Question

A 27-year-old G1P0 complains of mood swings and fatigue in the week prior to her menstrual period. These symptoms have worsened over the past six months. Some months the symptoms are so severe she misses several days of work. Her medical history is otherwise unremarkable and a physical examination is normal. Which of the following is the most appropriate next step in this patient's management?

A. Obtain a symptom diary for two months
B. Recommend dietary changes
C. Begin treatment with an anxiolytic agent
D. Refer for psychiatric consultation
E. Obtain a pelvic ultrasound

Answer 1

The most appropriate next step in the management of this patient's symptoms is to obtain a symptom diary for two months.

Step-by-step explanation:

The most appropriate next step in this patient's management is to obtain a symptom diary for two months (option A). This will help track her symptoms and identify any patterns or triggers. By keeping a record of her mood swings and fatigue in relation to her menstrual cycle, the patient and her healthcare provider can gain insight into her condition and develop an appropriate management plan. Other options such as recommending dietary changes (option B), beginning treatment with an anxiolytic agent (option C), referring for psychiatric consultation (option D), or obtaining a pelvic ultrasound (option E) may be considered in the future depending on the findings from the symptom diary.