Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gynaecology > 15. In the reproductive age group > Flashcards

15. In the reproductive age group Flashcards

1
Q

What is the focus of the approach to abnormal uterine bleeding (AUB) in the reproductive age group?

A

The focus is on an approach to the problem rather than the management of specific disorders.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When discussing AUB, which sources of bleeding must first be excluded?

A

Rectal, bladder, lower genital tract, and cervical pathology must be excluded.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Does this approach to AUB include bleeding related to pregnancy?

A

No, bleeding related to pregnancy is not reviewed in this approach.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How should a woman presenting with bleeding be initially described before determining the source?

A

She should be described as having abnormal vaginal bleeding until a gynecological examination confirms the source.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the four key features to assess when describing a menstrual bleeding pattern?

A
  1. Regularity of onset
  2. Frequency of onset
  3. Duration of flow
  4. Heaviness/volume of flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the normal frequency of menstrual cycles?

A

24–38 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is a menstrual cycle classified if it occurs more frequently than every 24 days?

A

Frequent (<24 days).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is a menstrual cycle classified if it occurs less frequently than every 38 days?

A

Infrequent (>38 days).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is considered a regular menstrual cycle based on cycle-to-cycle variation over 12 months?

A

A variation of 2–20 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What cycle-to-cycle variation is classified as irregular?

A

A variation of >20 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the normal duration of menstrual flow?

A

4.5–8 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is menstrual flow classified if it lasts more than 8 days?

A

Prolonged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is menstrual flow classified if it lasts less than 4.5 days?

A

Shortened

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the normal range for monthly blood loss?

A

5–80 mL.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is menstrual bleeding classified if blood loss is >80 mL per month?

A

Heavy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is menstrual bleeding classified if blood loss is <5 mL per month?

A

Light.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is heavy menstrual bleeding (HMB) defined according to the UK NICE guidelines?

A

Excessive menstrual blood loss that interferes with a woman’s physical, emotional, social, and material quality of life, occurring alone or with other symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is intermenstrual bleeding?

A

Bleeding that occurs between normally timed cycles, in either a regular or irregular pattern.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the definition of acute uterine bleeding?

A

An episode of bleeding in a non-pregnant woman of reproductive age that requires immediate intervention to prevent further blood loss.

20
Q

What is the definition of chronic abnormal uterine bleeding?

A

Bleeding from the uterine corpus that is abnormal in duration, volume, and/or frequency, and has been present for the majority of the last 6 months.

21
Q

Why should the term dysfunctional uterine bleeding (DUB) no longer be used?

A

The term is obsolete and has been replaced by more specific classifications of abnormal uterine bleeding.

22
Q

What does the PALM-COEIN classification system describe?

A

It categorizes the causes of abnormal uterine bleeding into structural (PALM) and non-structural (COEIN) causes.

23
Q

What does the P in PALM stand for?

A

Polyp – a benign overgrowth of endometrial or cervical tissue.

24
Q

What does the A in PALM stand for?

A

Adenomyosis – endometrial tissue growing into the myometrium.

25
Q

What does the L in PALM stand for?

A

Leiomyoma (fibroids) – classified into submucosal and other types.

26
Q

What does the M in PALM stand for?

A

Malignancy & hyperplasia – abnormal endometrial growth, which can be precancerous or cancerous.

27
Q

What does the C in COEIN stand for?

A

Coagulopathy – bleeding disorders that affect clotting, such as von Willebrand disease.

28
Q

What does the O in COEIN stand for?

A

Ovulatory dysfunction – irregular or absent ovulation leading to unpredictable bleeding patterns.

29
Q

What does the E in COEIN stand for?

A

Endometrial causes – local endometrial dysfunction leading to abnormal bleeding.

30
Q

What does the I in COEIN stand for?

A

Iatrogenic – bleeding caused by medications or medical interventions (e.g., hormonal therapy, anticoagulants, IUDs).

31
Q

What does the N in COEIN stand for?

A

Not yet classified – emerging or unknown causes of abnormal uterine bleeding.

32
Q

What is the primary goal of history-taking in AUB?

A

To determine ovulatory status and possible underlying causes

33
Q

How does ovulatory bleeding typically present?

A

Predictable, cyclic menstruation (suggests normal ovulation).

34
Q

How does anovulatory bleeding typically present?

A

Irregular, unpredictable cycles (suggests ovulatory dysfunction).

35
Q

How sensitive is a structured history for detecting coagulation disorders?

A

90% sensitive.

36
Q

What is a positive screening result for a coagulopathy?

A

Any of the following:

  • Heavy menstrual bleeding since menarche
  • One of the following:
  • Postpartum hemorrhage
  • Surgical-related bleeding
  • Bleeding after dental work
  • Two or more of the following:
  • Bruising 1–2 times per month
  • Epistaxis 1–2 times per month
  • Frequent gum bleeding
  • Family history of bleeding disorders
37
Q

How is AUB due to anticoagulants classified?

A

AUB-C1

38
Q

What are the key objectives of the physical exam in AUB?

A
  • Detect problems not obvious from history
  • Identify anaemia and other consequences of blood loss
  • Exclude cervical and lower genital tract pathology
  • Confirm that bleeding is of uterine origin
  • Identify pelvic masses that may contribute to symptoms
39
Q

What basic laboratory test should be done in all AUB patients?

A

Full blood count (FBC) to assess for anaemia.

40
Q

When should endocrinopathy be evaluated?

A

If anovulation is suspected.

41
Q

When should testing for inherited coagulopathy be done?

A

If screening for coagulopathy is positive.

42
Q

When should an endometrial sample be taken?

A
  • All women >45 years
  • Younger women at high risk for endometrial cancer
43
Q

What imaging tests may be useful in AUB?

A

Transvaginal and/or transabdominal ultrasound

Sonohysterography and hysteroscopy

44
Q

When should a PAP smear be performed?

A

As per screening guidelines to exclude cervical pathology.

45
Q

Management

A

As per screening guidelines to exclude cervical pathology.

Gynaecology (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions