Authors notes: Dysmenorrhoea is painful menstral cramps, and it is divided into two categories: Primary dysmenorrhoea o No underlying cause

e o More common Secondary dysmenorrhoea o Dysmenorrhoea is a symptom due to an underlying problem o 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. 2. 3. 4. 5. 6. 7. Antibiotic treatment Diabetes Pregnancy Inflammatory skin conditions (eczema or dermatitis) Immunosuppressed patients Tight clothing which encourages excessive sweating 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. Dysuria a. Painful urination

2. Change in urinary frequency 3. Urgency 4. Nocturia a. Need to wake up to urinate at night 5. Haematuria a. Blood in the urine b. Caution: can also indicate cancers. Refer this patient Other, 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 Clear/white Thin None None Candidiasis Yellowish/white Cottage cheese Little Most Trichomoniasis Green-yellow Frothy Bad smelling Most Bacterial vaginitis White Thin Fishy Not usually

Colour Consistency Odour Redness/itching

Therefore: Candidiasis o Itching o Yellow/white, thick discharge o Itching o BUT: Generally no bad odours Trichomoniasis o Green-yellow, frothy discharge o Itching o Bad smelling Bacterial vaginitis o White, fishy discharge

BUT is thin and doesnt itch