Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
22 Cards in this Set
- Front
- Back
|
What determines the cycle length?
|
Day 1 of bright red bleeding to the next time of bright red bleeding
Average is is 28 days 21-35 still within normal limits |
|
|
What defines oligo and hypermenorrhea?
|
Oligomenorrhea > 35 day cycles
Hypermenorrhea < 21 day cycles |
|
|
biggest cause of oligomenorrhea? others? tx?
|
biggest: anovulation
others: Extremes of age – teens and perimenopause Tx: Oral contraceptives Cyclic progestins (trick the body into thinking it is in withdrawal) |
|
|
What problem can hypothyroidism cause with respect to a woman's cycle? what is important to remember about the tx?
|
oligomenorrhea
Treat with thyroid hormone – clinical response won't show up for 6 – 8 weeks |
|
|
What problem can hyperthyroidism cause with respect to a woman's cycle?
|
Oligomenorrhea or hypermenorrhea
|
|
|
pt has amenorrhea that is attributed to a prolactinoma...what do you do for tx? (there are 2 things to consider here)
ALSO; this had **** on her slide, but she didn't even mention it |
TSH can be elevated... so one tx:
****Treat hypothyroidism if TSH is elevated ****Treat with bromocriptine if isolated ^prolactin |
|
|
What effects can anorexia and obesity have on cycles?
|
Anorexia: Period loss
Obesity: Lots of estrogen, gets converted to testosterone-->leads to Polycystic Ovarian Syndrome |
|
|
An overweight woman comes to the office with oligomenorrhea, acne, and hirsuitism. She comes in because she is having difficulty getting pregnant. What should you start thinking?
|
Polycystic Ovarian Syndrome
Note: this can also be in normal weight women |
|
|
Rosary beads/String of pearls=
(she said this is common for boards, not in real life, or really important for her) |
cysts arrested in development that line the peripheral of the ovary
POLYCYSTIC OVARIAN SYNDROME |
|
|
27 year old woman trying to get pregnant has oligomenorrhea. You do an ultrasound and see slight endometrial proliferation. Why should you get a biopsy?
|
this is POLYCYSTIC OVARIAN SYNDROME
it can lead to ENDOMETRIAL CANCER |
|
|
What role does insulin resistance play in PCOS?
|
Insulin like growth factor abnormally stimulates an already overestrogenized endometrium – furthers endometrial cancer risk
|
|
|
Weight loss can help increase ovulation, how much do you need to lose do this?
|
only 10%
|
|
|
Major tx for PCOS?
|
Oral contraceptives
Increase SHBG – decrease free testosterone Improves acne, hair growth, male pattern balding Empties uterus monthly – may reduce long term risk of endometrial cancer |
|
|
This drug increases insulin sensitivity and thus can be used as a tx for PCOS. What is the drug? What is a possible side-effect that can be beneficial?
|
Metformin
May aid in weight loss- they will poop their brains out |
|
|
What is Ovarian drilling?
|
allows for rupture and release of follicles by poking holes into the ovary
you do this when you see the rosary beads/pearls pattern (PCOS) |
|
|
What is the difference between dysfunctional and abnormal bleeding?
****COMMON PIMP QUESTION: TEST CITY |
Dysfunctional uterine bleeding – physiological dysfunction (anovulation)
Abnormal uterine bleeding – anatomical abnormality (think like a polyp on the uterus or fibroids) |
|
|
Most common reason of Abnormal uterine bleeding?
|
FIBROID
remember, AUB is due to anatomical abnormality while DUB is due to physiological bleeding....aka this is AUB |
|
|
what are the common presentations for:
Endometrial cancer? Cervical cancer? (I don't think these will be on the test, but who knows) |
Endometrial Cancer – postmenopausal bleeding
Cervical Cancer – postcoital bleeding note to remember: Endometrial Hyperplasia – precancerous |
|
|
What are some of the tx options for DUB?
|
OCP’s
Cyclic progestins Continuous progestins – includes Depo Provera (she HATES this drug, tons of side effects), Mirena IUD (she LIKES this drug but it can be expensive and have side effects) |
|
|
you suspect a pt has DUB so you start her on an OCP. She comes back later and is still bleeding, what is going on?
***STARRED ON SLIDE |
****If the bleeding is due to an anatomical cause, it won’t respond.
so she likely has a fibroid or polyp or some ANATOMICAL cause (AUB) |
|
|
What is Dilation and Curettage?
possible adverse effect? |
Scrape endometrium--Diagnostic test
DOES NOT TREAT ABNORMAL BLEEDING Adverse effect: Asherman’s Syndrome – amenorrhea, uterine synechiae, infertility (get tons of scarring, looks like spiderwebs, can't get preggo) |
|
|
what treatment can help reduce flow in up to 80% of biddies?
|
Endometrial ablation
|
