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Reproductive > Abnormal Uterine Bleeding: Tate > Flashcards

Abnormal Uterine Bleeding: Tate Flashcards

1
Q

Menorrhagia def:

A

> 7day prolonged or excessive >80ml uterine bleeding occurring at regular intervals

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2
Q

Metrorrhagia de:

A

Uterine bleeding occurring at irregular but frequent intervals

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3
Q

Menometrorrhagia def:

A

Prolonged uterine bleeding occurring at irregular intervals

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4
Q

Hypermenorrhea synonym?

A

Menorrhagia

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5
Q

What is polymenorrhagia?

A

Bleeding less than every 21 days

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6
Q

What is intermenstrual bleeding?

A

Bleeding variable amounts between regular periods

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7
Q

What are the three most common OB complains?

A

Bleeding
Pelvic pain
Vaginal discharge

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8
Q

What are the organic categories of AUB?

A 
Pregnancy
Neoplastic/anatomic
Inflamatory
Trauma
Systemic disease
Drug induced
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9
Q

What are the dysfunctional (HPA axis) ranges of AUB?

A

Postpuberty
During reproductive years
Preimenopausal

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10
Q

What are the AUB related to pregnancy?

A

Implantation
Abortion
Molar-Trophoblastic
Extopic

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11
Q

What is implantation bleeding? When?

A

Minimal
occurs at time of 1st missed cycle
very short (1-2 days)

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12
Q

What is abortion bleeding? when?

A

When baby dies… bleeding

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13
Q

What are the five types of AUB abortion?

A 
Threatedned
Inevitable
Complete: it all gets out
Incomplte: part of it gets out
Missed: embryo is still in there
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14
Q

What is a molar pregnancy?

A

Passage of grape like structures (hydropic villi)
SUPER HIGH hCG!!!!!!> 100,000
May have preeclampsia

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15
Q

What type of bleeding do we worry about in ectopic pregnancy?

A

Intraperitoneal

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16
Q

STEP: What s a AUB related to neoplasm of vagina?

A

Diethylestrone exposure=clear cell vaginal cancer

17
Q

What is a AUB related to cervix?

A

Squamous cell carcinoma

Benign: cervical polyp, necrotic nabothian cyst, etc..

18
Q

What are the most common causes of uterine bleeding?

A

Fibroids
Endometrial cancer is most common malignancy
Polyp
Adenomyosis

19
Q

DES exposure= what?

A

Clear cell vaginal tumor

20
Q

Infection/inflammation bleeding is not related to what cycle?

A

menses

21
Q

What is used for pelvic organ prolapse?

A

Pessary

22
Q

TEST?: What is MCC menorrhagia in young female who just started menses?

A

Von Willebrands! Must test.

23
Q

What systemic disorders can lead to AUB?

A

VWF def
Prothrombin def
Blood dyscrasias: ITP, low platelets, sepsis
Endocrinopathy: hypoThyroid, hyperThyroid, cirrhosis

24
Q

What are main drugs for AUB?

A 
Liver effectors: CYPs: estrogen increases stroke 
Anticoagulation
Salicilates
PG inhibitors
Contraception
Psychotropics
25
Q

What is the cause of post puberty dysfunctional bleeding?

A

HPA axis not in tune yet… irregular and messy

26
Q

What are the causes of AUB dysfunctional bleeding in reproductive years?

A 
Anovulation
Polycystic ovarian syndrome
thyroid dysfunction
pituitary dysfunciton
stress
increased exercise
excessive weight change
27
Q

What are the causes of perimenopausal dysfunction?

A

Ovarian failure… out of eggs

Non secretory Endometrium bleeds

28
Q

What is the go-to for imaging in OB?

A

Pelvic ultrasound

29
Q

What set of patients have a higher risk of OB cancer?

A 
Age 35 or higher
Obese
Infertile
Estrogen exposure
Hx of cancer
30
Q

What is first line of Tx for AUB?

A

Estrogen… works quick. Really any birth control pill will be okay if you give more than 1x a day

31
Q

Who do you not give estrogen to?

A

DVT
Stroke
CV event

32
Q

What is another drug for AUB?

A

Progesterone: stops growth
NSAIDS: PG inhibitors: not in renal failure

33
Q

Morena is only what hormone?

A

Progesterone

34
Q

What is surgical management of AUB?

A

Dilation

Curettage: scrape out the bleeding layer

35
Q

When all else fails… what surgery?

A

Hysterectomy

Reproductive (31 decks)

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