Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GYN/OBS > Dysmenorrhea > Flashcards

Dysmenorrhea Flashcards

Endometriosis, adenomyosis, PID

1
Q

Dysmenorrhea

A

Painful menstruation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

2 types of dysmenorrhea

A
  • Primary
  • Secondary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Primary dysmenorrhea

A

Painful menstruation usually appearing in 1 year of menarche

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Primary dysmenorrhea occurs with

A

ovulatory cycles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When does pain occur in primary dysmenorrhea

A

begins with onset of menstruation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Type of pain in primary dysmenorrhea

A

spasmodic- type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cause of primary dysmenorrhea

A

Due to physiological release of Prostaglandin 2 (PGE2) which cause contraction and cause pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mx of primary dysmenorrhea

A

usually self- limiting
* NSAIDs
* COCP- combined Oral Contraceptives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Main component responsible for primary dysmenorrhea

A

Prostaglandin 2 (PGE 2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Secondary dysmenorrhea onset

A

3rd - 4th decade of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Secondary dysmenorrhea- type of pain

A

Congestive pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Associated Sx of Secondary dysmenorrhea

A
  • Pelvic heaviness
  • Back pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Secondary dysmenorrhea is associated with

A
  • Cycle irregularity
  • Heavy periods
  • Dyspareunia
  • Vaginal discharge
  • IMB
  • Post- coital bleeding and pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of Secondary dysmenorrhea

A
  • Endometriosis
  • Adenomyosis
  • Intra- uterine polyps
  • Submucosal fibroids
  • IUCD
  • PID
  • Congestive uterine abnormalities
  • Cervical stenosis
  • Ashermann Syndrome
  • Uterine retroversion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Endometriosis

Epidemiology

A

8%- 10% of women in reproductive years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Endometriosis

Endometriosis

A

Presence of functioning endometrial tissue ( glands and stroma) at** sites outside the uterine cavity** which induces a chronic inflammatory reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Endometriosis

Theories about the pathophysiology

A
  • Retrograde menstruation
  • Hematological or lymphatic spread
  • Celomic hyperplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T/F

  1. MCC of dysmenorrhea is PID
  2. Cause of endometriosis is unknown
  3. Secondary dysmenorrhea pain is spasmodic
  4. Dysmenorrhea is due to the release of PGE2
  5. Secondary dysmenorrhea is seen from 2nd to 4th decade of life
A
  1. F ( endometriosis)
  2. T
  3. F ( congestive- type)
  4. F (only primary )
  5. F (3-4th decades)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Endometriosis

Sites

A
  • Uterosacral ligament
  • Ovaries
  • Fallopian tube
  • Rectovaginal septum
  • Outer surface of uterus
  • lining of the pelvic cavity
  • Bladder
  • Bowel
  • Vagina
  • Cervix
  • Vulva
  • Abdominal surgical scars
  • Less common- arm, lung, thigh
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Endometriosis

Risk factors

A
  • Age
  • Increased peripheral body fat
  • Greater exposure to menstruation
  • Genetic predisposition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Endometriosis

Why is greater exposure to menstruation a risk factor

A

due to short cycles, Long duration of flow, reduced parity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Endometriosis

Sx

A
  • Dysmenorrhea >6 months
  • Chronic pelvic pain
  • Deep dyspareunia
  • Dyschezia
  • Pain on micturition
  • Pain on exercise
  • Subfertility
  • Non specific Sx- Fatigue, General malaise, sleep disturbances
  • Cyclical rectal bleeding (hematochezia)
  • Hematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Endometriosis

Dysmenorrhea should be present for

A

> 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Endometriosis

  1. Most patients are asymptomatic
  2. Endomteriosis can be seen in vulva
  3. Celomic hypoplasia is a pathophysiological theory behind endometriosis
A
  1. T
  2. T
  3. F ( hyperplasia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Endometriosis

Ix

A
  • Laparoscopy
  • CA 125
  • TVUSS
  • MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Endometriosis

Gold standard Dx test

A

Laparoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Endometriosis

Why is laparoscopy the gold standard test

A

for direct visualization and confirmation by biopsy when there is a doubt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Endometriosis

Why is laparoscopy done

A

to exclude malignancy- malignant transformation of endometrioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Endometriosis

Endometrioma

A

a malignant tumor with chocolate coloured blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Endometriosis

Is endometrioma common

A

Rare 0.7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Endometriosis

CA125 uses

A

No evidence to say it is useful as a screening test but levels will be high in severe disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Endometriosis

CA 125 levels in severe endometriosis

A

raised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Endometriosis

TVUSS uses

A

to detect ovarian endometrioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Endometriosis

MRI uses

A

to evaluate deep lesions involving the cul de sac ( rectouterine pouch)

35
Q

Endometriosis

Main methods of Mx

A
  • Surgical
  • Medical
  • Combination of surgical and medical
36
Q

Endometriosis

Surgical Mx

A
  • Laparoscopy
  • Laparotomy
    Adhesiolysis, Cystectomy
37
Q

Endometriosis

Medical Mx

A
  • Non- hormonal
  • Hormonal
  • Different types of progestagens
38
Q

Endometriosis

Hormonal drugs

A
  • COCP
  • Anti- progetagens
  • Gestrinone
  • GnRH agonists
  • Aromatase inhibitors
39
Q

Endometriosis

Danazole is not a treatment according to…..

A

EISHRE GUIDELINES

40
Q

Endometriosis

Non- hormonal Drugs

A
  • NSAIDs- mefenamic acid (Analgesic)
41
Q

Endometriosis

Progestagens used

A
  • Medroxyprogesterone acetate
  • Dienogest
  • LNG- IUS
  • Cyproterone acetate
  • Norethisterone acetate
42
Q

Endometriosis

Medroxyprogesterone acetate is used as

A

oral or depot

43
Q

Adenomyosis

Adenomyosis

A

Presence of endometrium in the myometrium

44
Q

Adenomyosis

can involve the

A

whole muscle thickness down to the serosa

45
Q

Adenomyosis

Risk factors

A
  • Parity
  • Smoking
  • Spontaneous miscarriage
  • Endometriosis
  • Menorrhagia
  • Endometrial hyperplasia
  • Infertility
  • Preterm birth
  • Surgical termination/ curettage in PG
46
Q

Adenomyosis

Ix

A
  • TVS
  • MRI
  • FBC
47
Q

Adenomyosis

TVS or TAS

A

Trans vaginal is superior to trans abdominal USS in Dx

48
Q

Adenomyosis

Why is FBC done

A

assess the Hb

49
Q

Adenomyosis

Mx options

A
  • Medical
  • Surgical
50
Q

Adenomyosis

Medical Mx

A
  • Non- hormonal
  • Hormonal
51
Q

Adenomyosis

Non hormonal Therapy

A

Mefenamic Acid and tranaxemic acid - Sx relief

52
Q

Adenomyosis

Hormonal Rx

A
  • Progestogen- LNG- IUS
  • COCP- continuous combined Oral contraceptives
  • GnRH analogues- reduce uterine volume
53
Q

Adenomyosis

Advantage of giving GnRH analogues

A

reduce the uterine volume

54
Q

Adenomyosis

Surgical Mx

A
  • Localized excision of affected myometrium
  • Reduction of the uterine blood flow by uterine artery embolization
  • Hysterectomy
55
Q

Adenomyosis

Adenomyomectomy

A

Localized excision of affected myometrium

56
Q

Adenomyosis

Hysterectomy methods

A
  • abdominal
  • vaginal
  • laparoscopic
57
Q

PID

Sites

A
  • Upper genital tracts
  • Fallopian tubes
  • ovaries
58
Q

PID

Types of inflammation

A
  • endometritis
  • Salpingitis
  • Tubo- ovarian abscess
  • Pelvic peritonitis
59
Q

PID

Is PID unilateral or bilateral

A

Bilateral usually

60
Q

MCC of preventable cause of infertility

A

Pelvic inflammatory disease

61
Q

PID

Sx

A
  • Abdominal pain, pelvic pain and dyspareunia
  • Mucopurulent vaginal discharge
  • Fever
  • HMB
62
Q

PID

Signs

A
  • Pelvic tenderness
  • Cervical excitation
  • Tender adnexal mass
  • Tubal damage
63
Q

PID

Cervical excitation

A

Pushing the cervix to one side with a finger causes stretching of the upper genital tract to the opposite side giving pain.
IN PID PUSHING TO BOTH SIDES WILL CAUSE PAIN (B/L INVOLVEMENT)

64
Q

cervical excitation is used in

A

PID and ectopic PG

65
Q

How to differentiate cervical excitation in ectopic PG and PID

A
  • Ectopic PG- pain only on pushing to one side
  • PID- pain on both sides
66
Q

PID

MCC of PID

A

STDs

67
Q

PID

STDs commonly causing PID

A
  • Neisseria gonorrhea
  • Chlamydia trachomatis
  • anaerobes
68
Q

PID

Anaerobes

A
  • H. influenzae
  • Gardanella vaginalis
  • Strep agalactaie
  • Myco hominis
  • Ureaplasma urealyticum
69
Q

PID

MO common in bacterial vaginosis

A

Ureaplasma urealyticum

70
Q

PID

Risk factors

A
  • Adolescence
  • Hx of STD
  • Multiple sexual partners
  • Insertion of IUCD
  • Bacterial vaginosis
  • Nonuse of barrier methods- OCP
71
Q

PID

Long- term complications

A
  • Tubal factor infertility
  • Ectopic PG
  • Chronic pelvic pain
  • Recurrent PID
72
Q

PID

Dx

A
  • Hx
  • Clinical examination
73
Q

PID

Definitive test for Dx PID

A

No Definitive test

74
Q

PID

Supportive tests

A
  • WBC - raised
  • CRP/ ESR- raised
  • USS- adnexal mass, hydrosalphynx
  • Laparoscopy
75
Q

PID

Gold standard test

A

Laparoscopy

76
Q

PID

Mx is done Out-patient or in- patient

A

Out- patient in mild to moderate PID cases

77
Q

PID

Indications for admitting and IV ABX

A
  • Severe infection
  • Adnexal mass suspicious abscess
  • Generalized sepsis
  • Inadequate response to oral Rx
78
Q

PID

The test that should be done in a woman who comes with acute abdominal pain suspecting of PID

A

urine PG test to exclude ectopic PG

78
Q

PID

Mx of severe PID

A
  • IV fluids
  • IV ABX
  • Analgesics
79
Q

PID

When to start ABX

A

should be started** without waiting for culture report**

80
Q

PID

First line ABx

A
  • Ceftriaxone - 500mg IM single
  • Doxycycline oral 100mg BD for 14 days
  • Metronidazole oral 400mg BD for 10 days
81
Q

PID

2nd line ABx

A
  • Ofloxacin
  • Cefixime
82
Q

PID

Surgical Mx

A

I&D of tubo- ovarian abscess Laparotomy

GYN/OBS (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions