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48 Cards in this Set
- Front
- Back
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What is hypermenorrhea?
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heavy or prolonged bleeding & regular
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What is the difference between menorrhagia and metorrhagia?
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• menorrhagia is heavy bleeding
• metorrhagia is bleeding in between periods |
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What is menometrorrhagia?
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prolonged flow with intermenstrual bleeding
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What is the oligomenorrhea?
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infrequent periods
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What is Mittelschmerz?
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mid-cycle lower abdominal pains associated with ovulation
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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?
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dysmenorrhea
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What is believed to be the cause of the pain from dysmenorrhea?
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excess prostagladin-mediated uterine smooth muscle stimulation from inflammation and vasoconstriction
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Describe the pain of primary dysmennorhea
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• sharp, diffuse colicky suprapubic abdominal pain
• radiates to the back • lasts for 1-3 days |
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True/False: Primary dysmenorrhea can occur mid-cycle
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• Primary dysmenorrhea does not occur between cycle or with anovulatory conditions
• The correct answer is: False |
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What are treatment options of primary dysmenorrhea?
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• NSAIDS
• oral birth control pills • Danazol (low dose tesosterone) |
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What causes the pain from secondary dysmenorrhea?
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• hemmorhage
• inflammation • ischemia • peritoneal irritation • perforation • stretch receptors |
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When can the pain from secondary dysmenorrhea occur?
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• pain may occur between menstrual cycles, but increases with menses
* when pain occurs between cycles, becomes chronic pelvic pain |
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Generally, what are causes of secondary dysmenorrhea?
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• extrauterine
• intramural • intrauterine |
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What are extrauterine causes of secondary dysmenorrhea?
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• adhesions
• endometriosis • inflammation • tumors |
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What are intramural causes of secondary dysmenorrhea?q
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• adenomyosis
• leiomyomata |
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What are intrauterine causes of secondary dysmenorrhea?
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• cervical stenosis
• congenital uterine abnormalties • endocervical adhesions • infections • IUD • leiomyomata • polyps |
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Secondary dysmenorrhea associated with heavy flow suggests what etiology?
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intramural or intrauterine etiologies
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Dysmenorrhea assoicated with coexisting infertility suggests what cause?
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endometriosis
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What is the diagnostic gold standard for pelvic disorders?
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pelvic ultrasound
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What are causes of primary amenorrhea?
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• chromosomal (ex. Turners 45X)
• congenital abnormalities (absent vagina, imperofrated hymen • failure of pituitary-ovarian axis • genital agenesis |
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What is the most common non-pathogenic cause of secondary amenorrhea? most common pathogenic cause?
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• non-pathogenic: pregnancy
• pathogenic: ovarian failure |
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Generally, what are causes of secondary amenorrhea?
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• hypothalamic disorders
• ovarian disorders • pituitary disorders • reproductive outflow disorders |
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What are examples of reproductive outflow disorders that can cause secondary amenorrhea?
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• androgen insensitivity
• cervical stenosis • imperforated hymen • intrauterine adhesions • mullerian agenesis (absence of either vagina or uterus) |
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What are ovarian disorders that can cause secondary amenorrhea?
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• chronic anovulation
• gonadal dysgenesis • premature ovarian failure • resistant ovary |
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What are pituitary disorders that can cause secondary amenorrhea?
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• hyperprolactinemia
• pituitary insufficiency • various tumors |
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What is the some important information to obtain from the history when evaluating secondary amenorrhea?
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• details of possible endocrine symptoms
• exercise & weight loss • history of anorexia or bulemia • history of emotional stress• nutritional, medical, & psychological history • physical & sexual development |
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What is Stein-Leventhal Syndrome?
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• aka polycystic ovary disease
• most common cause of chronic anovulation |
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Why are pregnant women with PCOS at risk for gestational diabetes?
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due to insulin resistance
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What is the triad of symptoms of PCOS?
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• amenorrhea
• hirsutism • obesity |
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What causes PCOS?
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• 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 |
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What are significant lab findings in patients with PCOS?
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• elevated LH and decreased FSH
• elevated progesterone, low-near normal estrogens |
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What is the treatment for PCOS?
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• weight reduction
• medroxyprogesterone acetate (MPA) |
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What is the treatment for PCOS if the patients wants to become pregnant?
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Clomiphene
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How can you medically treat hirsutism?
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spironolactone
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What is the most common cause of early menopause?
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ovarian failure
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What are symptoms of menopause?
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• cardiovascular changes
• neuro/psych changes (depression, mood changes, decreased sexual desire) • osteoporosis • urogenital atrophy • vasomotor disturbances (75% w/ hot flashes) |
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What are absolute contraindications for hormone replacement therapy (HRT) for menopause symptoms?
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• history of breast cancer
• thrombophlebitis/thrombotic disorders • ovarian & endometrial cancers • undiagnosed vaginal bleeding |
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What are signs and symptoms of estrogen deficiency?
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• Signs:
- dyspareunia - hot flashes - mood changes - sleep disturbances - vaginal dryness • Symptoms: - hot flashes - thinning of skin & hair - vaginal atrophy |
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What is atrophic vaginitis?
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• 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 |
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What are women with atrophic vaginitis more susceptible to trauma and infections?
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• pH changes
• cracking and dryness of the vaginal wall |
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What can be used to treat atrophic vaginitis?
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• KY jelly
• estrogen replacement therapy |
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What is the most common cause of abnormal uterine bleeding prior to menopuase?
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dysfunctional uterine bleeding
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Compare the duration and blood loss of normal and dysfunctional uterine bleeding
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• 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 |
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Generally, what are causes of abnormal uterine bleeding?
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• organic causes
• uterine causes • non-organic causes (ex. persistent ovulatory failure, dysfunctional uterine bleeding) |
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What are organic causes of abnormal uterine bleeding?
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• coagulopathies
• drugs • endocrine abnormalities • liver/renal disease • obesity |
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What are uterine causes of abnormal uterine bleeding?
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• active endocrine tumors
• cancer • endometrial hyperplasia • IUD • leiomyomas • PID • polyps • pregnancy |
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What are causes of PMS?
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• fluid retention
• mineral deficiency • neurotransmitter dysfunction • prostaglandin release • psychosomatic illness • steroid imbalance • vitamin deficiency |
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What are signs and symptoms of PMS?
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• abdominal bloating
• anxiety • breast tenderness • depression • emotional liability • fatigue • irritability • weight/water gain |
