AUB

Question 1

How do you treat acute heavy bleeding with thin lining?

Answer 1

ESTROGEN! OC WITH 35 MCG EE or 25 mg CEE IV q 4-6 hrs until stops or 24 hours, then oral, then add progestin

Question 2

How do you treat acute heavy bleeding with a tHICK lining?

Answer 2

Progestin! (medroxy progesterone acetate 20 mg BID/TID, megase 20-40 mg BID, norethindrone 5 mg, OCP BID or TID)

Question 3

Who do we screen for coagulopathy?

Answer 3

ONE OF THE FOLLOWING; HMB since menarche, ONE ( PPH, surgery related bleeding, bleeding with dental work), two or more (bruising, epistaxis, frequent gum bleeding, FHx bleeding)

Question 4

What labs do you order for AUB?

Answer 4

pregnancy test, CBC, TSH/Prolactin, GC/CT, PCOS

Question 5

what is MOA of desmopressin or DDAVP

Answer 5

promotes release of VWF from storage sites!

Question 6

what is most common inherited bleeding disorder in women?

Answer 6

VWD

Question 7

what is nonhormal treatment and MOA?

Answer 7

Tranexamic acid - binds to site on tissue plasminogen activator, reduced plasmin lysis of fibrin! ablation, UAE

Question 8

what are contraindications to ablation?

Answer 8

pregnancy, postmenopausal, endo hyperplasia, prior classical or myomectomy, congenital anomaly, IUD

Question 9

what tech for ablation?

Answer 9

NovaSure (radiofrequency with wire mesh) radiofreq with heat into lining

Question 10

hysteroscopy fluid choice and why?

Answer 10

low viscosity electrolyte (NS), safer when absorbed in large quantities, BUT can’t use monopolar

Question 11

What do you do if fluid overload from hysteroscopy?

Answer 11

Stop, notify, lasix, hypertonic saline

Question 12

side effects of UAE

Answer 12

pain, nausea, vomiting, fever