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16 Cards in this Set
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- Back
- 3rd side (hint)
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Intermenstrual bleeding
(Painless) |
Uterine pathology: endometrial polyp, endometrial CA, adenomyosis, fibroids
Cervical pathology: ectropion, infective cervicitis, polyp, CA Vagina: trauma, cancer, atrophic vaginitis Ovary: Anovulatory DUB Pregnancy Irregular bleeding related to OCP Anticoagulants |
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IMB in women > 40 should raise what alarm bells?
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Endometrial CA
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Female Fertility Investigations
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FSH (day 2-5) N: 1-11
LH (day 2-5) N: 0.5 - 14.5 Day 21 Progesterone (7days before next anticipated menstrual period) N>30 Prolactin Testosterone TFTs (not routine) Rubella immune status Folic acid supplements until 12 weeks gestation Tubal patency testing +/- Semen analysis |
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Causes of prolactinaemia
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Micro/macroadenoma
Idiopathic secretion Drugs Hypothyroidism Ectropic PRL secretion Chronic renal failure |
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Drugs causing hyperPRL (due to anti-DA effects)
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Metoclopramide
Phenothiazines Reserpine Methyldopa Omeprazole, ranitidine, bendrofluazide |
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Secondary Amenorrhea
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No periods for 6 months or more
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Sheehan's Syndrome
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Pituitary necrosis after PPH
-amenorrhea -inhibits breast-feeding |
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Prevalence of premature menopause
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1% of women <40 y/o
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Hypo-oestrogenic effects of menopause
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Vaginal dryness
Vasomotor symptoms (hot flushes, night sweats) Osteoporosis Increased CVS risk |
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Psychological and social effects of premenopause
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Infertility
Need to take HRT Feeling if inadequacy as a woman Impact on relationships |
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Menopausal investigations
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FSH
LH Prolactin Oestradiol Testosterone TFTs FBC: Hb, WBC, plts Repeat to ensure no mid-cycle surge. Do baseline bonescan. |
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Management of premature menopause
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HRT
Fertility options: adoption, childlessness, IVF Patient support organisations |
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Typical presentation of fibroids (4)
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Menorrhagia
Abdominal mass Pressure effects from pressure on the bladder, stomach or bowel Infertility |
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DDx of secondary amenorrhea
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Hypothalamic: chronic illness, stress, anorexia, excessive exercise
Pituitary: hyperPRL, hypothyroidism, breast-feeding Ovarian: PCOS, premature ovarian failure, iatrogenic(chemotherapy, radiotherapy, Oophorectomy), long-acting progesterone contraception Uterine: pregnancy, Asherman's syndrome, cervical stenosis |
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DDx of secondary amenorrhea
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Hypothalamic: chronic illness, stress, anorexia, excessive exercise
Pituitary: hyperPRL, hypothyroidism, breast-feeding Ovarian: PCOS, premature ovarian failure, iatrogenic(chemotherapy, radiotherapy, Oophorectomy), long-acting progesterone contraception Uterine: pregnancy, Asherman's syndrome, cervical stenosis |
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DDx Postmenopausal bleeding
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Endometrial cancer
Endometrial/ endocervical polyp Endometrial hyperplasia Atrophic vaginitis Iatrogenic (anticoagulants, IUD, HRT) Infective (candidiasis) |
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