Abnormal bleeding Flashcards
mechanism of hormonally responsivity of uterine fibroids
increased amts of estrogen and progesterone mRNA
anovulation with abnormal uterine bleeding results from
chronic exposure of endometrium to estrogen without beefit of cyclic exposure ot postovulatory progesterone
endometrium becomes abnromally thickened and structurally incompetent
endometriosis =
presence of endometrial glnads and stroma outside the endometrial cavity and uterine musculature
can result in ahesions, pain, infertility and inflammation
time of appearance uterine fibroids
reproductive years
rare before puberty
typically regress before menopause
menometrorrhagia =
oligomenorrhea =
metorrhagia =
menorrhagia =
menometrorrhagia = irregualr bleeding intervals with ecessive flow or duration
oligomenorrhea =mensturation fewer than 9 times per year (>35 day interval)
metorrhagia =irregular intervals
menorrhagia = excessive bleeding (>7d, >80mls)
overall risk of progression to endometrial cancer based on
duration of unopposed estrogen exposure
endometriosis contributes to infertility via
ahesions distort anatomy
ovarian cysts
macrophages and cytokines .> inflammatory state
adversely affects endometrial receptivity
increases risk of uterine fibroids
decreases risk
parity decreases risk
obesity increases risk
benign uterine neoplasms
endometrial polyps - fleshy outgrowths
endocervical polyps - outgrowths of cervical mucosa
adenomyosis - invasion of endometrium into myometrium, causes menorrhagia and dysmenorrhea, enlarged, tender uterus
endometrial atrophy =
often described as spotting
related to hypoestroenism
clinically similar to endometrial cancer: Biopsy!!
symptoms leiomymoma (uterine fibroids)
menorrhaiga, menometrorrhagia
refractory anemia
spotting
pelvic pain
mass symptoms (urinary pressure/urgency, flank pain, abd girth)
