PMS and PMDD CMS 250
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Questions and Answers

Which tool is recommended for making the DSM-5 diagnosis of PMDD using two cycles of daily symptom ratings?

  • Carolina Premenstrual Assessment Scoring System (C-PASS) (correct)
  • Daily record of severity of problems (DRSP)
  • International Association for Premenstrual Disorders (IAPMD) screening tool
  • Excel macro download

    • Which disorder can have symptoms similar to those of PMS and PMDD, leading to a differential diagnosis consideration?

  • Diabetes
  • Fibrocystic breast changes
  • Chronic fatigue syndrome (correct)
  • Endometriosis

    • What is the positive predictive value (PPV) for the alternate diagnostic criteria for PMS?

  • 75.0% (correct)
  • 63.2%
  • 81.3%
  • 63.4%

    • Which diagnostic algorithm is used for making the DSM-5 diagnosis of PMDD based on daily symptom ratings?

    <p>Carolina Premenstrual Assessment Scoring System (C-PASS)</p> Signup and view all the answers

    What is the negative predictive value (NPV) for the standard diagnostic criteria for PMS?

    <p>88.4%</p> Signup and view all the answers

    Which criteria must be present for a diagnosis of moderate to severe PMS?

    <p>At least four symptoms must be moderate to severe</p> Signup and view all the answers

    According to the Premenstrual Symptoms Screening Tool (PSST), what is required for a presumptive diagnosis of PMDD?

    <p>At least four symptoms must be moderate to severe</p> Signup and view all the answers

    What does the Premenstrual Symptoms Screening Tool (PSST) measure?

    <p>Severity of PMS and PMDD symptoms</p> Signup and view all the answers

    How many symptoms need to be moderate to severe for a presumptive diagnosis of PMDD?

    <p>At least four symptoms</p> Signup and view all the answers

    In the Premenstrual Symptoms Screening Tool (PSST), what criteria must be met for a diagnosis of moderate to severe PMS?

    <p>#1, #2, #3, or #4 must be moderate to severe</p> Signup and view all the answers

    Which screening tool is mentioned as a simple, user-friendly tool to identify women with severe Premenstrual Syndrome or Premenstrual Dysphoric Disorder?

    <p>Premenstrual Symptoms Screening Tool (PSST)</p> Signup and view all the answers

    In the PSST, what is the specificity level for identifying women with severe Premenstrual Syndrome or Premenstrual Dysphoric Disorder?

    <p>81.4%</p> Signup and view all the answers

    What common misconception might patients have when diagnosing PMS and PMDD?

    <p>Overestimating the cyclic nature of their symptoms</p> Signup and view all the answers

    Which daily record tool is described as being available for download and categorized from 'not at all' to 'extreme' severity for various symptoms?

    <p>Daily Record of Severity of Problems (DRSP)</p> Signup and view all the answers

    Which study by Steiner, Macdougall, & Brown (2003) introduced an important screening tool for identifying severe Premenstrual Syndrome and Premenstrual Dysphoric Disorder?

    <p>Archives of Women’s Mental Health, 6, 203-209</p> Signup and view all the answers

    Which of the following is NOT a symptom typically associated with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD)?

    <p>Euphoria</p> Signup and view all the answers

    Which tool is used for retrospective questionnaires in the assessment of premenstrual symptoms?

    <p>Rating Scale for Premenstrual Tension Syndrome (PMTS)</p> Signup and view all the answers

    Which criteria should be confirmed by prospective daily ratings during at least 2 symptomatic cycles for a diagnosis of PMDD?

    <p>Criterion A</p> Signup and view all the answers

    What is a key requirement for diagnosing moderate to severe premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) provisionally?

    <p>Prospective daily ratings during at least 2 symptomatic cycles</p> Signup and view all the answers

    Which screening tool is used for prospective symptom tracking in the assessment of premenstrual symptoms?

    <p>Premenstrual Symptoms Screening Tool (PSST)</p> Signup and view all the answers

    Which symptom is NOT typically associated with Premenstrual Syndrome (PMS)?

    <p>Nausea</p> Signup and view all the answers

    What is a key diagnostic criterion for moderate to severe PMS?

    <p>Symptoms that significantly interfere with daily activities</p> Signup and view all the answers

    Which statement accurately reflects the validity of the Premenstrual Symptoms Screening Tool?

    <p>It has a high sensitivity but low specificity</p> Signup and view all the answers

    What is a key diagnostic criterion for Premenstrual Dysphoric Disorder (PMDD)?

    <p>Presence of at least 5 mood symptoms</p> Signup and view all the answers

    Which tool is commonly used for screening and monitoring symptoms of PMS and PMDD over menstrual cycles?

    <p>Daily Record of Severity of Problems (DRSP)</p> Signup and view all the answers

    What does a total score ≥ 50 in the first day of menses using the Daily Record of Severity of Problems (DRSP) suggest?

    <p>Moderate to severe PMS</p> Signup and view all the answers

    For a PMDD diagnosis, how many symptoms must have a score ≥ 4 in the week prior to menses?

    <p>5 symptoms</p> Signup and view all the answers

    What is one of the excused symptoms that should not be considered in the Daily Record of Severity of Problems (DRSP) assessment for PMS or PMDD diagnosis?

    <p>Appetite</p> Signup and view all the answers

    How many days must the PMDD diagnosis criteria be met for in the week prior to menses?

    <p>2 days</p> Signup and view all the answers

    Which phase should have an average score ≥ 3 for clinical judgment to correlate with the daily rating assessment?

    <p>Mid-follicular phase</p> Signup and view all the answers

    Which of the following best describes premenstrual syndrome (PMS)?

    <p>Cyclical and repetitive changes in the luteal phase causing distress and impairment</p> Signup and view all the answers

    What distinguishes premenstrual dysphoric disorder (PMDD) from premenstrual syndrome (PMS)?

    <p>Mood and physical symptoms starting about one to two weeks before menses</p> Signup and view all the answers

    What is an essential aspect in diagnosing moderate to severe PMS?

    <p>Substantial distress and impairment in functional capacity in the luteal phase</p> Signup and view all the answers

    Which screening tool is commonly used for premenstrual disorders?

    <p>Premenstrual Symptoms Screening Tool (PSST)</p> Signup and view all the answers

    What role does comprehensive history taking play in diagnosing PMS and PMDD?

    <p>It helps rule out other conditions like hypothyroidism and anemia</p> Signup and view all the answers

    Why is a detailed physical examination important in diagnosing premenstrual disorders?

    <p>To rule out other conditions with similar symptoms</p> Signup and view all the answers

    When do symptoms of PMDD typically start according to the text?

    <p>One to two weeks before menses onset</p> Signup and view all the answers

    What is the key difference between PMS and PMDD according to the information provided?

    <p>Distress and impairment caused during the luteal phase</p> Signup and view all the answers

    What is an essential aspect of diagnosing PMDD?

    <p>Distress and impairment causing significant dysfunction</p> Signup and view all the answers

    Which criterion is necessary for diagnosing moderate to severe PMS?

    <p>Substantial distress and impairment in functional capacity during luteal phase</p> Signup and view all the answers

    What is the odds ratio for anxiety or tension in relation to PMS symptoms?

    <p>1.07</p> Signup and view all the answers

    Which symptom is statistically significant and correlated with mood swings according to the text?

    <p>Depressed mood</p> Signup and view all the answers

    According to the provided data, what is the odds ratio for fatigue in relation to PMS symptoms?

    <p>1.03</p> Signup and view all the answers

    Which symptom has an odds ratio of 0.95, indicating a weaker correlation with PMS symptoms?

    <p>Poor concentration</p> Signup and view all the answers

    Based on the text, which symptom had an odds ratio of 1.01 in relation to PMS symptoms?

    <p>Headache</p> Signup and view all the answers

    Which symptom is NOT considered a key criterion for diagnosing premenstrual dysphoric disorder (PMDD) according to the DSM-5?

    <p>Fatigue and lack of energy</p> Signup and view all the answers

    In the context of PMDD diagnosis, what should be present to reach a total of five symptoms when combined with symptoms from Criterion B?

    <p>Overeating or specific food cravings</p> Signup and view all the answers

    Which symptom is specifically required to be present for a presumptive diagnosis of premenstrual dysphoric disorder (PMDD)?

    <p>Marked anxiety and tension</p> Signup and view all the answers

    What is the key difference between moderate to severe PMS and PMDD in terms of symptom manifestation?

    <p>Presence of depressed mood in PMDD but not PMS</p> Signup and view all the answers

    Which symptom is commonly mistaken for physical manifestations of premenstrual disorders like PMDD?

    <p>Breast tenderness</p> Signup and view all the answers

    Which symptom is likely to be the most severe in moderate to severe PMS or PMDD?

    <p>Fatigue and lack of energy</p> Signup and view all the answers

    What symptom might be misinterpreted as anxiety in the context of premenstrual disorders?

    <p>Feeling overwhelmed or out of control</p> Signup and view all the answers

    In the context of PMS and PMDD, which symptom can significantly impact work efficiency and productivity?

    <p>Insomnia</p> Signup and view all the answers

    Which symptom can lead to difficulties in maintaining relationships with family members during moderate to severe PMS or PMDD?

    <p>Feeling overwhelmed or out of control</p> Signup and view all the answers

    Which symptom, if experienced severely in PMS or PMDD, could lead to misinterpretation as affective lability?

    <p>Insomnia</p> Signup and view all the answers

    Which condition is characterized by non-cyclic fatigue, mood changes, and difficulty concentrating?

    <p>Hypothyroidism</p> Signup and view all the answers

    What distinguishes fibrocystic breast changes from other conditions mentioned in the text?

    <p>Increased discomfort in premenstrual phase</p> Signup and view all the answers

    Which disorder can be associated with affective lability, depressed mood, and anxiety?

    <p>Affective disorder</p> Signup and view all the answers

    Which condition is likely to cause fatigue, tachycardia, and dyspnea on exertion?

    <p>Anemia</p> Signup and view all the answers

    Which disorder is associated with persistent symptoms that may include fatigue and mood changes over time?

    <p>Perimenopause</p> Signup and view all the answers

    Which symptom is NOT included in the Daily Record of Severity of Problems (DRSP) assessment for PMS or PMDD diagnosis?

    <p>Feeling overwhelmed</p> Signup and view all the answers

    What is the sensitivity of the Premenstrual Symptoms Screening Tool (PSST) for identifying women with severe PMS or PMDD?

    <p>79%</p> Signup and view all the answers

    What level of severity must a symptom reach to be categorized as 'extreme' in the Daily Record of Severity of Problems (DRSP)?

    <p>Score of 6</p> Signup and view all the answers

    Which symptom is specifically mentioned as causing a reduction in the production efficiency in the daily routine?

    <p>Difficulty concentrating</p> Signup and view all the answers

    What is the LR+ (Likelihood Ratio Positive) for diagnosing women with severe PMS or PMDD using the Premenstrual Symptoms Screening Tool (PSST)?

    <p>1.18</p> Signup and view all the answers

    What is the sensitivity of the Carolina Premenstrual Assessment Scoring System (C-PASS) for diagnosing PMDD?

    <p>82.1%</p> Signup and view all the answers

    When comparing the standard and alternate diagnostic criteria for PMS, which one has a lower negative predictive value (NPV)?

    <p>Alternate diagnostic criteria</p> Signup and view all the answers

    Which condition is NOT listed as a potential cause of symptoms that can be part of a differential diagnosis with PMS or PMDD?

    <p>Hypoglycemia</p> Signup and view all the answers

    What is a common misconception related to diagnosing PMDD based on the information provided?

    <p>PMDD symptoms always occur consistently in every menstrual cycle</p> Signup and view all the answers

    Which tool provides a validated diagnostic algorithm for making a DSM-5 diagnosis of PMDD by using daily symptom ratings over two menstrual cycles?

    <p>Carolina Premenstrual Assessment Scoring System (C-PASS)</p> Signup and view all the answers

    What is suspected to be altered in females with PMDD in response to emotional stimuli?

    <p>Frontocortical activation</p> Signup and view all the answers

    Which genetic predisposition is possibly linked to PMDD according to the text?

    <p>Serotonin 1A receptor C(−1019) G polymorphism</p> Signup and view all the answers

    What is common among females with PMDD regarding gonadal steroid hormones?

    <p>Normal levels of both estrogen and progesterone</p> Signup and view all the answers

    What is the approximate heritability percentage associated with PMDD?

    <p>50-60%</p> Signup and view all the answers

    In PMDD, what is the abnormal sensitivity related to during the luteal phase?

    <p>Hormonal changes</p> Signup and view all the answers

    What is enhanced and diminished in females with PMDD in response to emotional stimuli?

    <p>Amygdala activation and frontocortical activation</p> Signup and view all the answers

    Which neurotransmitter receptor polymorphism is associated with PMDD?

    <p>Serotonin 1A receptor C(−1019) G</p> Signup and view all the answers

    What is the suspected cause of abnormal sensitivity to normal hormone changes during the luteal phase in PMDD?

    <p>Altered CNS sensitivity</p> Signup and view all the answers

    What is possibly genetically predisposed in females with PMDD based on family and twin studies?

    <p>Enhanced amygdala activation</p> Signup and view all the answers

    What aspect of CNS sensitivity is suspected to be altered in females with PMDD?

    <p>Response to emotional stimuli</p> Signup and view all the answers

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