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22 Cards in this Set
- Front
- Back
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25. Metrorrhagia?
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a. Bleeding that occurs between regular menstrual cycles.
b. This bleeding is usually < than or equal to menses. |
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26. Primary causes of Metrorrhagia?
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a. Cervical lesions (polyps, eversion, carcinoma)
b. Endometrial polyps and carcinoma. |
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27. Menometrorrhagia?
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a. Excessive (>80ml) or prolonged bleeding at irregular intervals.
b. Usual causes: uterine fibroids, adenomyosis, endometrial polyps, hyperplasia, cancer. |
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28. Thyroid and vaginal blood flow?
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a. Thyroid disorders can result in ↑ or ↓ flow or no change.
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29. Oligomenorrhea definition?
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a. Periods GREATER THAN 35 days apart.
b. Causes are similar to amenorrhea w/disruption of hypothalamic-pituitary-gonadal axis or systemic diseases such as hyperprolactinemia and thyroid disorders. |
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30. Most common causes of oligomenorrhea?
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30. Most common causes of oligomenorrhea?
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31. When a pt has no period for 6 consecutive months?
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a. Secondary amenorrhea is diagnosed.
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32. Polymenorrhea?
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a. Frequent periods.
b. Describes regular periods that occur <21 days apart. c. Can be confused with metrorrhagia (intermenstrual bleeding). d. However, if all of the bleeding episodes are similar in amount and fewer than 21 days apart, polymenorrhea should be considered |
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33. Usual cause of polymenorrhea?
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a. Anovulation!
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34. When should bleeding warrant an endometrial biopsy?
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a. Any woman age 35 or older with abnormal uterine bleeding (excessive or insufficient).
b. Obese pts w/prolonged oligomenorrhea should also undergo endometrial biopsy even if they are under age 35. |
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35. 4 causes of pathologic anovulation?
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1. Hypothyroidism
2. Hyperprolactinemia 3. Hyperandrogenism 4. PMOF. |
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36. Tests for ovulation?
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a. Basal body temperature rise at ovulation.
b. Tests for detecting LH surge. c. Mid-luteal, day 21-24 serum progesterone level may also indicate if a pt is ovulating |
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37. Tx of Acute haemorrhage in dysfunction uterine bleeding?
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a. IV oestrogen provides a quick response but also carries risk of ↑’d thromboembolic events.
i. Typical dosing is 14-21 days followed by medroxyprogesterone. b. An OCP taper also be used for endometrial stabilization. |
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38. Nonhormonal therapy for chronic DUB?
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a. NSAIDS have been shown to ↓ menstrual blood loss by 20-50%.
b. This may be used alone or in conjunction w/oestrogen and progesterone therapy. |
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39. Primary tx for anovulatory DUB?
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a. Hormonal therapy.
b. This can include a combination of oestrogen and progesterone in the form of OCPs, Ortho Evra patch, or NuvaRing. c. In pts of whom oestroen is contraindicated, a progestin-only dosing can be used. (either Medroxyprogesterone or Progesterone in the form of Depo Provera levonorgestrel-releasing IUS (Mirena), or Implanon. |
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40. Surgical tx of DUB?
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a. May be necessary if not responsive to meds.
b. D&C may be both diagnostic and therapeutic but the result can be temporary. c. In women who have completed childbearing, endometrial ablation can also be used to tx DUB. d. Hysterectomy is the definitive surgery for DUB. |
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41. Note: Any postmenopausal bleeding is abnormal and should be investigated given the increased risk of reproductive cancers in women in this age group.
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a. The most common cause however, is endometrial and/or vaginal atrophy, not cancer.
b. 10-15% are cancer. |
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42. Most common cause of lower genital tract post-menopausal bleeding?
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a. Vaginal atrophy due to lack of oestrogen.
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43. Pathologic causes of post menopausal bleeding from upper genital tract?
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a. Endometrial polyps
b. Endometrial hyperplasia c. Endometrial cancer. |
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44. Most common cause of postmenopausal bleeding?
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a. Exogenous hormones.
b. Still requires eval to r/o endometrial hyperplasia/cancer. |
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45. How wide should the endometrial stripe be in postmenopausal women?
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a. ≤ 3mm.
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46. Tx of endometrial hyperplasia?
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a. Progestin therapy or hysterectomy.
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