Abnormal uterine bleeding

Question 1

The follicular phase represents what days of the menstrual cycle?

Answer 1

Day 1 - 14

Question 2

The luteal phase represents what days of the menstrual cycle?

Answer 2

Day 14 - 28

Question 3

What is the dominant hormone during the follicular phase?

Answer 3

Estrogen

Question 4

The follicular phase corresponds to what phase of endometrium?

Answer 4

Proliferative

Question 5

What is the dominant hormone during the luteal phase?

Answer 5

Progesterone

Question 6

The luteal phase corresponds to what phase of endometrium?

Answer 6

Secretory

Question 7

Menorrhagia is defined as____.

Answer 7

Bleeding > 80 cc or more, bleeding lasting > 7 days

Question 8

Dysfunctional uterine bleeding is defined as ____.

Answer 8

Abnormal uterine bleeding due to hormonal irregularity

Question 9

Metrorrhagia is defined as ______.

Answer 9

bleeding at irregular intervals or between periods

Question 10

What are the two new terms to describe abnormal uterine bleeding?

Answer 10

Heavy menstrual bleeding, Inter-menstrual bleeding

Question 11

What happens to the length of cycles in the perimenopausal period?

Answer 11

Increased length of cycle

Question 12

What studies should be ordered when evaluating a patient with heavy menstrual periods and a suspected bleeding disorder?

Answer 12

CBC, PT, PTT

Question 13

What is the most common inherited bleeding disorder?

Answer 13

Von Willebrands Disease

Question 14

What percent of women with menorrhagia have Von Willebrand disease?

Answer 14

5 - 15%

Question 15

What is the genetic inheritance patter of Von Willebrand Disease?

Answer 15

Autosomal Dominant

Question 16

VW factor is a protein necessary for _____.

Answer 16

Platelet Adhesion

Question 17

what are the 4 basic tests to order to evaluate for abnormal uterine bleeding?

Answer 17

hCG, CBC, TVUS, Day 20 progesterone

Question 18

an EMB achieves an adequate sample of endometrium in what percent of postmenopausal women?

Answer 18

84%

Question 19

an EMB achieves an adequate sample of endometrium in what percent of pre or perimenopausal women?

Answer 19

90%

Question 20

In what percentage of postmenopausal women does an EMB detect cancer?

Answer 20

99.6%

Question 21

What is the detection rate of atypical hyperplasia using an EMB?

Answer 21

81%

Question 22

What percentage of blind D&C procedures missed over 1/2 of the endometrial cavity?

Answer 22

60%

Question 23

An endometrial stripe < 4 mm has a ____ negative predictive value for endometrial cancer.

Answer 23

> 99%

Question 24

True or false: Transvaginal US is highly accurate at detecting intracavitary lesions in reproductive age women?

Answer 24

False

Question 25

What imaging modality should be used when trying to evaluate for an intracavitary lesion in s premenopausal woman?

Answer 25

sonohysterography

Question 26

What is the most accurate way to diagnose an endometrial polyp?

Answer 26

Hysteroscopy

Question 27

What type of medical treatment is the gold standard for PCOS?

Answer 27

OCPs

Question 28

What treatment should you consider in a patient with PMB associated with endometrial atrophy?

Answer 28

Estrogen

Question 29

NSAIDS decrease menstrual blood loss by what percen?

Answer 29

20 - 40%

Question 30

What is first line treatment for adolescents with heavy painful menstrual periods?

Answer 30

NSAIDS

Question 31

Levonorgesterel IUD decreases menstrual blood loss by what percent?

Answer 31

75- 95%

Question 32

When should you use IV estrogen for heavy menstrual bleeding?

Answer 32

For profuse, acute bleeding

Question 33

What is the dose of IV estrogen used for acute heavy vaginal bleeding?

Answer 33

25mg q 4 for up to 24 hrs

Question 34

What is the dose of PO estrogen used for acute heavy bleeding?

Answer 34

10 - 20 mg/day divided into 4 doses

Question 35

What percentage of patients will undergo hysterectomy within 4 years of endometrial ablation?

Answer 35

25%