AUB Flashcards
Adenomyosis MUSA criteria (8)
asymmetrical thickening
fan-shaped shadowing
translesional vascularity
irregular junctional zone
myometrial cysts
hyperechoic islands
echogenic subendometrial lines and buds
interrupted junctional zone
changes AUB classification 1
1) frequency: amenorrhea included
2) duration: normal 8 and below
3): frequency: 24-38
4) regularity: normal cycle interval is <7-9 days, irregular >8-10 days
5) HMB NIH definition of disrupts QOL
6) included if intermenstrual scheduled/cyclic or random
7) included if breakthrough bleeding while on pills/meds
COIEN changes
medication under iatrogenic
n = not otherwise classified including isthmocele and av malformation
chronic aub
6 months
PALM changes
MUSA criteria for adeno
AUB-L: type 3 is SM
0 vs 1, 6 vs 7 –> pedicle has to be 10% of mass diameter
2 vs 3: need hystero with minimal visualization
AUB-C criteria
1) heavy menses since menarche
2) one of the following:
postpartum hemorrhage
surgical related bleeding
bleeding associated with dental work
3) two or more:
bruising 1-2x/month
epistaxis 1-2x/month
frequent gum bleeding
fam hx of bleeding sx
menses MOA
progesterone withdrawal > destabilizes lysososme membrane > release of MMPs, acid phosphatase > enzymatic degradation of functionalis layer
progesterone withdrawal > release of inflammatory cells
end of menses MOA
vasoconstriction in the denuded spiral arterioles in the basal layer of the endometrium and also possibly in the radial arteries of the superficial myometrium.
mediated by prostaglandins esp PGF2a
estrogen withdrawal bleeding
as in those post BSO or estrogen only pills
estrogen breakthrough bleeding
as in PCOS or those with chronic anovulation/unopposed estrogen
progesterone withdrawal
ex as in progestin challenge test
progesterone breakthrough bleeding
ex those on dienogest or DMPA
MOA anovulatory bleeding
patchy endometrial growth but no dominant follicle - Em proliferates and outgrows blood supply = fragile EM > bleed and regrow patchy
