GYN-Mentrual Abnormalities Flashcards
what is dysmenorrhea
pain and cramping during menstruation taht interferes with normal activity
etiology and treamtnet for 1/1 dysmenorrhea
inc PGF2 –> uterine contractions
tx NSAIDS and/or OCPs
etiologies of 2/2 dysmenorrhea
endometriosis, adenomyosis
fibroids
cervical stenosis
pelvic adhesions
treatment for cervical stenosis
surgical dilation or laminaria
what is PMS/PMDD
HA, weight gain, dysphoric mood during leuteal phase for 2+ consecutive cycles
What is the etiology of PMD/PMDD
interaction between 5-HT and E/P
How is PMS/PMDD managed?
SSRIs/SNRIs
alprazolam (xanax)
Yaz (OCP (E + drospirenone)
diet and exercise
normal volume of blood loss during normal menses
30-50ml
MCC menorrhagia
heavy flow
cervical or endometrial lesions
MCC hypomenorrhea
light flow
hypogonadotrophic hypogonasism in athlethes/anorexics
what is metrorrhagia? MCC?
irregular timing
due to cervical or endometrial lesions
what is menometrorrhagia? MCC?
heavy and irregular bleeding
due to cervical or endometrial lesionds
what is oligionemorrhea? MCC
slow cycles (>5wks, for < 6 mos)
anovulation, PCOS, pregnancy, thyroid disease
polymenorrhea MCC
fast cycles < 3 wks
anovulation
DUB? MCC
heavy or irregular bleeding without identifiable cause, dx of exclusion
anovulation
next step for AUB
b-hCG to r/o preg
if > 35 or obese get endometrial Bx + pelvic US
AUB 2/2 to ___. Tx?
Fibroids
myomectomy vs hysterectomy
AUB 2/2 to ___. Tx?
Adenomyositis
NSAID/OCP vs hysterectomy
AUB 2/2 to ___. Tx?
cervical polyps
polypectomy
AUB 2/2 to ___. Tx?
endometrial polyps
hysteroscopy vs polypectomy +/- D&C
AUB 2/2 to ___. Tx?
endometrial hyperplasia
progestins vs hysterectomy
AUB 2/2 to ___. Tx?
endometrial cancer
hysterectomy + BSO + radiation
AUB 2/2 to ___. Tx?
ectopic preg
MTX vs surgery
AUB 2/2 to ___. Tx?
hypothyroid
synthroid
AUB 2/2 to ___. Tx?
hyperPRL
bromocriptine or carbergoline
AUB 2/2 to ___. Tx?
anovulation
cyclic OCP or progestins
treatment for DUB with acute hemorrhage
25mg IV estrogen
treatment for DUB with chronic hemorrhage
NSAIDs + OCPs
if unresponsive, D&C, endometrial ablation or hysterectomy are options
how to define postmenopausal bleeding
any vaginal bleeding aftwe 12_ mos after LMP
etiologies of postmenopausal bleeding
vaginal/endometrial atrophy exogenous estrogens (MCC)
**must r/o endometrial cancer
next steps for post menopausal bleeding
CBC, TSH, PRL, FSH levels
endometrial bx
pelvic us
6 etiologies of postmenopausal bleeding
lacerations vaginal atrophy (give E cream) cervical polyps endometrial polyp endometrial hyperplasia endometrial cancer
