GYN-Mentrual Abnormalities

Question 1

what is dysmenorrhea

Answer 1

pain and cramping during menstruation taht interferes with normal activity

Question 2

etiology and treamtnet for 1/1 dysmenorrhea

Answer 2

inc PGF2 –> uterine contractions

tx NSAIDS and/or OCPs

Question 3

etiologies of 2/2 dysmenorrhea

Answer 3

endometriosis, adenomyosis
fibroids
cervical stenosis
pelvic adhesions

Question 4

treatment for cervical stenosis

Answer 4

surgical dilation or laminaria

Question 5

what is PMS/PMDD

Answer 5

HA, weight gain, dysphoric mood during leuteal phase for 2+ consecutive cycles

Question 6

What is the etiology of PMD/PMDD

Answer 6

interaction between 5-HT and E/P

Question 7

How is PMS/PMDD managed?

Answer 7

SSRIs/SNRIs
alprazolam (xanax)
Yaz (OCP (E + drospirenone)
diet and exercise

Question 8

normal volume of blood loss during normal menses

Answer 8

30-50ml

Question 9

MCC menorrhagia

Answer 9

heavy flow

cervical or endometrial lesions

Question 10

MCC hypomenorrhea

Answer 10

light flow

hypogonadotrophic hypogonasism in athlethes/anorexics

Question 11

what is metrorrhagia? MCC?

Answer 11

irregular timing

due to cervical or endometrial lesions

Question 12

what is menometrorrhagia? MCC?

Answer 12

heavy and irregular bleeding

due to cervical or endometrial lesionds

Question 13

what is oligionemorrhea? MCC

Answer 13

slow cycles (>5wks, for < 6 mos)

anovulation, PCOS, pregnancy, thyroid disease

Question 14

polymenorrhea MCC

Answer 14

fast cycles < 3 wks

anovulation

Question 15

DUB? MCC

Answer 15

heavy or irregular bleeding without identifiable cause, dx of exclusion

anovulation

Question 16

next step for AUB

Answer 16

b-hCG to r/o preg

if > 35 or obese get endometrial Bx + pelvic US

Question 17

AUB 2/2 to ___. Tx?

Fibroids

Answer 17

myomectomy vs hysterectomy

Question 18

AUB 2/2 to ___. Tx?

Adenomyositis

Answer 18

NSAID/OCP vs hysterectomy

Question 19

AUB 2/2 to ___. Tx?

cervical polyps

Answer 19

polypectomy

Question 20

AUB 2/2 to ___. Tx?

endometrial polyps

Answer 20

hysteroscopy vs polypectomy +/- D&C

Question 21

AUB 2/2 to ___. Tx?

endometrial hyperplasia

Answer 21

progestins vs hysterectomy

Question 22

AUB 2/2 to ___. Tx?

endometrial cancer

Answer 22

hysterectomy + BSO + radiation

Question 23

AUB 2/2 to ___. Tx?

ectopic preg

Answer 23

MTX vs surgery

Question 24

AUB 2/2 to ___. Tx?

hypothyroid

Answer 24

synthroid

Question 25

AUB 2/2 to ___. Tx?

hyperPRL

Answer 25

bromocriptine or carbergoline

Question 26

AUB 2/2 to ___. Tx?

anovulation

Answer 26

cyclic OCP or progestins

Question 27

treatment for DUB with acute hemorrhage

Answer 27

25mg IV estrogen

Question 28

treatment for DUB with chronic hemorrhage

Answer 28

NSAIDs + OCPs

if unresponsive, D&C, endometrial ablation or hysterectomy are options

Question 29

how to define postmenopausal bleeding

Answer 29

any vaginal bleeding aftwe 12_ mos after LMP

Question 30

etiologies of postmenopausal bleeding

Answer 30

vaginal/endometrial atrophy
exogenous estrogens (MCC)

**must r/o endometrial cancer

Question 31

next steps for post menopausal bleeding

Answer 31

CBC, TSH, PRL, FSH levels
endometrial bx
pelvic us

Question 32

6 etiologies of postmenopausal bleeding

Answer 32

lacerations
vaginal atrophy (give E cream)
cervical polyps
endometrial polyp
endometrial hyperplasia
endometrial cancer