Dobbs - Uterine Disorders Flashcards
regular interval btw menses, excessive flow and duration
menorrhagia
decreased flow during normal duration of regular menses
hypomenorrhea
metorrhagia
irregular interval of menses, excessive flow and duration
shortened interval btw menses < 9-21 days
polymenorrhea
irregular or excessive bleeding during menses and btw menses
menomotorrhagia
lengthened interval btw menses > 35 day intervals
oligomenorrhea
procedure to remove tissue from inside the uterus
dilation and curettage (D&C)
D&C is used to dx and treat (2)
heavy bleeding
clear uterine lining after miscarriage/abortion
pain associated w. menses
1-2 days of mild discomfort-severe pain everyday of menses
dysmenorrhea
sx associated w. dysmenorrhea (3)
n.v
fatigue
diarrhea
what causes dysmenorrhea
prostaglandin overactivity
tx for dysmenorrhea (4)
NSAIDs
heat
avoid nicotine, etoh, caffeine
reduce frequency of menses
persistent dysmenorrhea → r.o (3)
leiomyomas
endometriosis
ovarian cysts
common benign uterine tumor
round, firm, often multiple; composed of smooth m/CT
leiomyoma (same-same uterine fibroid)
fibroids depend on
estrogen
fibroids are classified by
location
uterine fibroids may be asymptomatic; name 4 sx if not
bleeding → MC
pressure or fullness in pelvis
menorrhagia, metorrhagia, intermenstrual bleeding, dysmenorrhea
anemia w. heavy bleeding
during bimanual exam, you feel firm, enlarged, irregular uterine mass; what do you think
uterine fibroid
mc dx for uterine fibroid
US
other dx options for fibroids (4)
saline hysteroscopy
hysterosalpingography
laparascopy → large fibroids
MRI/CT
tx for asymptomatic fibroids
obs
tx for symptomatic fibroids (3)
myomectomy or D&C
uterine arterial embolization or endometrial ablation
hysterectomy
pharm for uterine fibroids
GnRH agonists (Lupron)
transexamic acid → non hormonal; eases heavy periods
s.e of Lupron
medical menopause → sweats, mood disturbance, sleep disturbance, feel awful
major consideration pre uterine arterial embolization/endometrial ablation
no desire for future fertility
condition where endometrial tissue is found outside of endometrial cavity
endometriosis
4 locations for endometriosis
ovaries
uterosacral ligament
GI tract
lungs/brain → uncommon
definitive dx for endometriosis
have to visualize it (surgically/histologically)
when you see pt w. infertility, think
endometriosis
infertility in endometriosis is related to
adhesions
chocolate cysts on ovaries
endometriosis
insertions filled w. blood