Exam 2: Abnormal Uterine Bleeding

Question 1

Normal menstrual bleed lasts how long? Range?

Answer 1

5d. 2-7 day range.

Question 2

Normal menstrual bleed volume loss?

Answer 2

40mL per cycle

Question 3

Menorrhagia volume blood loss?

Answer 3

> 80mL

Question 4

Menorrhagia frequently produces?

Answer 4

Anemia

Question 5

Metrorrhagia definition?

Answer 5

Bleeding between periods

Question 6

Polymenorrhea definition?

Answer 6

Bleeding more often than 21 days

Question 7

Oligomenorrhea definition?

Answer 7

Bleeding less frequently than 35 days

Question 8

AUB Etiology mneumonic?

Answer 8

PALM-COEIN

Polyps Adenomyosis Leimyoma Malignancy - Coagulopathy Ovulatory dysfunction Endometrial Iatrogenic Not yet classified

Question 9

Which test has the primary role to determine if carcinoma or premalignant lesion is present?

Answer 9

Endometrial sampling

Question 10

2 group which get Endometrial Sampling

Answer 10

1. ≥45 w/AUB

2. Youger patients with hx of unoposed estrogen exposure or failed med management

Question 11

Is neonatal vaginal bleeding normal?

Answer 11

Yes

Question 12

Etiology neonatal vaginal bleeding?

Answer 12

Withdrawl from hormones while in womb

Question 13

How long does the menstrual cycle vary after menarche?

Answer 13

for first 5-7 years

Question 14

Why does menstrual cycle vary after menarche for first 5-7 years?

Answer 14

HPO-axis immature resulting in many anovulatory cycles

Question 15

Mild anovulatory uterine bleeding lasts for how long? Flow?

Answer 15

Longer than normal menses >7 days or shortened cycles <24d, for at least 2 months. SLightly or moderately increased flow.

Question 16

Moderate anovulatory uterine bleeding lasts for how long? Flow? Hgb?

Answer 16

Prlonged >7d or frequent menses q1-3 weeks. Moderate to heavy flow. Hgb ≥10.

Question 17

Severe anovulatory uterine bleeding lasts for how long? Flow? Hgb?

Answer 17

Disruptive menstrual cycles with heavy bleeding. Hgb <10. +/- hemodynamically unstable.

Question 18

Tx for Adolescent Anovulatory Uterine Bleeding?

Answer 18

Mestrual calendar, observe and reassure vs progestin hormone tx, f/u in 3-6 months

Question 19

Tx for heavy adult AUB?

Answer 19

COC

Question 20

Tx for intractable adult AUB?

Answer 20

GnRH-agonist to cease mestruation

Question 21

Tx for hospitalized adult AUB?

Answer 21

IV conjugated estrogens

Question 22

Endometrial Polyp can occur when?

Answer 22

At any time of reproductive or post-menopausal years

Question 23

Endometrial Polyp most common in…?

Answer 23

Menstrual transition and early post-menopause

Question 24

MC sx of Endometrial Polyp?

Answer 24

Intermenstrual bleeding, often after straining or heavy lifting

Question 25

Dx of Endometrial Polyp?

Answer 25

Histologic

Question 26

Tx for sympomatic Endometrial Polyp?

Answer 26

Polyepctomy

Question 27

All women with unexplained uterine bleed should be evalued for what?

Answer 27

Endometrial carcinoma

Question 28

When does Post-menopausal bleed occur?

Answer 28

≥6 months following menstrual function

Question 29

How to measure endometrial thickness?

Answer 29

Transvaginal U/S

Question 30

Endometrial thickness <4mm is a low likelihood of what?

Answer 30

Hyperplasia or endometrial carcinoma

Question 31

Endometrial thickness >4mm which is global requires what dx?

Answer 31

Biopsy

Question 32

Endometrial thickness >4mm which is focal requires what dx?

Answer 32

Sample

Question 33

Tx for post-menopausal bleed

Answer 33

Cyclic or continuous progrestin therapy

Question 34

AUB in women 19-39 most often to do what?

Answer 34

Pregnancy, Structural lesions, Anovulatory cycles, Use of hormonal contraception, Endometrial hyperplasia

Question 35

What should always be r/o as a cause in reproductive age women - premenopausal patients with AUB

Answer 35

PREGNANCY