Abnormal uterine bleeding Flashcards
Classic symptoms of polyp x2
Intermenstrual bleeding
Heavy menstrual bleeding
Differential diagnosis for polyp x4
Endocervical polyp
Condylomata acuminata
Fibrinoid carcinoma
Granulation tissue
USS findings of adenomyosis x3
Bulky uterus
Heterogenous myometrium
Asymmetric thickness
Management of adenomyosis and leiomyoma x3
NSAIDs
Hormonal contraception
Hysterectomy
True or false. Leiomyoma causes changes in bowel and bladder habits
True
4 types of a leiomyoma
Subserosal
Submucosal
Intramural
Pedunculated
Causes of excess estrogen exposure x4
PCOS
Obesity
Early menarche
Late menopause
USS feature of endometrial hyperplasia
Endometrial thickness of 4mm+
Structural causes of AUB x4
Polyp
Adenomyosis
Leiomyoma
Malignancy/hyperplasia
Non structural causes of AUB x5
Coagulopathy
Ovulatory dysfunction
Endometrial
Iatrogenic
Not yet classified
Pathophysiology of von Willebrand disease x2
Von Willebrand disease
1. Decreased platelet adhesion in primary hemostasis > increased BT
2. Decreased clotting factor 8 activity in secondary hemostasis > Increased aPTT
2 points in history suggestive of coagulopathy
Hx of bleeding with dental procedures
Fam hx of heavy menses
Define metrorrhagia
Bleeding between periods
Periods more frequent than normal
Endocrine disorders associated with ovarian dysfunction x5
PCOS
Perimenopause
Hyperprolactinemia
Thyroid dysfunction
Hypothalamic hypogonadism
Iatrogenic causes of abnormal uterine bleeding x5
Hormonal therapy
Intrauterine devices
Tricyclic antidepressants
Anticoagulants
Corticosteroids
Endometrial causes of AUB x4
Endometritis
Cervicitis
PID
Intrauterine AV malformations
Management of endometrial causes of AUB x4
Antibiotics
Hormonal therapy
Analgesia
Hysterectomy
Unclassified causes of AUB x7
AV malformations
C/S scar defect
Myometrial hypertrophy
Endometrial pseudoaneurysm
Excessiveexercise, stress, anorexia
Define oligomenorrhea and 3 causes
Bleeding that occurs less frequently than 35 days
Pregnancy, PCOS, chronic anovulation
Define polymenorrhea
Bleeding that occur more often than 21 days
Pathophysiology of Depo provera on endometrial hyperplasia x2
Upregulates progesterone receptors on endometrium > decidualization of the endometrial hyperplasia
Causes of AUB in a 13-18y/o x5
Persistent anovulation
Hormonal contraceptives
Pelvic infection
Pregnancy
Coagulopathies
Causes of AUB in a 19-39y/o x5
Pregnancy
Anovulatory cycles PCOS
Hormonal contraception
Endometrial hyperplasia
Structural lesions -polyps, leiomyoma
Causes of AUB in perimenopausal women x4
Endometrial hyperplasia
Endometrial cancer
Endometrial atrophy
Leiomyoma
4 causes of AUB/HMB
Endometrial polyp
Adenomyosis
Leiomyoma
PCOS
Risk factors of polyps x5
HTN
Obesity
Tamoxifen
Hormonal therapy
Post-menopause
Define adenomyosis and what causes it
Endometrial tissue appearing in the myometrium
Caused by hyperplasia of the endometrial basal layer
What causes dysmenorrhea in AUB/A x4
Enlarged uterus> increased secretion of prostaglandins> increased contraction of uterus during menses> dysmenorrhea
Women at risk of leiomyomas x4
Nulliparous
Pregnant
Breastfeeding
Perimenopause
High risks of infertility in x2
Polyps
Leiomyomas
Risk factors of endometrial cancer x5
DM
Obesity
Age>35
Nulliparity
Anovulatory cycles
4 causes of light menstrual bleeding
Congenital malformations
Hypogonadotropic hypogonadism
Intrauterine trauma
Asherman’s syndrome
3 causes of coagulopathy
vWF
Immune thrombocytopenia
Myeloproliferative disorders
Describe pathophysiology of endometrial AUB x3
Local disturbance of Hemostasis and vasoconstriction > vasodilation > increased rate of blood loss
