- a. An underlying pelvic pathology, such as endometriosis or fibroids.
- b. Prostaglandins only.
- c. Stress.
- d. A poor diet.
Answer: a. An underlying pelvic pathology, such as endometriosis or fibroids.
20. An active learning session on women’s health is part of the Patient Care 5 course.
- a. True
- b. False
Answer: a. True
21. A patient with primary dysmenorrhea who does not get relief from NSAIDs could be a candidate for what second-line therapy?
- a. Acetaminophen with codeine
- b. A higher dose of a different NSAID
- c. A combined hormonal contraceptive
- d. Both b and c are potential options.
Answer: d. Both b and c are potential options.
22. Which of the following is NOT a typical symptom of PMS?
- a. Bloating
- b. Mood swings
- c. Breast tenderness
- d. High fever
Answer: d. High fever
23. The lecture on contraception is part of the women’s health module.
- a. True
- b. False
Answer: a. True
24. An active learning session on women’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
25. A pharmacist’s role in managing menstruation-related disorders includes:
- a. Differentiating between conditions appropriate for self-care and those needing referral.
- b. Recommending appropriate OTC analgesics.
- c. Counseling on non-pharmacologic therapies.
- d. All of the above.
Answer: d. All of the above.
26. Tranexamic acid is a prescription medication used to treat heavy menstrual bleeding. What is its mechanism of action?
- a. It is a hormonal agent.
- b. It is an anti-fibrinolytic agent that helps stabilize blood clots.
- c. It is a potent NSAID.
- d. It is an iron supplement.
Answer: b. It is an anti-fibrinolytic agent that helps stabilize blood clots.
27. Which of the following would be a reason to refer a patient with dysmenorrhea to a physician?
- a. The pain is relieved by ibuprofen.
- b. It is her first time experiencing menstrual cramps.
- c. The patient has a history of pelvic inflammatory disease or has severe pain that is not relieved by OTCs.
- d. The pain lasts for 2 days each month.
Answer: c. The patient has a history of pelvic inflammatory disease or has severe pain that is not relieved by OTCs.
28. An active learning session on women’s health is part of which course module?
- a. Module 3: Women’s Health
- b. Module 1: Diabetes Mellitus
- c. Module 4: Medication Safety
- d. Module 8: Men’s Health
Answer: a. Module 3: Women’s Health
29. The use of SSRIs for PMDD can be dosed:
- a. Only on the first day of the period.
- b. Continuously throughout the month or intermittently during the luteal phase only.
- c. Only during the follicular phase.
- d. At a much higher dose than for depression.
Answer: b. Continuously throughout the month or intermittently during the luteal phase only.
30. The “Introduction to Women’s Health” is a lecture within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
31. Which of the following statements about primary dysmenorrhea is TRUE?
- a. It typically begins many years after menarche.
- b. It is caused by a structural abnormality.
- c. The pain is often described as cramping in the lower abdomen that can radiate to the back.
- d. It is best treated with antibiotics.
Answer: c. The pain is often described as cramping in the lower abdomen that can radiate to the back.
32. The primary hormone responsible for the symptoms of PMS and PMDD is thought to be the cyclical fluctuation of:
- a. Estrogen and progesterone, which affects neurotransmitters like serotonin.
- b. TSH.
- c. Cortisol.
- d. LH.
Answer: a. Estrogen and progesterone, which affects neurotransmitters like serotonin.
33. Counseling a patient to keep a symptom diary can be helpful in diagnosing:
- a. Anemia
- b. Osteoporosis
- c. PMS or PMDD
- d. A urinary tract infection
Answer: c. PMS or PMDD
34. Which levonorgestrel-releasing IUD is FDA-approved for the treatment of heavy menstrual bleeding?
- a. Paragard
- b. Nexplanon
- c. Mirena
- d. Skyla
Answer: c. Mirena
35. A patient taking an NSAID for dysmenorrhea should be counseled about what potential side effect?
- a. Drowsiness
- b. GI upset
- c. Weight gain
- d. Increased bleeding
Answer: b. GI upset
36. The term “amenorrhea” means:
- a. Heavy bleeding
- b. Irregular bleeding
- c. Painful bleeding
- d. Absence of bleeding
Answer: d. Absence of bleeding
37. Which of the following can cause secondary amenorrhea?
- a. Polycystic Ovary Syndrome (PCOS)
- b. Hyperprolactinemia
- c. Thyroid dysfunction
- d. All of the above
Answer: d. All of the above
38. The lecture “Management of Women’s Health” is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
39. A patient’s PMS symptoms should resolve:
- a. During ovulation.
- b. In the middle of the luteal phase.
- c. With the onset of menses.
- d. During the follicular phase.
Answer: c. With the onset of menses.
40. An active learning session covering women’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
41. Which of the following is NOT a typical non-pharmacologic therapy for dysmenorrhea?
- a. Applying a heating pad to the abdomen.
- b. Engaging in light physical activity.
- c. Consuming high amounts of caffeine.
- d. Yoga or stretching.
Answer: c. Consuming high amounts of caffeine.
42. The “self-care” approach to primary dysmenorrhea is covered in the Patient Care I curriculum.
- a. True
- b. False
Answer: a. True
43. A pharmacist’s role in managing these disorders includes empowering women with education and appropriate treatment options.
- a. True
- b. False
Answer: a. True
44. What is the main difference in pathophysiology between primary and secondary dysmenorrhea?
- a. There is no difference.
- b. Primary dysmenorrhea has no underlying pelvic disease, whereas secondary does.
- c. Secondary dysmenorrhea is not painful.
- d. Primary dysmenorrhea is caused by endometriosis.
Answer: b. Primary dysmenorrhea has no underlying pelvic disease, whereas secondary does.
45. Which of the following is a symptom more characteristic of PMDD than PMS?
- a. Mild breast tenderness
- b. Food cravings
- c. Marked anger, irritability, or feelings of hopelessness
- d. Minor bloating
Answer: c. Marked anger, irritability, or feelings of hopelessness
46. A patient wishes to use a continuous-cycle combined hormonal contraceptive. This would likely help with which condition?
- a. Infertility
- b. Menstruation-related symptoms like dysmenorrhea and PMS.
- c. Osteoporosis
- d. Anemia
Answer: b. Menstruation-related symptoms like dysmenorrhea and PMS.
47. The management of anemia, a potential complication of menorrhagia, is covered in the Patient Care 4 curriculum.
- a. True
- b. False
Answer: a. True
48. An active learning session on women’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
49. The overall management of menstruation-related disorders often involves:
- a. A stepwise approach, starting with non-pharmacologic and OTC options.
- b. A “one-size-fits-all” treatment for every patient.
- c. Immediate referral for surgery.
- d. A focus on high-dose opioid therapy.
Answer: a. A stepwise approach, starting with non-pharmacologic and OTC options.
50. The ultimate goal of learning about menstruation-related disorders is to:
- a. Help patients improve their quality of life by providing safe and effective management strategies.
- b. Memorize all the phases of the menstrual cycle.
- c. Pass the final exam.
- d. Convince all patients to take hormonal contraceptives.
Answer: a. Help patients improve their quality of life by providing safe and effective management strategies.