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    "Please Do Something For My Period Pain": Max Brinsmead MB Bs PHD May 2015

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    Nina
    A 16-year-old female presented with daily nausea, epigastric pain, and increasingly painful periods accompanied by her mother. The patient complains of central, constant, disabling pain throughout her period and 1-2 days after. Her usual cycle is monthly for 7 days with no irregular bleeding. Additional history revealed intermittent diarrhea, NSAIDs make nausea worse, no sexual activity, and a family history of endometriosis. Differential diagnoses included primary dysmenorrhoea, gastritis, PID, endometriosis, and psychogenic causes. Tests planned were FBC, ESR, UEC, LFTs, upper GIT evaluation, pelvic USS, menstrual phase CA125 and CA19.9,

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    "Please Do Something For My Period Pain": Max Brinsmead MB Bs PHD May 2015

    Uploaded by

    Nina
    20 views18 pages
    A 16-year-old female presented with daily nausea, epigastric pain, and increasingly painful periods accompanied by her mother. The patient complains of central, constant, disabling pain throughout her period and 1-2 days after. Her usual cycle is monthly for 7 days with no irregular bleeding. Additional history revealed intermittent diarrhea, NSAIDs make nausea worse, no sexual activity, and a family history of endometriosis. Differential diagnoses included primary dysmenorrhoea, gastritis, PID, endometriosis, and psychogenic causes. Tests planned were FBC, ESR, UEC, LFTs, upper GIT evaluation, pelvic USS, menstrual phase CA125 and CA19.9,

    Original Title

    CaseDysmenorrhoea

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    A 16-year-old female presented with daily nausea, epigastric pain, and increasingly painful periods accompanied by her mother. The patient complains of central, constant, disabling pain throughout her period and 1-2 days after. Her usual cycle is monthly for 7 days with no irregular bleeding. Additional history revealed intermittent diarrhea, NSAIDs make nausea worse, no sexual activity, and a family history of endometriosis. Differential diagnoses included primary dysmenorrhoea, gastritis, PID, endometriosis, and psychogenic causes. Tests planned were FBC, ESR, UEC, LFTs, upper GIT evaluation, pelvic USS, menstrual phase CA125 and CA19.9,

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    20 views18 pages

    "Please Do Something For My Period Pain": Max Brinsmead MB Bs PHD May 2015

    Uploaded by

    Nina
    A 16-year-old female presented with daily nausea, epigastric pain, and increasingly painful periods accompanied by her mother. The patient complains of central, constant, disabling pain throughout her period and 1-2 days after. Her usual cycle is monthly for 7 days with no irregular bleeding. Additional history revealed intermittent diarrhea, NSAIDs make nausea worse, no sexual activity, and a family history of endometriosis. Differential diagnoses included primary dysmenorrhoea, gastritis, PID, endometriosis, and psychogenic causes. Tests planned were FBC, ESR, UEC, LFTs, upper GIT evaluation, pelvic USS, menstrual phase CA125 and CA19.9,

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 18

    “Please do something

    for my period pain”

    Max Brinsmead MB BS PhD


    May 2015
    Ms. SD Age 16
    Complains of daily nausea, epigastric
    pain and increasingly painful periods

    Accompanied by mother who reports


    complete personality change in 24
    months
    Ms SD Age 16

    Complains of daily nausea, epigastric


    pain and increasingly painful periods

    WHAT ARE THE POSSIBLE


    CAUSES?
    Ms SD Differential
    Diagnosis
    Ms SD Differential
    Diagnosis
    Primary dysmenorrhoea
    Gastritis or peptic ulcer
    PID
    Endometriosis
    Psychogenic
    Ms SD Age 16
    Complains of nausea, epigastric pain
    and painful periods

    WHAT ADDITIONAL INFORMATION


    DO YOU REQUIRE?
    Ms SD Additional History
    Required
    Usual menstrual pattern
    Sexual history
    When does the pain occur
    Description of the pain
    Other GIT tract symptoms
    Drugs & medications incl smoking
    Any pre menstrual staining or pain with defecation
    during menstruation?
    Family history of gynaecological problems
    Ms SD Additional History
    Usual cycle Monthly, 7d No IMB
    Ms SD Additional History
    Usual cycle Monthly, 7d No IMB
    Sexual history Coitus never
    Ms SD Additional History
    Usual cycle Monthly, 7d No IMB
    Sexual history Never
    Pain occurs Throughout period
    and 1-2 days after
    Ms SD Additional History
    Usual cycle Monthly, 7d No IMB
    Sexual history Never
    Pain occurs Throughout period
    and 1-2 days after
    Description of the Central, constant,
    pain disabling
    Ms SD Additional History
    Usual cycle Monthly, 7d No IMB
    Sexual history Never
    Pain occurs Throughout period
    Description of the and 1-2 days after
    pain Central, constant,
    disabling
    Other GIT tract Intermittent
    symptoms diarrhoea
    Ms SD Additional History
    Usual cycle Monthly, 7d No IMB
    Never
    Sexual history Throughout period and
    Pain occurs 1-2 days after
    Description of the Central, constant,
    disabling
    pain
    Other GIT tract Intermittent diarrhoea
    symptoms
    Drugs NSAIDs makes nausea
    worse. Non smoker
    Ms SD Additional History
    PMS and Pain c YES
    defaecation during
    menstruation
    Ms SD Additional History
    PMS and Pain c YES
    defaecation during
    menstruation
    Family history Older sister with
    endometriosis and
    infertility. Mother had
    hysterectomy at age 34
    Ms SD Age 16
    Complains of nausea and increasingly
    painful periods

    Do you examine this patient?

    What tests would you perform?


    Ms SD Tests
    FBC ESR or C-Reactive Protein
    UEC & LFTs
    Upper GIT evaluation
    USS pelvis
    Menstrual phase CA125 and CA19.9
    Laparoscopy
    Ms SD Treatment
    Options while waiting Ix
    NSAID c anti emetic
    Other analgesic
    Rectal NSAID
    Continuous COC c extra progestin
    IM Depo Provera

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