Abnormal Uterine Bleeding

Question 1

Abnormal uterine bleeding (AUB) refers to menstrual bleeding of abnormal______

Answer 1

quantity, duration, or schedule

Question 2

the causes of AUB is referred to by the acronym ___

Answer 2

PALM-COEIN

Question 3

PALM-COEIN means

Answer 3

P: Polyp
A: Adenomyosis
L: Leiomyoma
M: Malignancy/Hyperplasia
C: Coagulopathy
O: Ovulatory dysfunction
E: Endometrial
I: Iatrogenic (anticoagulants, OCPs, IUD) or Infection/Inflammation
N: Not yet classified

Question 4

Postcoital bleeding is ___ until proven otherwise

Answer 4

cervical cancer

Question 5

AUB workup

Answer 5

CBC to see if hemoglobin and hematocrit have dropped
PT/PTT to evaluate for coagulation disorder
Pelvic ultrasound to visualize any anatomical abnormality

Question 6

When is an endometrial biopsy indicated?

Answer 6

-Any postmenopausal bleeding
- AUB in women >45 years old
- In women <45 years old, with the esTpetial risk factors.
Atypical glandular cells on Pap smear

Question 7

What is that you call “the esTpetial risk factors”?

Answer 7

• with BMI ≥30
• chronic unopposed estrogen exposure
• failed medical management of AUB, or
• high risk of endometrial cancer