Abnormal Intrauterine bleeding Flashcards
Defined as menstrual bleeding of abnormal
Normal menses occur in cycles every __ days
Volume < ___
Duration
quantity, duration, schedule
21-35
80mL
2-7 dyas
Menorrhagia is ___ uterine bleeding
Metorrhagia (polymenorrhea) is ___ bleeding
Menometrorrhagia is __ bleeding
heavy, regular
frequent, irregular
heavy, irregular
Etiologies of AUB acronym
Structural causes is the
Non structural causes is the
P A L M C O E I N
PALM-COEIN
Palm portion
Coein portion
Poylp Adenoma Leiomyoma Malignancy/hyperplasia Coagulopathy Ovulatory dysfxn Endometrial Iatrogenic No classification
Polyps are overgrowths of
Majority are ___, can be assc w
Patho is ____ responsive
RF include
Endometrial glands/stroma
Benign, premalignant/malignant cx
Hormone
Exogenous estrogen
Tamoxifen
Obesity
Adenomysosis benign ___ and ____ present within the ___
Patho is
Typically dx after ___ confirming glands in ___
endometrial glands, stroma, myometrium
not understood
hysterectomy, muscle tissue
Leiomyomas aka
Benign ___ tumors arising from
MC __ in women
Can be submucosal __
Intramural ___
Subserosal ____, more ___
Patho is
More common in
Can be tx w
fibroid tumors/myomas
SM, myometrium
pelvic tumor
underneath myometrium
win center wall of myometrium
under serosal surface, exophytic
multifactorial
black women
hormonal meds, surgery
Endometrial hyperplasia is a ___ to malignancy
May be ___/___ w/wo ___
Atypical variants have high risk for progression to malignancy w/out ___
___ may reverse, ___ is definitive management
precursor lesion
simple/complex, atypia
tx
Progesterone, surgery
Endometrial Adenocarcinoma __ lesions more common
Tend to be ___ to __ differentiated, endometrioid, ____ invasive
__ prognosis
Classically occurs in obese women w ____
comorbids include
Type 1
well/moderately, superficially
good
hyperestrogenism
DM, HTN, hyperlipidemia
Endometrial Adenocarcinoma Type 2
more __/___
No clear pathway resulting in
tend to be __ differentiated, ___ cell types (serous, clear cell) w deep invasion
___ metastasis
Prognosis is
RF: N, L, D/H/O, I, T
Adipose converts ___ into estrone, a weak estrogen via ___ to stimulate the endometrium (link for __)
rare, aggressive
carcinoma
poorly, aggressive
lymph node
poor
Nulliparity, Late menopause, DM/HTN/Obesity, Iatrogenic unopposed estrogen, Tamoxifen
androstenedione, aromatase, obesity
Hereditary endometrial cancer possible w ___ due to mutations in ___
Most prominent sx
Dx by
HNPCC (lynch), mismatch repair
post menopausal bleeding, AUB
Endometrial biopsy, D/C
Uterine sarcomas
___ is a rare maligancy of myometrium
may not be distinguishable from ___, but are ____
Endometrial stromal sarcoma often ___ and ____ responsive
Carcinosarcoma is ___ with ___/___ components
Leiomyosarcoma
fibroid tumor, aggressive
low grade, hormonally
very aggressive, endometrial/stromal
Cervical cancer
Caused by high risk strains of ___, such as
Primary prevention via
Secondary prevention via
Precursor lesion is
Sx include ___ (esp postcoital), ___
Late stages may have ___ pain and signs of ____ due to ureteral obs
Dx made by
HPV, 16/18
vaccination
Pap smear/HPV screening
cervical dysplasia
vaginal bleeding, vaginal discharge
back, renal failure
exam/biopsy
Coagulopathy
can present at
May have hx of ___ or ___ w minor injury
Ovulatory dysfxn
dysreg of menstrual cycle due to ___/___ ovulation may lead to ____ bleeding as endometrium sheds in ___
young age
easy bruising, heavy bleeding
infreq, absent, erratic, non uniform pattern
Endmetrial causes
can be related to __ leading to ___, either acute/chronic
Lack of __ leads to atrophy of endometrial tissue and eventually ____
infection, endometritis
estrogen, bleeding
Iatrogenic
due to medically indicated ____ such as W, F, A
If unable to stop med, ___ can stop bleeding
NOS
rare causes such as
pharm agents, Warfair, Factor Xa inhib, Anti-platelet agents
surgery
AVM
