Dysmenorrhea: ABFM practice questions

4 board-style questions on dysmenorrhea in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 29-year-old woman presents with a 2-year history of progressive dysmenorrhea, deep dyspareunia, and dyschezia (pain with defecation) during menses. She has been trying to conceive for 14 months without success. Pelvic examination reveals a fixed, retroverted uterus with tender nodularity in the posterior cul-de-sac. Transvaginal ultrasound shows a 3-cm homogeneous hypoechoic cyst in the left ovary with diffuse low-level internal echoes. Which of the following is the most likely diagnosis?

  1. Endometriosis with endometrioma
  2. Ovarian torsion
  3. Tubo-ovarian abscess
  4. Ovarian dermoid cyst (mature teratoma)

Sample question 2

An 18-year-old woman presents with crampy lower abdominal pain that occurs with each menstrual period and began about 1 year after menarche. The pain starts on the first day of menses and lasts 2-3 days. She has regular cycles and a normal pelvic examination. What is the most appropriate initial treatment?

  1. NSAIDs such as ibuprofen, started at onset of menses
  2. Acetaminophen 1000 mg every 8 hours as needed
  3. Diagnostic laparoscopy to rule out endometriosis
  4. Medroxyprogesterone acetate (Depo-Provera) injection

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