Dysfunction Uterine Bleeding/Assault Flashcards
Oligomenorrhea
-cycle intervals >35 days
Hypomenorrhea
-scant menses, nl intervals
Polymenorrhea
-intervals <21 days
Amenorrhea
-absence of menses for 3 cycles
Metrorrhagia
-irregular intervals, nl flow
Menometrorrhagia
-irregular/excessive
proliferative phase
Characterized by a predominance of estrogen over progesterone
Buildup of endometrium layer
secretory phase
beginsafterovulation
triggersprogesterone production.
Marked by a reaction to the combination of estrogen & progesterone
Stabilization in the thickness of the endometrium
When does menstrual bleeding occur?
Menstrual bleeding occurs after secretion of estrogen and progesterone tapers off
Estrogen breakthrough bleeding (only one that is DUB)
Low continuous levels of estrogen cause intermittent spotting
High continuous levels cause endometrial proliferation, resulting in amenorrhea followed by menometrorrhagia
Caused by anovulation, when progesterone not present to induce a secretory endometrium with eventual shedding
Estrogen withdrawal bleeding
After oophorectomy
Irradiation of mature ovarian follicles
Administration and withdrawal of estrogen to a castrate (no ovaries present)
Normal midcycle spotting due to drop in estrogen
Progesterone breakthrough bleeding
Only occurs in presence of high ratio of progesterone to estrogen
Norplant/Implanon, Depo-provera, Minipill
Progesterone withdrawal bleeding
Follows normal corpus luteum degeneration
Only occurs if endometrium previously primed with estrogen
timing for forensic exam
<72 hours
Sexual Assault treatment
-Hep B vaccine
-Ceftraixone 125mg IM; single dose
PLUS: Metronidazole 2g PO; single dose
PLUS: Azithromycin 1g PO; single dose
Levonorgestrel
possible HIV meds if high risk
