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OBGYN > Abnormal Uterine Bleeding > Flashcards

Abnormal Uterine Bleeding Flashcards

1
Q

what is defined as uterine bleeding occurring at regular intervals of less than 21 days?

A

polymenorrhea

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2
Q

what is defined as prolonged (greater than 7 days) or excessive (greater than 80mL) uterine bleeding occurring at regular intervals?

A

menorrhagia

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3
Q

what is defined as uterine bleeding occurring at intervals greater than 35 days?

A

oligomenorrhea

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4
Q

what is defined as bleeding that occurs at frequent, but irregular intervals?

A

metrorrhagia

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5
Q

what is defined as uterine bleeding that is prolonged or excessive but also frequent and irregular ?

A

menometrorrhagia

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6
Q

how much blood loss is necessary to define menorrhagia?

A

greater than 80 mL

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7
Q

what are the two main mechanisms for hemostasis during menstruation?

A

formation of hemostatic plug; vasoconstriction

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8
Q

a pt with postcoital bleeding should be worked up for which two differentials?

A

cervical cancer and cervicitis

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9
Q

what 4 tests should be ordered as part of the workup for abnormal uterine bleeding?

A

FSH, TSH, PRL, and beta hCG

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10
Q

what is the time frame for a normal menstrual cycle?

A

every 21 to 35 days w/ menstruation lasting 2 to 7 days

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11
Q

what are the most common types of cancer associated with reproductive age bleeding?

A

cervical and endometrial

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12
Q

what is the most common cause of hospital admission for menorrhagia in adolescents?

A

von Willebrand disease

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13
Q

t or f: hyperthyroidism causes an ovulation and is frequently associated with menorrhagia and intermenstrual bleeding

A

FALSE - hyPO

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14
Q

t or f: cirrhosis can be a cause of excessive bleeding during menstruation

A

TRUE - secondary to reduced capacity of the liver to metabolize estrogens

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15
Q

t or f: abnormal uterine bleeding is a diagnosis of exclusion

A

TRUE

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16
Q

how is the diagnosis of ovulatory abnormal uterine bleeding made?

A

endometrial biospy

17
Q

what is the relationship between estrogen and the endometrium? progesterone?

A

estrogen stimulation leads to constant endometrial proliferation; progesterone is what mediates maturation and shedding

18
Q

what is the treatment of choice for pts with heavy bleeding and hemodynamic instability?

A

d&c; note: once bleeding is controlled, pt can be placed on medical management

19
Q

t or f: medical management is the first line treatment for pts with abnormal uterine bleeding.

A

true

20
Q

what is the mainstay of treatment for anovulatory bleeding?

A

OCP

21
Q

what is the mcc of post menopausal bleeding?

A

atrophy (vaginal/endometrial)

22
Q

how is post menopausal bleeding defined?

A

bleeding that occurs after 1 year of amenorrhea

23
Q

what is the most common lethal cause of post menopausal bleeding?

A

endometrial cancer

24
Q

t or f: HRT for menopausal women with a uterus must contain estrogen only pills

A

FALSE: must contain progestin ALONG with estrogen to prevent endometrial hyperplasia/carcinoma

25
Q

what is the MOA behind vaginal/endometrial atrophy?

A

in the uterus, the collapsed endometrial surface contains little or no fluid to prevent intrauterine cavitary friction resulting in micro erosions leading to bleeding

26
Q

why is it that obese women have higher levels of endogenous estrogen?

A

b/c of the conversion of androstenedione to estrone and the aromatization of androgens to estradiol, both of which occur in peripheral adipose

27
Q

vaginal bleeding plus foul smelling discharge in a post menopausal female is diagnostic of what?

A

cervical cancer

28
Q

what are the top 4 ddx for thickened endometrial stripe in a post menopausal woman? (stripe is seen of TVUS)

A

endometrial ca, endometrial hyperplasia, leiomyoma and polyps

29
Q

what is the MOA behind cervical cancer causing bleeding?

A

the cancer has outgrown its blood supply

30
Q

when should uterine sarcoma be considered part of the differential for post menopause women?

A

when there’s are rapidly growing leiomyomata

31
Q

physical exam, it reveals dry pale vaginal mucosa with lost rugae - what is the diagnosis?

A

vaginal atrophy

32
Q

how is vaginal atrophy treated?

A

topical estrogen cream

33
Q

how is endometrial hyperplasia with atypia treated?

A

as CA as this indicates underlying CA typically; hysterectomy is treatment of choice

34
Q

what is the treatment for endometrial hyperplasia without atypia?

A

progestin and ongoining monitoring

OBGYN (21 decks)

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