Obgyn - Menstruation & Bleeding

Front 1

What is the average age of menarche?

Back 1

12.43

Front 2

What is the average age of menopause?

Back 2

51.4

Front 3

The average woman has ___years of ovulatory reproductive cycles.

Back 3

30

Front 4

Duration of a cycle averages ____ with a range of ____ days and ____ distinct phases.

Back 4

- average 28d
- range 23-35d
- three distinct phases

Front 5

Describe the HPO

Back 5

Hypothalamic-Pituitary-Ovarian axis.
- Hypothal secretes GnRH
- Pituitary releases LH and FSH
- LH and FSH work on ovaries to release estradiol and progesterone. (neg feedback to pituitary and hypothalamsu)

Front 6

Estrogen, which consists of what three subhormones (a), is secreted by the ____ cells of the ovaries?

Back 6

a) Estrone, Estradiol, and Estriol
b) granulosa cells & corpus luteum structure

Front 7

Progesterone is secreted by the ____ within the ovaries.

Back 7

Corpus luteum structure

Front 8

The theca cells of the ovaries secrete _____, which is converted to ____

Back 8

a) androstenedione & testosterone
b) estrogen in the granulosa cells

Front 9

Phase I of the menstrual cycle includes:

Back 9

Menstruation and hte FOLLICULAR PHASE

Front 10

FSH stimulation is triggered by what?

Back 10

withdrawal of progesterone

Front 11

During the follicular phase, what hormone predominates?

Back 11

Estrogen.

Front 12

The follicular phase begins ____ and ends ____. It usually lasts ___ days.

Back 12

- onset of menses
- surge of LH
- 14d

Front 13

The second phase of menstrual cycle is:

Back 13

- ovulation

Front 14

Ovulation occurs within ___hrs of the LH surge on day ___ of hte cycle.

Back 14

- 30-36h
- day 11-13

Front 15

Phase III of menstrual cycle includes:

Back 15

- luteal phase:

Front 16

What is the predominant hormone in the luteal phase?

Back 16

Progesterone

Front 17

How long is the luteal phase?

Back 17

14 days

Front 18

Endocervix mucus during the follicular phase would appear how?

Back 18

thin, clear, watery (estrogen)

Front 19

Endocervix mucus during the luteal phase would be how?

Back 19

thick (progesterone)

Front 20

Breast tenderness and fullness are mediated by ___(estrogen/progesterone)

Back 20

Progesterone

Front 21

PMS is cyclical and associated with ____

Back 21

decreased serotonin during luteal phase

Front 22

Diagnosis of PMS requires:

Back 22

- asymptomatic follicular phase, absence of other confounding factors, 3+ consectuive cycles, and 1 of the following
- depression, anger, irritability, anxiety, confusion, withdrawal, bloating, headache, edema

Front 23

What is PMDD?

Back 23

Premenstrual dysphoric disorder.

PMS to the extreme: 5/11 symptoms with one core symptoms (depression, anxiety, irritability, or anhedonia).
- interferes with life,
- 2+ consecutive cycles

Front 24

Tx of PMS is:
Tx of PPMD is?

Back 24

- diet, exercise, sodium rest., eliminate ETOH or caffien, NSAIDS, OCPs, SSRIs
- PPMD: same, but more aggressive... SSRI's = GOLD STANDARD, OCPs

Front 25

What is defined as secondary amenorrhea?

Back 25

- absence of menstruation for 3-6mos in previously normally menstruating woman, or 3 typical cycle lengths in a woman with oligomenorrhea.

Front 26

What is the most common cause of amenorrhea?

Back 26

Prenancy

Front 27

Ovarian failure is considered premature under age ___

Back 27

40

Front 28

What are the two types of abnormal uterine bleeding?

Back 28

anovulatory: endometrium outgrows its blood supply and shloughs at irregular and unpredicatble times

ovulatory: luteal phase defect. insufficient progesterone sectretion.

Front 29

Why is it important to treat AUB?

Back 29

risks of anemia, acute homorrhage, endometrial hyperplasia/CA

Front 30

How do you treat AUB?

Back 30

Mirena IUD
Provera
OCP

Front 31

differentiate between primary and secondary dysmenorrhea.

Back 31

Primary: excess prostaglandids lead to painful uterine muscle cramping

Secondary: caused by clinically identifiable cause (extrauterine, tumors, intramual, intrauterine)

Front 32

How can you differentiate between dysmenorrhea and chronic pelvic pain?

Back 32

- cyclic vs constant nature of pain (respectively)

Front 33

The goal of tx for CPP is:

Back 33

- to improve quality of life, may not be able to cure - no IDable cause/ no accepted definition.