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45 Cards in this Set

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The typical menstrual cycle last for how many days?
~28 days
How long does the follicular phase last?
~14 days
how long does the luteal phase last?
Exactly 14 days
Average duration of menses?
4 days
What is Menorrhagia?
Abnormally heavy or prolonged menstrual period @ regular intervals

Bleeding for > 7 days
and/or
more than 80cc
What is Hypermenorrhea?
The same thing as Menorrhagia
What is Menometrorrhagia?
Prolonged uterine bleeding at irregular intervals
What is Metorrhagia?
Uterine bleeding @ irregular but frequent intervals (variable amount)

"spotting"
How reliable are women in determining if their bleeding is small to moderate or heavy?
Not at all
what is the flow of hormones controlling the menstrual cycle?
Hypothalamus--> GnRH
Ant. Pituitary-->FSH and LH
Ovaries-->Progesterone, Estradiol
What parts of the endometrium cycle?
Only the upper 2/3rds (the functionalis)

the basal third (basalis) stays in place
Luteal and Follicular are also known as?
Luteal Phase = Secretory
Follicular = Proliferative
Histological appearance of Proliferative Endometrium?
Tubular Glands w/ Columnar Cells
Surrounding Dense Stroma
Histological appearance of the Secretory Endometrium?
Larger Tortuous Glands w/ Secretions
Usual causes of abnormal neonatal uterine bleeding?
Estrogen withdrawal
Usual causes of abnormal genital bleeding in Premenarchal patients?
Foreign Body
Trauma
Infection
Urethral Prolapse
Sarcoma Botryoides
Ovarian Tumor
Precocious Puberty
Usual causes of abnormal genital bleeding in early post menarche pts?
Anovulation
Bleeding diathesis
Stress
Pregnancy
Infection
Usual causes of genital bleeding during the reproductive years?
Anovulation
Pregnancy
Cancer
Polyps, fibroids, adenomyosis
Infection
Endocrine Dysfxn
Bleeding diathesis
Meds
Types of endocrine dysfxn affecting stuff?
PCOS
Thyroid
pituitary adenoma
What is adenomyosis?
when endometrial glands and stroma are found in the myometrium
Perimenopausal causes of genital bleeding?
Anovulation
Polyps, Fibroids, Adenomyosis
Cancer
Menopausal causes of genital bleeding?
Atrophy
Cancer
Estrogen Replacement Therapy
What is Dysfunctional Uterine Bleeding?
Excessive bleeding w/o demonstrable organic cause (typically endocrine origin)
Amenorrhea is?
no cycle for at least 6 months
Polymenorrhea is?
bleeding at regular intervals of <21 days
what is Oligomenorrhea?
Uterine bleeding at intervals of > 35 days
Where else might vaginal bleeding originate?
Urinary Tract
GI Tract
What is the most common cause of abnormal bleeding in adolescents?
Pregnancy
what is the usual cause of Anovulation?
Unopposed Estrogen
What is a normal early U/S sign of pregnancy?
Double Decidual Sac Sign
What else is PCOS associated w/?
Hyperandrogenism and insulin resistance, obesity
Rx for PCOS?
OCPs (cause they have anti-androgenic effects)
Insulin-sensitizing agents
How many of adolescent admissions for menorrhagia are due to Coagulopathies?
12-33%
What % of adolescents presenting w/ menorrhagia at menarche have a coagulopathy?
50%
???
Initial Work-Up for an adolescent w/ AUB?
H & P (thyroid, abd, GU/Breasts)
Cultures
B-HCG, TSH, Prolactin
Rx for AUB?
Progesterone Challenge
OCPs (low dose, monophasic)
Rx underlying cause
Majority of post-menopausal AUB cases are caused by?
Atrophy (60%)
Other big deal for post-menopausal AUB?
Endometrial Cancer
Kicker for Dx of post-menopausal AUB?
BIOPSY
What are the most common pelvic tumors in women?
Leiomyomata (fibroids)
What the heck are Leiomyomatas?
Overgrowth of fibroblast in myometrium
What are the goals of Rx for bleeding?
Reduce blood loss
Regulate Cycle
Stimulate fertility?
Different Types of Pharmacotherapy
Hormones (ocp's)
Progestins
IUD
NSAIDs
Why are NSAIDs good?
Decrease pain and blood loss via prostaglandin effects
Types of Surgical Therapy?
Hysteroscopy