185- abnormal uterine bleeding Flashcards

1
Q

vulvovaginal atrophy: what? why? who?

A

thin, friable tissue due to lack of estrogen. Common in post-menopausal women

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2
Q

endometrial hyperplasia: what is it? typical presentation? precursor to? Treatment?

A

increase in estrogen promoting endometrial proliferation with lack of progesterone. Leads to lack of normal shedding. Usually presents with abnormal uterine bleeding. Precursor to Type 1 endometrial cancer. Hysterectomy when there is complex atypical hyperplasia. Progesterone if they still want to be fertile

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3
Q

what are irregular and heavy menses a hallmark of?

A

anovulatory bleeding which results in prolonged estrogen exposure without opposing progesterone from ovulation

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4
Q

why does obesity increase risk of endometrial CA?

A

peripheral conversion of A->E by aromatase

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5
Q

What percent of postmenopausal bleeding is endometrial cancer? what are the two types

A

15-25%. Type1: estrogen dependent, arise in background of hyperplasia. Type 2: estrogen independent, arise in background of atrophy, more aggressive than type1.

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6
Q

Nonclassical CAH: deficiency of what? what do you test for?

A

21-hydroxylase deficiency. Test 17-hydroxyprogesterone

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7
Q

why do OCPs improve hirsutism and acne in PCOS?

A

increase SHBG and therefor decrease free T

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8
Q

clomiphene: mechanism of action? who do you use it on? side effects?

A

SERM. partial agonist at estrogen receptors in hypothal (prevents feedback inhibition which ^ FSH/LH which stimulates ovulation).

Use for infertility and PCOS.

multiple pregnancies, hot flashes, ovarian enlargement, visual disturbances

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9
Q

uterine fibroids: arise from what cells? how common? Changes with hormones? presentation? Other effects?

A

SM cells of myometrium. 80% prevalence. Estrogen dependent. Half are asymptomatic but others p/w menorrhagia, pelvic pain, constipation, urinary frequency. Increase risk of miscarriage, breech presentation

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