Brainscape's Knowledge GenomeTM

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


See full index

Gynaecology > Dysmenorrhoea > Flashcards

Dysmenorrhoea Flashcards

1
Q

Structural causes of HMB

A

Polyps, adenomyosis, leiomyoma, malignancy or hyperplasia

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

Non-structural causes of HMB

A

Coagulopathy (Von Willebrand disease), ovulatory disorder, endometrial, iatrogenic (hormone induced), non-specific (AV malformations, CS niche)

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

Associated symptoms to ask for in HMB

A

Intermenstrual bleeding
Postcoital bleeding
Dysmenorrhoea
Dyschezia
Dysparenuria
Bladder symptoms

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

What are fibroids

A

Also known as uterine leiomyomas, which are benign tumours of smooth muscle of the womb.

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

How do fibroids change over time

A

Increasing prevalence with age, and can shink after menopause and grow during pregnancy as they are oestrogen sensitive.

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

What are the classifications of fibroids

A

Subserosal
Intramural
Submucosal
Pedunculated
Intracavitary

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

Where are subserosal fibroids found

A

On the outside of the uterus, below, can fill the abdominal cavity

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

Where are intramural fibroids found

A

Within wall of the myometrium and can distort shape of the uterus

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

Where are submucosal fibroids found

A

Impinging on the cavity of the womb, just below the lining of the uterus (endometrium)

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

What are pedunculated and intracavitary fibroids

A

Both found on a stem, with pedunculated found outside the womb and intracavitary within the womb

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

Presentation of fibroids

A

Can be asymptomatic, or have range of symptoms including:
HMB, abdominal pain, prolonged menstruation, bloating or full feelings, bowel or urinary symptoms if they are pushing on cavities, dysparenuria, reduced fertility

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

What are the examination, investigations and findings of fibroids

A

Bimanual – firm mass
Hysteroscopy - submucosal fibroids
PUSS - larger fibroids
MRI - before surgical option but not part of routine work up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment of fibroids which are less than 3cm

A

Mirena coil
NSAIDs
COCP
Cyclical oral progesterones
Surgical - endometrial ablation, resection or hysterectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment of fibroids which are more than 3cm

A

NSAIDs and TXA
Mirena coil depending on size and shape
COCP
Cyclical oral progesterones
UTerine artery embolisation
Myomectomy
Hysterectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are GnRH agonists used for in fibroids

A

Goserelin or leuprorelin may be used to reduce the size of fibroids before surgery - working to induce a menopause like state

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

What does uterine artery embolisation do in fibroid treatment

A

Catheter is inserted into femoral and uterine artery to block the arterial supply to the fibroid

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

What is involved in endometrial ablation

A

Destroying the endometrium and used as second generation non-hysteroscopic technique such as balloon thermal ablation, which involves inserting a specially designed balloon into the endometrial cavity and filling it with a high temperature

18
Q

Complications of fibroids

A

HMB leading to anaemia
Reduced fertility
Pregnancy complications
Constipation
Urinary outflow obstruction and UTI
Reduced degeneration of fibroids
Torsion of fibroid
Malignant change is very rare

19
Q

What are endometrial polyps

A

Hyperplastic localised overgrowths of endometrial glands and stoma

20
Q

When are polyps markers for malignancy

A

> 1cm
associated with abnormal bleeding patterns
Presence in postmenopausal women
Necrotic, vascular or whitish appearance at hysteroscopy

21
Q

Presentation of polyps

A

Increased prevalence with age until menopause, may be asymptomatic or affect fertility and contribute to HMB

22
Q

What is adenomyosis

A

Endometrial tissue inside the myometrium.

23
Q

What is the prevalence of adenomyosis

A

More common in later reproductive years and those that have had several pregnancies - 10% women overall

24
Q

Presentation of adenomyosis

A

Painful periods
Heavy periods
Pain during intercourse
Infetility or pregnancy related complications
1/3 are asymptomatic

25
Q

Examination of adenomyosis

A

Large tender and globular uterus which feels softer

26
Q

Diagnosis of adenomyosis

A

Transvaginal US first line
Can do MRI and transabdominal US
GOLD is histological exam under hysteroscopy

27
Q

Management of adenomyosis

A

Depending on age, symptoms and pregnancy plans.
TXA, mefenamic acid, mirena coil is first line, COCP, cyclical oral progesterones, other options further down the line such as andometrial ablation, GnRH analogues, uterine artery emolisation

28
Q

What is adenomyosis associated with

A

Infertility, miscarriage, preterm birth, SGA, PPROM, malpresentation, caesarean, postpartum haemorrhage

29
Q

What is endometriosis

A

Presence of endometrial like tissue outside of the uterus, which induces a chronic and inflammatory response

30
Q

What areas can be affected by endometriosis

A

Ovaries, uterosacral ligaments, pouch of douglas and broad ligaments, CNS, nasal septum and lungs rarely

31
Q

What is an endometrioma

A

Tumour outside of the endometrium

32
Q

Suspected aetiology of endometriosis

A

Retrograde menstruation (into fallopian tubes instead of cervix), metaplasia, haematological or lymphatic spread, altered immune function, combination of the above

33
Q

Presentation of endometriosis

A

Cyclical
Dysmenorrhoea
Dysparenuria
Chronic pelvic pain from adhesions
Dyschesia
Intermenstrual bleeding
Infertility
Asymptomatic

34
Q

Why can there be infertility in endometriosis

A

Abnormal position from adhesions, endometrioma inflammation

35
Q

Examination findings of endometriosis

A

On speculum there can be deposits in the vagina
On bimanual exam there is a fixed uterus, fixed cervix, deep tender pain, adnexa tender

36
Q

US findings of endometriosis

A

Large endometriomas, chocolate cysts, often normal

37
Q

What is the GOLD standard investigation for endometriosis

A

Laparoscopic surgery

38
Q

What is the GOLD standard investigation for endometriosis

A

Laparoscopic surgery

39
Q

Overall treatment aims of endometriosis

A

Stop ovulation and stop endometrial thickening, give analgesia

40
Q

Medical management of endometriosis

A

Analgesia
Progesterones
COCP
Mirena coil
GnRH release hormone +/- HRT

41
Q

Surgical options for endometriosis

A

Diathermy
Excision
Remove adhesions
Remove endometiomas
Laser
Radical therapy such as hysterectomy and salpingoopharectomy

Gynaecology (7 decks)

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