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21 Cards in this Set
- Front
- Back
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What is dysfunctional uterine bleeding
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Is a form of AUB between menarche and menopause, caused by hormones (anything affect the first 3 cycles) , that can not be attributed to medications, blood dyscrasias, systemic diseases, trauma, uterine neoplasms or pregnancy
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Is premanarchial and postmenopausal bleeding DUB?
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No
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What are the 4 cycles of human menstruation and dysfunction to which ones causes bleeding?
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Hypothalamic: GnRH pulses
Pituitary: LH and FSH Ovarian: Follicular and Luteal Endometrial: Proliferative and Secretory dysfunction of the first 3 cycles causes abnormal bleeding |
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What dominates in the proliferative phase of the endometrial cycle and what happens
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Estrogen (mainly E2), causes tissue to grow and proliferate
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What dominates in the secretory phase of the endometrial cycle and what happends
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Progesterone dominates (still estrogen production) and the tissues become SECRETORY
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DUB is bleeding from which endometrial phase?
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proliferative or discordant endometrium, associated with anovulatory or oligo-ovulatory ovarian cycles
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How can tissue biopsy confirm DUB?
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If the tissue sample shows shows a proliferative stage, then that indicates DUB
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What type of bleeding pattern is most common in DUB?
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Menometrorrhagia (heavy and irregular)
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At what life stage does most DUB occur?
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Menarche (11-14) and at perimenopause (45-50)
but can occur at any time, even after pregnancy (due to elevated prolactinemia from breast feeding) |
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IDSTO
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Iatrogenic
Dyscrasias Systemic Disorders Trauma Organic (Tumor, Infection, Pregnancy) |
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What are some non-surgical management options for DUB?
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Anovulatory DUB: combined estrogen and progestin
Light to moderate DUB: NSAIDs Antifbirnolytic agents (tranexsamic acid): somewhat more effective than NSAIDs |
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Is surgical management of DUB common? What are some types? What type of management therapy is effective?
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No, rare
D&C Ablation Hysterectomy hormonal management is successful >90% |
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Causes of premenarchial bleeding? AUB or DUB
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Hormone producing tumors (Granulosa cell tumors)
Foreignn objects in the vagina Infections |
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Define postmenopausal bleeding? why is this significant
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AUB after menopause, or bleeding after absence of bleeding of one year
higher incidence of endometrial cancer |
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what are some other causes of postmenopausal bleeding
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estrogen withdrawal and atrophic bleeding
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avg age of women menopause
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51, >90% by 55
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when does perimenopause usually start, how long does it last?
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47, usually last 4-5 years, may only last 2 years
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define perimenopause
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changes in amount, duration of menses, change in length cycle, skipped periods are common
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what is the life span vs life expectancy
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life span: genetically determined
life expectancy: effected by environmental factors |
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what are symptoms of menopause
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Hot flashes
vaginal discomfort bladder symptoms (affected by estrogent) heart disease osteoporosis |
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what are some common symptoms associated with estrogen deficiency
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Vasomotor: hot flashes, day and night sweats
Vaginal dryness dyspareunia stiffness/soreness, insomnia, urine leakage, changes in libido, headaches, backaches, mood swings, irritability, anxiety, depression; forgetfullness, palpaitations, UTI and fatigue Skin temp goes up, core body temps go down NOT RELATED TO MAJOR DEPRESSIVE DISORDER |
