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Women's Health > Abnormal Menstruation > Flashcards

Abnormal Menstruation Flashcards

1
Q

What is a cause of primary dysmenorrhea?

A

prostaglandin abnormalities (overproduced)

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2
Q

What are some common causes of secondary dysmenorrhea

A

endometriosis & uterine fibroids, infxn, or IUD

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3
Q

How is abnl menstruation defined:

A

interval: less than 21 days or more than 45
Flow: more than 8-10 days or less than 2

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4
Q

define menorrhagia

A

heavy or prolonged bleeding

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5
Q

define metrorrhagia

A

intermensrual bleeding, spotting, or breakthrough bleeding

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6
Q

A pt comes in complaining of cyclic dysmenorrhea that lasts longer and becomes more severe over time, pelvic pain, worse w/ menses & ovulation

A

Endometriosis

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7
Q

What PE findings will help support ur suspicion of endometriosis?

A

Cervical motion tenderness, palpable nodules, fixed/tender/enlarged adnexa

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8
Q

How do u work up a pt suspected of endometriosis?

A

U can U/S

Diagnostic is laparoscopy

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9
Q

How do u tx a pt with endometriosis?

A

Mild pain-NSAID’s or OCP

& if no relief refer to GYN for surgery or hormone interventions

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10
Q

Who is at risk for uterine leiomyomata aka Fibroids

A

African American women in 30-40’s

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11
Q

List the 7 RF’s for fibroids aka uterine leiomyomata

A

early menarche, meat consumption, family hx, beer, history of uterine infxn, vit. d deficiency, obesity

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12
Q

List the 9 factors that decrease ur risk for fibroids

A

> 1 pregnancy, OCP’s, smoking, green veggies/fruits, dietary vit. A, progestin only injectable, menopause, exercise

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13
Q

what are the sx of increased uterine bleeding, pelvic pressure/pain, and in some infertility

A

fibroids

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14
Q

what is the PE findings going to be for fibroids

A

enlarged, irregular, mobile uterus

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15
Q

Which labs would u be likely to order for fibroid w/u

A

TSH, CBC, pap smear

Also, transvaginal U/S

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16
Q

how do we manage fibroids aka uterine leiomyomata

A

observe

prophylactic myomectomy vs. hysterectomy depending on age & if they want to remain fertile… OCPs and Lupron

17
Q

What is the COPE calendar used for?

A

following sx of PMS for a month to assess dx & tx

18
Q

If someone is having worse sx than PMS such as anger, irritability, internal tension what dx would u consider

A

premenstrual dysphoric d/o

19
Q

what are some causes of primary amenhorrea? how is it defined?

A

None by age 15 or by time sexual maturation.. causes-stress, athletics, wt, turner syndrome

20
Q

what is the #1 cause of 2ndary amenorrhea

A

pregnancy

21
Q

what are some other causes of secondary amenorrhea

A

hypothalamic dysfxn; female athlete triad, thyroid dz, pituitary dz, polycystic ovarian syndrome, asherman’s syndrome

22
Q

How do u define Asherman’s syndrome? How would u evaluate it…

A

scarring of endometrial lining due to previous infxn or surgery… pelvic U/S, progestin challenge

23
Q

How would a normal uterus respond to the progestin challenge?

A

If they are amenorrhic, they will have their period if everything is intact

24
Q

how do we tx asherman’s syndrome

A

hysteroscope lysis or estrogen therapy

25
Q

If someone bleeds in response to the progesterone challenge, which dx are we considering?

A

Polycystic ovarian dz or anovulation

26
Q

If someone doesn’t respond to progestin challenge, what are possible dx?

A

asherman’s or outlet obstruction..

27
Q

what is the mnemonic we use for classification system for abnormal uterine bleeding

A 
PALM-COEIN
Polyp
Adenomyosis
Leiomyoma
Malignancy/hyperplasia
Coagulopathy
Ovulatory dysfxn
endometrial 
iatrogenic 
Not yet haclassified
28
Q

What is the cardinal finding for endometrial cancer

A

uterine bleeding in a postmenopausal women

29
Q

what can chronic unopposed estrogen cause…

A

endometrial hyperplasia

30
Q

what are some RF’s for endometrial ca

A

age, unopposed estrogen tx, late menopause, PCOS, obese, DM, hereditary colorectal ca, tamoxifen therapy, early menarche, nulliparity(having no children)

31
Q

what is diagnostic for endometrial ca

A

thickened endometrial stripe on U/S & endometrial bx

32
Q

If endometrial bx shows hyperplasia without atypia how would u tx?

A

D&C

33
Q

endometrial bx shows hyperplasia with atypia how would u tx?

A

hysterectomy

34
Q

how do u tx endometrial ca if found on bx

A

refer to GYN

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