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Reproduction Week 1 2018/19 > 5: Menstrual disorders > Flashcards

5: Menstrual disorders Flashcards

1
Q

What are the two important gonadotrophins?

A

FSH

LH

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2
Q

Where are FSH and LH produced?

A

Posterior pituitary gland

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3
Q

In the first 12 days of the menstrual cycle, which hormones

a) stimulate development of ovarian follicles
b) trigger ovulation?

A

a) FSH

b) LH

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4
Q

What hormone is produced by the corpus luteum?

A

Progesterone

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5
Q

How long does an average menstrual cycle last?

A

28 days

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6
Q

Which hormone, produced in the proliferative phase of the menstrual cycle, stimulates thickening of the endometrium?

A

Oestrogen

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7
Q

Why does menstruation occur?

A

Endometrium outgrows blood supply

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8
Q

How long does menstruation last?

A

4 - 6 days of 28 day menstrual cycle

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9
Q

When does peak menstruation occur?

A

Days 1 - 2 of menstruation

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10
Q

Menstruation should be (light / heavy).

A

light

< 80ml

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11
Q

Menstrual loss should not contain ___.

A

clots

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12
Q

What is menorrhagia?

A

Prolonged, increased menstrual bleeding

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13
Q

What is metrorrhagia?

A

Regular intermenstrual bleeding

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14
Q

What is amenorrhoea?

A

No menstruation for > 6 months

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15
Q

What is oligomenorrhoea?

A

Menstruations more than 35 days apart

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16
Q

What is polymenorrhoea?

A

Menstruations less than 21 days apart

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17
Q

In the context of menorrhagia, what is dysfunctional uterine bleeding?

A

Non-organic menorrhagia

No organic cause or pathology

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18
Q

What is meant by a local cause of organic menorrhagia?

A

Limited to genital tract

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19
Q

What is the usual causal organism of pelvic inflammatory disease?

What structures does it tend to affect?

A

Chlamydia

Fallopian tubes

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20
Q

Which malignancies commonly cause menorrhagia?

A

Cervical carcinoma

Uterine carcinoma

21
Q

Which specific lining of the uterus may develop carcinomas?

A

Endometrium

22
Q

What is endometriosis?

A

Growth of endometrial tissue OUTWITH the uterus

23
Q

Which hormone, which thickens the endometrial lining in the uterus, does endometriosis grow in response to?

A

Oestrogen

24
Q

Organic causes of menorrhagia can be ___ or ___.

A

local or systemic

25
Q

What endocrine disease notably causes amenorrhoea and menorrhagia?

A

Hyperprolactinaemia

26
Q

systemic causes of amenorrhoea

A
27
Q

Why can liver disease cause menorrhagia?

A

Damaged liver doesn’t produce as much clotting factors

28
Q

Which class of drug, used to treat cardiovascular disease, may cause menorrhagia?

A

Anticoagulants e.g warfarin, NOACs

29
Q

Which abnormal pregnancy outcomes may cause menorrhagia?

A

Miscarriage

Ectopic pregnancy

Molar pregnancy

30
Q

Dysfunctional uterine bleeding is a diagnosis of ___.

A

diagnosis of exclusion

31
Q

dysfunctional uterine bleeding

A
32
Q

When are the ovaries’ best quality eggs released?

A

Teens / 20s

33
Q

Why does ovulatory DUB occur?

A

Defective corpus luteum doesn’t secrete as much progesterone, so secretory phase ends sooner and endometrium sheds more often

34
Q

What investigations should be done for a woman with dysfunctional uterine bleeding?

A

FBC (including coagulation. LFTs)

Cervical smear test

Liver, renal and thyroid function tests

USS (transvaginal)

Endometrial biopsy

35
Q

What are the two most common endometrial causes of organic menorrhagia?

A

Cervical/Endometrial? carcinoma

Fibroids

36
Q

What device is used to perform an endometrial biopsy?

A

Pipelle

37
Q

revise anatomy re: differentiating cervix and upper uterus

A
38
Q

Which device can be used to look inside the uterine cavity for polyps or tumours?

A

Hysteroscope

39
Q

pharma management of DUB

A
40
Q

give progestrogen five days into cycle i.e five days after cycle

stop at 25 days

repeats

A
41
Q

combined oral contraceptive pill also contains progestrogen

makes periods lighter and more frequent

A
42
Q

Which NSAID is often used for dysfunctional uterine bleeding?

Why?

A

Mefenamic acid

Inhibits prostaglandin production

43
Q

Which device can be fitted to slowly release progesterone to treat dysfunctional uterine bleeding?

A

Intrauterine coil

44
Q

What are two surgical treatments for dysfunctional uterine bleeding?

A

Resection / ablation of endometrium

Hysterectomy (surgical removal of the uterus)

45
Q

sub-total hysterectomy - cervix retained, body of uterus removed

A
46
Q

What is a consequence of doing a hysterectomy for DUB?

A

Infertility

47
Q

What is the technical name for bleeding after giving birth?

A

Post-partum haemorrhage

48
Q

Performing a hysterectomy renders a woman ___.

A

infertile

49
Q

Giving a patient excessive oestrogen (why would you do this)?? increases the risk of what?

A

Endometrial carcinoma

Reproduction Week 1 2018/19 (9 decks)

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