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6 Cards in this Set
- Front
- Back
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Define post menopausal bleeding? |
- Any vaginal bleeding after a period of amenorrhoea of 6 months or more in the perimenopausal age group
- Menstruation after age 55 years - Vaginal bleeding in the presence of raised FSH and LH values in perimenopausal age group |
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What are the dangerous causes of postmenopausal bleeding? |
Carcinomas (Cx, endometrium, sarcomas)
Submucous fibroids Endometrial polyps Oestrogen therapy Bleeding from bladder or rectum Trauma Atrophic endometritis |
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What are the frequent causes of postmenopausal bleeding? |
Atrophicendometritis 40-45%
Malignancies25% –Endometrialcarcinoma –Cervicalcarcinoma –Uterinesarcomas –Endometrialhyperplasia Polypsand fibroids 10-15% Hormonetherapy 25% Otherdisorders 10% |
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What is the approach to a patient with postmenopausal bleeding? |
History–Full history of: bleeding, medication, trauma, climacteric complaints, medical status,operations
Examination - Generaland systemic, abdomen - Noteobesity, diabetes, anemia, hypertension - Gynaecologic:inspection, speculum, e/e smear, bimanual examination |
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What special tests should be preformed in a patient with post menopausal bleeding? |
Endometrialthickness measurement on ultrasound
–Side-to-side4mm or less: 97% chance for atrophy Endometrialsampling –Outpatientprocedure, small vacuum pipettes D&Cand hysteroscopy –Ifnot possible to do sampling in office |
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How do we treat postmenopausal bleeding? |
Treat the cause- Atrophy: topical or systemic oestrogens- Polyps or fibroids: usually hysterectomy- Hyperplasia: P Rx or hysterectomy- Malignancies: treat as for specific typeFollow-up
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