Clinical quiz - dysmenorrhoea | Nursing in Practice

Dysmenorrhoea (painful periods) is a common presentation in primary care and it’s important for nurses to feel confident to take the appropriate steps in assessment and management.

Our latest clinical quiz aims to support your knowledge of how to manage dysmenorrhoea appropriately including appropriate treatment and referral. The case-based questions explore appropriate examinations, distinguishing between primary and secondary dysmenorrhoea and how to choose analgesia and contraception treatment options, in line with the latest guidance from the College of Sexual and Reproductive Health.

Work your way through the questions and explanations to refresh your knowledge on management of dysmenorrhoea – click ‘start’ below to begin the quiz.

<section data-block="MultipleChoice"> <h3>Your first patient in an ANP clinic is a 15-year-old who has come to see you about her painful periods (dysmenorrhoea). Her mother is with her. Which of the following is true about your initial assessment?</h3> <ul> <li>You should always examine the abdomen in a patient presenting with dysmenorrhoea.</li> <li>You should always do a vaginal examination in a patient presenting with dysmenorrhoea.</li> <li>You should always request a pelvic ultrasound in a patient presenting with dysmenorrhoea.</li> <li>You should always request a full blood count (FBC) in a patient presenting with dysmenorrhoea.</li> </ul> </section> <section data-block="SingleChoice"> <h3>Your patient tells you that her periods started when she was 12 and that they started to be painful about six months later. The pain generally starts a day or two before her period and lasts for up to 3 days – by the last couple of days of her 5-day period she is generally pain-free. She can feel sick and tired during her periods but doesn’t have any other symptoms – her periods aren’t heavy, there is no bleeding in between the periods, no pain at other times of the month and no vaginal discharge. What type of dysmenorrhoea does she probably have?</h3> <ul> <li>Primary dysmenorrhoea.</li> <li>Secondary dysmenorrhoea.</li> </ul> </section> <section data-block="SingleChoice"> <h3>You think the patient probably has primary dysmenorrhoea, but you reflect about your knowledge of causes of secondary dysmenorrhoea. What is the commonest cause of secondary dysmenorrhoea in a woman of this age?</h3> <ul> <li>Endometriosis.</li> <li>Sexually transmitted infection.</li> <li>Fibroids.</li> <li>Genetic abnormalities of the reproductive tract.</li> </ul> </section> <section data-block="MultipleChoice"> <h3>You examine the patient’s abdomen (which is normal) and speak to her alone. She has never had sex and there is nothing that she wanted to tell you but wasn’t able to say in front of her mother, who then rejoins the consultation. The pain isn’t so bad that she has had to miss school. She hasn’t tried anything over the counter and would rather take something just during her period than all month. Which of the following would be an appropriate first-line treatment option? Select all that apply</h3> <ul> <li>Over the counter paracetamol.</li> <li>Over the counter ibuprofen.</li> <li>Mefenamic acid.</li> <li>Tranexamic acid.</li> <li>Co-codamol.</li> </ul> </section> <section data-block="MultipleChoice"> <h3>You see another patient at your clinic with dysmenorrhoea. She is a 25-year-old woman who has tried over-the-counter analgesia at an appropriate dose, but it hasn’t helped. She is having to miss work when her periods are particularly bad and so is keen to get them sorted – she has already had a normal pelvic ultrasound.&nbsp;Mindful of the fact that a normal ultrasound doesn’t exclude conditions such as endometriosis, you review her history but there is nothing to suggest a secondary cause.What treatment options are available to her? Select all that apply</h3> <ul> <li>Combined hormonal contraception.</li> <li>Oral danazol.</li> <li>Progestogen-only hormonal contraception.</li> <li>The levonorgestrel intrauterine device.</li> <li>Goserelin injection.</li> </ul> </section> <p>  <p>

Note all cases described in this series are hypothetical scenarios created for educational purposes

Clinical quiz – dysmenorrhoea

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Clinical quiz – dysmenorrhoea

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