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48 Cards in this Set

  • Front
  • Back
What is hypermenorrhea?
heavy or prolonged bleeding & regular
What is the difference between menorrhagia and metorrhagia?
• menorrhagia is heavy bleeding
• metorrhagia is bleeding in between periods
What is menometrorrhagia?
prolonged flow with intermenstrual bleeding
What is the oligomenorrhea?
infrequent periods
What is Mittelschmerz?
mid-cycle lower abdominal pains associated with ovulation
What is condition is associated with painful menses occuring within 24-48 hours of the onset of menses and is the most common medical problem of young women?
What is believed to be the cause of the pain from dysmenorrhea?
excess prostagladin-mediated uterine smooth muscle stimulation from inflammation and vasoconstriction
Describe the pain of primary dysmennorhea
• sharp, diffuse colicky suprapubic abdominal pain
• radiates to the back
• lasts for 1-3 days
True/False: Primary dysmenorrhea can occur mid-cycle
• Primary dysmenorrhea does not occur between cycle or with anovulatory conditions
• The correct answer is: False
What are treatment options of primary dysmenorrhea?
• oral birth control pills
• Danazol (low dose tesosterone)
What causes the pain from secondary dysmenorrhea?
• hemmorhage
• inflammation
• ischemia
• peritoneal irritation
• perforation
• stretch receptors
When can the pain from secondary dysmenorrhea occur?
• pain may occur between menstrual cycles, but increases with menses

* when pain occurs between cycles, becomes chronic pelvic pain
Generally, what are causes of secondary dysmenorrhea?
• extrauterine
• intramural
• intrauterine
What are extrauterine causes of secondary dysmenorrhea?
• adhesions
• endometriosis
• inflammation
• tumors
What are intramural causes of secondary dysmenorrhea?q
• adenomyosis
• leiomyomata
What are intrauterine causes of secondary dysmenorrhea?
• cervical stenosis
• congenital uterine abnormalties
• endocervical adhesions
• infections
• leiomyomata
• polyps
Secondary dysmenorrhea associated with heavy flow suggests what etiology?
intramural or intrauterine etiologies
Dysmenorrhea assoicated with coexisting infertility suggests what cause?
What is the diagnostic gold standard for pelvic disorders?
pelvic ultrasound
What are causes of primary amenorrhea?
• chromosomal (ex. Turners 45X)
• congenital abnormalities (absent vagina, imperofrated hymen
• failure of pituitary-ovarian axis
• genital agenesis
What is the most common non-pathogenic cause of secondary amenorrhea? most common pathogenic cause?
• non-pathogenic: pregnancy
• pathogenic: ovarian failure
Generally, what are causes of secondary amenorrhea?
• hypothalamic disorders
• ovarian disorders
• pituitary disorders
• reproductive outflow disorders
What are examples of reproductive outflow disorders that can cause secondary amenorrhea?
• androgen insensitivity
• cervical stenosis
• imperforated hymen
• intrauterine adhesions
• mullerian agenesis (absence of either vagina or uterus)
What are ovarian disorders that can cause secondary amenorrhea?
• chronic anovulation
• gonadal dysgenesis
• premature ovarian failure
• resistant ovary
What are pituitary disorders that can cause secondary amenorrhea?
• hyperprolactinemia
• pituitary insufficiency
• various tumors
What is the some important information to obtain from the history when evaluating secondary amenorrhea?
• details of possible endocrine symptoms
• exercise & weight loss
• history of anorexia or bulemia
• history of emotional stress• nutritional, medical, & psychological history
• physical & sexual development
What is Stein-Leventhal Syndrome?
• aka polycystic ovary disease
• most common cause of chronic anovulation
Why are pregnant women with PCOS at risk for gestational diabetes?
due to insulin resistance
What is the triad of symptoms of PCOS?
• amenorrhea
• hirsutism
• obesity
What causes PCOS?
• increased adrenal androgens with obesity related increased extra-ovarian estrogens
• leads to inappropriate follicular development
• leads to premature but slow regression of the follicle » multiple cystic formation
What are significant lab findings in patients with PCOS?
• elevated LH and decreased FSH
• elevated progesterone, low-near normal estrogens
What is the treatment for PCOS?
• weight reduction
• medroxyprogesterone acetate (MPA)
What is the treatment for PCOS if the patients wants to become pregnant?
How can you medically treat hirsutism?
What is the most common cause of early menopause?
ovarian failure
What are symptoms of menopause?
• cardiovascular changes
• neuro/psych changes (depression, mood changes, decreased sexual desire)
• osteoporosis
• urogenital atrophy
• vasomotor disturbances (75% w/ hot flashes)
What are absolute contraindications for hormone replacement therapy (HRT) for menopause symptoms?
• history of breast cancer
• thrombophlebitis/thrombotic disorders
• ovarian & endometrial cancers
• undiagnosed vaginal bleeding
What are signs and symptoms of estrogen deficiency?
• Signs:
- dyspareunia
- hot flashes
- mood changes
- sleep disturbances
- vaginal dryness

• Symptoms:
- hot flashes
- thinning of skin & hair
- vaginal atrophy
What is atrophic vaginitis?
• aka senile vaginits, senile urethritis
• epithelial mucosal atrophy of the vagina, urethra, cervix, endocervix, endometrium, & myometrium
• mucosa becomes thin, pale, friable with decreased secretions
• caused by estrogen deficiency
What are women with atrophic vaginitis more susceptible to trauma and infections?
• pH changes
• cracking and dryness of the vaginal wall
What can be used to treat atrophic vaginitis?
• KY jelly
• estrogen replacement therapy
What is the most common cause of abnormal uterine bleeding prior to menopuase?
dysfunctional uterine bleeding
Compare the duration and blood loss of normal and dysfunctional uterine bleeding
• Normal uterine bleeding: lasts 3-7 days & 60-80 ml of blood loss
• Dysfunction uterine bleeding: lasts 7-18 days & 100-200 ml of blood loss
Generally, what are causes of abnormal uterine bleeding?
• organic causes
• uterine causes
• non-organic causes (ex. persistent ovulatory failure, dysfunctional uterine bleeding)
What are organic causes of abnormal uterine bleeding?
• coagulopathies
• drugs
• endocrine abnormalities
• liver/renal disease
• obesity
What are uterine causes of abnormal uterine bleeding?
• active endocrine tumors
• cancer
• endometrial hyperplasia
• leiomyomas
• polyps
• pregnancy
What are causes of PMS?
• fluid retention
• mineral deficiency
• neurotransmitter dysfunction
• prostaglandin release
• psychosomatic illness
• steroid imbalance
• vitamin deficiency
What are signs and symptoms of PMS?
• abdominal bloating
• anxiety
• breast tenderness
• depression
• emotional liability
• fatigue
• irritability
• weight/water gain