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Year2 Repro exam II > Abnormal uterine bleeding and contraception > Flashcards

Abnormal uterine bleeding and contraception Flashcards

1
Q

what can cause abnormal uterine bleeding in nongravid reproductive age women

A

Polyp
Adenomyosis
Leiomyoma
Malignancy and hyperplasia

Coagulopathy
Ovulatory Dysfunction
Endometrial
Iatrogenic
Not yet classified
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2
Q

what is an endometrial polyp

A

hyperplastic overgrowth of glands and stoma

benign

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3
Q

what can endometrial polyp cuase

A

early uterine bleeding

malignancy highger in post menopausal women

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4
Q

most common benign tumor in women

A

leiomyomas “fibroids”

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5
Q

Sx leiomyoma

A

abnormal painful menses

abdominal pain

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6
Q

what are subtypes leiomyomas

A

pedunculated
subserosal
submucosal
intramural

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7
Q

what is triad of adenomyosis

A

nocyclical pain, menorrhagia, enlarged uterus w/o adenexal tenderness

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8
Q

Tx adenomyosis

A

NSAIDs, OCPs, progestins, ablation, hysterectomy

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9
Q

fibroids are sensitive to what hormones

A

E and P

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10
Q

complications of fibroids

A

torsions and infertility

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11
Q

what is adenomyosis

A

endometrial tissue growth in myometrium

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12
Q

risk factors fibroids

A 
african american
early menarche
obesity
diet, alcohol, red meats beer
HTN
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13
Q

what type of surgeries can you do for fibroids

A

myomectomy, endometrial ablation, uterine artery embolization, hysterectomy

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14
Q

types of degeneration of leiomyoma

A

hyaline
cystic
red carneous
myxoid

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15
Q

common causes postmenopausal women

A 
atrophic endometrium
endometrial polyps
endometrial CA
endometrial hyperplasia
hormonal effects
cervical CA <1%
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16
Q

what causes atrophic endometrium

A

hypoE

dry vaginal epithelium that is smooth and shiny with loss of most rugation

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17
Q

why is endometrial hyperplasia weird in postmenopausal women warranting biopsy

A

because should not have hyperplasia since lack of E

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18
Q

what are classifications of endometrial hyperplasia

A

simple or complex hyperplasia without atypia

simple or complex hyperplasia with atypia

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19
Q

most common genital cancer in women over 45

A

adenoCA of endometrium

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20
Q

Tx atrophy of vagina

A

vaginal estrogen therapy

21
Q

Tx endometrial polyp

A

polypectomy

22
Q

Tx endometrial hyperplasia

A

cyclic progestin therapy

23
Q

Tx endometrial hyperplasia with atypia

A

hysterectomy

24
Q

Tx CA of endometrium

A

TAH BSO and LND for staging

25
Q

how to Tx menorrhagia

A 
ibuprofen
transamic acid (expensive)
26
Q

how does the implantable rod of contraception work

A

thickens uterus making in implantable

progesterone only

27
Q

problems with etonogestrel implant

A

increase bleeding and spotting

irregularity and unpredictability

28
Q

side effects etonogestrel implant

A

weight gain

29
Q

CI etonogestrel implant

A

SLE with anti phospholipid Ab
hepatocellular adenoma
discontinue if have migraines with aura
unexplained vaginal bleeding before evaluation

30
Q

What is paragard

A

copper IUD
no hormones— can have heavier bleeding
lasts 10 years

31
Q

what is mirena

A

levonorgestrel IUD
local progestin
lasts 5 years

32
Q

what disease not use copper IUD

A

wilsons disease

33
Q

how does copper IUD work

A

alters uterine and tubal fluid
hinders spermatozoa function
inhibits fertilization! not abortifacient

34
Q

how does mirena work

A

impaires spermatozoa motility/function

inhibits conception

35
Q

which IUD has no weight gain

A

mirena

36
Q

contraindications to IUD

A

current PID or within past 3 mo
current cervicitis
high risk women: screen first for STIs

37
Q

what is depot provera

A

progesterone shot every 3 mo

thickens cervical mucus

38
Q

side effects depot provera

A

bleeding irregularities
weight gain
delayed return fertility
decrease in bone mineral density

39
Q

how does depot provera change BMD

A

loss of BMD

returns to baseline once discontinued

40
Q

few CI to depot provera

A

severe HTN

DM with vascular disease

41
Q

special populations to use depot provera

A

sickle cell

epileptics

42
Q

which contraceptive use is weight dependent

A

the patch

>90 kg doesn’t work

43
Q

what is in nuva ring

A

ethinyl estradiol

etonorgestrel

44
Q

when is back up method for nuva ring needed

A

taken out for greater than 3 hours

45
Q

what increases weight

A

depot provera

46
Q

breakthrough bleeding more common in

A

smokers

cervical infections

47
Q

CI to oral contraception

A 
Hx VTE
known thrombogenic mutation
migraines WITH aura
HTN poorly controlled
lupus with antiphospholipid Ab (hypercoaguable)
48
Q

method for protection from STIs

A

condoms

Year2 Repro exam II (19 decks)

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