Case of the Week Flashcards
What does kappa mean?
The number of days within a cycle that a woman bleeds.
e.g. 8/28 = bleed for 8 days in 28 day cycle
What are the vital things to be included in menorrhagia history?
KCLAPS:
Age
Parity
Smear
Contraception
Last Menstrual Period
Kappa
What does menorrhagia mean?
Heavy Menstrual bleeding - (>80ml)
What does dysmenorrhoea mean?
Painful menstrual periods
Primary - not associated with organic disease or psychological cause
Secondary - cause can be found
What is inter-mentsrual bleeding?
Vaginal bleeding at any time during menstrual cycle other than during normal menstruation
What is post-coital bleeding?
Bleeding that occurs immediately after sexual intercourse
What is Dyspareunia?
Pain associated with sexual intercourse
What is another name for fibroids? and what are they?
Uterine Leiomyomas (benign tumours of myometrium)
Benign growths in the uterus, cause irregular heavy periods
What is endometriosis?
Endometrial Tissue found outside the uterus → painful period, persistent pain in pelvic area and infertility
What is adenomyolysis?
Ectopic endometrial tissue within the myometrium (thick muscular layer of the uterus)
Why is pallor/pale conjunctiva significant in menorrhagia?
Suggest anaemia from excess monthly blood loss
For someone with heavy regular periods → DUB or Fibroids
How would you decide which is more likely?
Look at the size of the uterus
Enlarged → Fibroids
No change in size → DUB
What is tranexamic acid?
Antifibrinolytic → reduces bleeding
Useful during menstruation
What is Mefenamic Acid?
NSAID for ↓Blood loss and improve dysmenorrhoea
Can be used with Tranexamic Acid
In patients that are very anaemic or bleeding continuously, what treatments can be used?
GnRH analogue → downregulates GnRH → ↓gonadotrophins (LH/FSH) → inhibit oestrogen/androgen release by ovary
SE: hot flushes and bone demineralisation
High dose progestogens - induce amenorrhoea
Give two examples of GnRH analogues
Leuprorelin acetate
Triptorelin
