Dysfunctional Uterine Bleeding, GYN Infections, Ovarian Disorders (cyst, torsion, rupture), Sexual Assault & Battery, GYN Trauma

Question 1

more common on the right, usually starts w/ mild pain, exacerbated by exercise or sexual intercourse

Answer 1

ovarian cyst

Question 2

unilateral pain that occurs near ovulation d/t presence/rupture of follicular cyst or corpeus lute

pain usually lasts a few hrs to a few days

treated w NSAIDS

Answer 2

mittelschmerz

Question 3

abnormal vital signs and acute abdomen

may require admissions for obs or surgery

Answer 3

hemorrhagic cyst

Question 4

ovarian germ cell neoplasm
most common btwn 10-30
may disappear w/in one or two menstrual cycles or may grow and require surgical removal

Answer 4

dermoid cyst

Question 5

sudden onset severe, unilateral, lower abd pain (often associated w exertion) more common on right

pain is sometimes a gradual onset or may be intermittent in nature

70% will have n/v

highest incidence in first year of life, during menarche and during pregnancy

may or may not be associated w/ ovarian cyst

Answer 5

ovarian torsion

Question 6

bilateral, constant, lower abd pain
dull, aching
usually begins a few days after the menstrual period and lasts seven days or less
exacerbated by motion, exercise or intercourse
cervical tenderness (chandeliers sign)

abnormal vaginal d/c
abnormal vaginal bleeding (often post-intercourse

Answer 6

PID

Question 7

equates to <30 cc of blood loss per day (ave length of menses is 4.5 to 8 days w/ 24 to 38 days btwn the end of cone period and the beginning of the next)

Answer 7

normal menses

Question 8

> 80 cc blood loss per day (variations in timing and act of blood loss most common during menarche and peri-menopausal time of life)

Answer 8

abnormal uterine blood loss

Question 9

saturating more than one pad or tampon per hr (depending on the product a nave pad or tampon holds 20-30 cc vaginal effluent)

Answer 9

excessive blood loss

Question 10

hx of heavy periods (chronic DUB), may act for 20% of DUB

Answer 10

coagulopathies (von willebrands disease, taking AC) - cause of DUB

Question 11

more common in women over 35
may cause intermenstrual bleeding
dx w US/hysteroscopy

Answer 11

polyps cause of DUB

Question 12

usually occurs in women over 45 and should always be suspected in post menopausal bleeding

Answer 12

malignancy (endometrial or cervical CA) cause of DUB

Question 13

common in menarche, peri menopausal, w/ hypothyroidism, eating disorders, excessive wt loss, stress and exercise

at menarche bleeding usually minimal and painless (sever bleeding more likely an underlying coagulopathy during menarche)

Answer 13

anovulation cause of DUB

Question 14

most common cause of intermenstrual bleeding especially in the first 4-6 mos of therapy

Answer 14

oral contraceptives and hormone replacement therapy at menopause - cause of DUB

Question 15

PID, retained vaginal foreign bodies, endometritis, cervicitis

Answer 15

other causes of DUB