Abnormal Menstrual Cycles Flashcards
What 2 items define Primary Amenorrhea?
- No menses by 15 WITH secondary sex characteristics
- No menses by 13 WITHOUT secondary sex characteristics
What 2 items define Primary Amenorrhea?
- No menses by 15 WITH secondary sex characteristics
- No menses by 13 WITHOUT secondary sex characteristics
Describe Androgen Insensitivity Syndrome. Karyotype?
46XY
- Phenotypically FEMALE
- NO pubic hair
- Absent cervix, uterus, ovaries
Describe Klinefelter Syndrome. Karyotype?
47XXY
- Phenotypically MALE + Female characteristics
- Long arms/legs and wide hips
- Larger breasts
- Lack of male pattern body hair
- Small testes
Signs of Kallmann’s Syndrome?
Hypogonadotropic Hypogonadism + anosmia
Besides Kallmann Syndrome, what else can lead to hypogonadism and delayed puberty?
Malnourished and excessive exercise
What things can be done in the workup for Primary Amenorrhea?
US
FSH/LH and Estrogen levels
Karyotype Analysis
What defines Secondary Amenorrhea?
NO menses for 6 months after previously having them
What defines Secondary Amenorrhea?
NO menses for 6 months after previously having them
What is the initial workup for Secondary Amenorrhea? (4)
UPT
FSH
TSH
Prolactin
What defines Primary Dysmenorrhea?
Pain with Menses with NO pathologic cause
What is a possible reason for Primary Dysmenorrhea?
Excess prostaglandins
What are some treatment options for Primary Dysmenorrhea?
NSAIDs
OCPs
IUD
Topical heat
What defines Secondary Dysmenorrhea?
Pain with Menses due to a specific organic cause
What are examples of things that cause Secondary Dysmenorrhea?
Endometriosis
Adenomyosis
Fibroids
PID
What is Endometriosis?
Endometrial glands/stroma outside of the uterus
How is Endometriosis diagnosed?
Laparoscopy and direct visualization of lesions
How may the lesions look with Endometriosis?
“Powder burned” – dark brown appearance
“Chocolate cyst” – Endometrioma on the ovary
What are some common symptoms of Endometriosis?
Infertility
Pain with menses/sex
Pelvic pain
What is Adenomyosis?
Endometrial tissue in the myometrium of the uterus
How will Adenomyosis present?
Pain and heavy periods
How will the uterus feel with Adenomyosis?
Symmetrically ENLARGED
How do you diagnose Adenomyosis?
Tissue sample
You can try symptomatic relief with Adenomyosis but what is the definitive treatment?
Hysterectomy
What is the pneumonic for abnormal bleeding?
PALM - COEIN
What are structural causes of abnormal uterine bleeding?
PALM
- Polyps
- Adenomyosis
- Leiomyomas
- Malignancy
What are non-structural causes of abnormal uterine bleeding?
COEIN
- Coagulopathy
- Ovulatory dysfunction
- Endometrial
- Iatrogenic
- Not yet classified
What is the pneumonic for abnormal uterine bleeding and what it stands for?
PALM - COEIN
Polyps
Adenomyosis
Leiomyomas
Malignancy
-
Coagulopathy
Ovulatory dysfunction
Endometrial
Iatrogenic
Not yet classified
Painful and very heavy periods with a symmetrically enlarged uterus?
Adenomyosis
Cyclic pelvic pain, pain with sex and menses and infertility is likely?
Endometriosis
More than 35 days between periods
Oligomenorrhea
Less than 21 days between periods
Polymenorrhea
Heavy periods
Menorrhagia
Intermenstrual bleeding
Metrorrhagia
Heavy periods with intermenstrual bleeding
Menometrorrhagia
