Gynecology Test #3 Flashcards by Alli Locke

Primary dysmenorrhea

Primary dysmenorrhea: lower abdomenal/lower back pain before or during the menstural cycle, primary dysmenorrhea begins since the very first menstrual cycle, also called functional dysmenorrhea

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Secondary dysmenorrhea

Secondary dysmenorrhea: lower abdomenal/lower back pain before or during the menstural cycle, secondary dysmenorrhea means the pain starts later in life, usually due to inflammation, endometriosis

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Dysmenorrhea pathogenesis

Pathogenesis: Excess (obstruction causing pain - blood stasis, cold, damp heat/inflammation, cold damp, qi stagnation) Deficiency (failure to nourish - qi and blood defiicency, liver and kidney deficiency, deficiency cold)

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Dysmenorrhea differentiation

Differentiation: ectopic pregnancy, pregnancy, appendicitis, twisting of the ovaries, burst ovary cyst, miscarriage

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Symptoms: Distending pain in the lower abdomen at one or two days before mensturation or during menstruation, dislike pressing, or with distention in the chest, hypochondriac region and breast, or small volume purple dark blood with clots, abdominal pain better after clots discharge and pain relieved after period, purple dark tongue with spots, wiry or wiry and slippery pulse,

QI STAGNATION AND BLOOD STASIS dysmenorrhea

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QI STAGNATION AND BLOOD STASIS dysmenorrhea TP

TP: regulate qi, remove blood stasis, relieve pain

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QI STAGNATION AND BLOOD STASIS dysmenorrhea formula

Formula: Ge Xia Zhu Yu Tang

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Symptoms: cold pain in the lower abdomen before or during menstruatio, prefer warming and dislike pressing, small volume of purple dark blood with clots, aversion to cold and body ache, white greasy coating, deep and tight pulse

COLD AND DAMPNESS dysmenorrhea

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COLD AND DAMPNESS dysmenorrhea TP

TP: warm meridian, dispel cold and dampness, remove blood stasis and releive pain

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COLD AND DAMPNESS dysmenorrhea formula

Formula: Shao Fu Zhu Yu Tang + Cang Zhu, Fu Ling

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Symptoms: cold pain in the lower abdomen during or after menstruation, prefer warmth and pressing, small light or dark blood, weakness in the lower back and legs, profuse urination, deep pulse, white and moist coating

DEFICIENCY COLD dysmenorrhea

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DEFICIENCY COLD dysmenorrhea TP

TP: warm meridian and uterus, relieve pain

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DEFICIENCY COLD dysmenorrhea formula

Formula: Wen Jing Tang + Fu Zi, Ai Ye, Xiao Hui Xiang

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Symptoms: lower abdominal pain with burning sensation before menstruation which dislikes pressure, or with distending pain on the lower back, or freuqent pain on the side of the abdomen but worse during menstruation, thick dark red blood with clots, low fever, yellow thick vaginal discharge, short yellow urine, red tongue with yellow greasy coating, wiry and rapid or floating soft and rapid pulse.

DAMP HEAT POURING DOWN dysmenorrhea

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DAMP HEAT POURING DOWN dysmenorrhea TP

TP: clear heat, dispel damp, remove blood stasis, relieve pain

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DAMP HEAT POURING DOWN dysmenorrhea Formula

Formula: Qing Re Tiao Xue Tang + Hong Teng, Bai Jiang Cao, Yi Yi Ren

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Symptoms: dull pain in the lower abdomen after or during menstruation, bearing down sensation in the lower abdomen, prefer pressing, small volume, light and thin blood

QI AND BLOOD DEFICIENCY dysmenorrhea

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QI AND BLOOD DEFICIENCY dysmenorrhea TP

TP: tonify qi, nourish blood, relieve pain

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QI AND BLOOD DEFICIENCY dysmenorrhea Formula

Formula: Shen Yu Tang minus Sheng Di Huang + Bai Shao, Xiang Fu, Yan Hu Suo

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Symptoms: dull pain in the lower abdomen after menstruation, small light dark blood

LIVER AND KIDNEY DEFICIENCY dysmenorrhea

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LIVER AND KIDNEY DEFICIENCY dysmenorrhea TP

TP: Nourish liver and kidney, relieve pain

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LIVER AND KIDNEY DEFICIENCY dysmenorrhea formula

Formula: Tiao Gan Tang

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Excess dysmenorrhea pain symptoms

Excess: pain before or during period 1-3 days, distending or stabbing or burning or spasm pain, dislikes pressure

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Deficiency dysmenorrhea pain symptoms

Deficiency: pain after period of the end of the period, dull pain that likes pressure

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Pain in the middle of the abdomen:

blood stasis or cold

Pain in the low back:

SP/KD yang xu cold

Distending pain with gas:

qi stagnation

Sharp, spasm pain:

blood stasis

Primary amenorrhea

Primary amenorrhea: no period at 16 years old

Secondary amenorrhea

Secondary amenorrhea: no period for 3 cycles

Amenorrhea pathogenesis

1. Obstruction due to qi and blood stagnation: can be from emotions, stress, or an organic problem such as hormone disruption, deficiency, or excess 2. Obstruction of phlegm and damp: PCOS 3. Deficiency of liver and kidney: lack of hormones 4. Qi and blood deficiency: can be from loss of blood from labor, causes Sheehan's syndrome 5. Yin deficiency and blood dryness

How is dysmenorrhea diagnoses different from amenorrhea?

Amenorrhea ( also has damp heat, cold and damp, deficiency cold). Amenorrhea also has phlegm damp and yin deficiency with blood dryness.

Symptoms: non appearance of menstruation by the age of 16 years old, slight amount of bleeding and delayed menstruation developing slowly to amenorrhea, weakness and soreness in the low back and knees, dizziness, tinnitus, weak constitution, grey hair, hair loss, frequent or night urination, FSH is high, estrogen is low, ovaries are small, pale tongue, little coating, deep weak or thready choppy pulse

LIVER AND KIDNEY DEFICIENCY amenorrhea

LIVER AND KIDNEY DEFICIENCY amenorrhea TP

TP: tonify kidney, nourish liver, regulate menstruation

LIVER AND KIDNEY DEFICIENCY amenorrhea formula

Formula: Gui Shen Wan + Ji Xue Teng, He Shou Wu

Symptoms: delayed menstruation with a slight amount of pale and thin blood that gradually develops into amenorrhea, qi and blood deficiency symptoms, mostly secondary amenorrhea, pale complexion, pale lips, nails, eyelids, pale tongue little coating, palpitations, shorntess of breath, insomnia, lassitude, poor appetite, hair loss, dry hair, early greying of hair, sallow complexion, deep deficient or deficient rapid pulse

QI AND BLOOD DEFICIENCY

QI AND BLOOD DEFICIENCY amenorrhea TP

TP: tonify qi, nourish blood, regulate menstruation

QI AND BLOOD DEFICIENCY amenorrhea formula

Formula: Ren Shen Yang Rong Tang

Symptoms of severe blood loss amenorrhea

If heavy blood loss, dry vagina, decreased libido or atrophy of reproductive organs (Sheehan syndrome) add Lu Rong, Lu Jiao Shuang, Zi He Che, Blood loss is unable to nourish the pituitary so hormone production is low

If patient has Sheehan's syndrome, what formula and added herbs do you use

Ren Shen Yang Rong Tang + Lu Rong, Lu Jiao Shuang, Zi He Che

Symptoms: scanty menstruation gradually becoming amenorrhea, yin and blood deficiency symptoms, night sweating, steaming bone, malar flush, cough with blood, red tongue, little coating, thready rapid pulse

YIN DEFICIENCY AND DRY BLOOD amenorrhea

YIN DEFICIENCY AND DRY BLOOD amenorrhea TP

TP: nourish yin, clear heat, regulate menstruation

YIN DEFICIENCY AND DRY BLOOD amenorrhea formula

Formula: Jia Jian Yi Yin Jian + Huang Jing, Dan Shen, Zhi Ke

Symptoms: amenorrhea for several months, qi and blood stagnation symptoms, fullness and distention in the chest and hypochondrium, distending or stabbing pain in the lower abdomen, dislike pressure, purple dark tongue with purple/black spots, deep wiry or deep choppy pulse

QI STAGNATION AND BLOOD STASIS amenorrhea

QI STAGNATION AND BLOOD STASIS amenorrhea TP

TP: regulate qi, remove blood, regulate menstruation

QI STAGNATION AND BLOOD STASIS amenorrhea formula

Formula: Xue Fu Zhu Yu Tang

Symptoms: amenorrhea, phlegm and damp symptoms, feeling of heaviness, tongue with thick greasy coating, slippery pulse, poor digestion, phlegm sound in the throat, overweight, oppression in the chest, nausea, vomiting with phlegm, lassitude, profuse vaginal discharge, edema

PHLEGM AND DAMP OBSTRUCTION amenorrhea

PHLEGM AND DAMP OBSTRUCTION amenorrhea TP

TP: dispel damp and phlegm, regulate qi, remove blood stasis, regulate menstruation

PHLEGM AND DAMP OBSTRUCTION amenorrhea formula

Formula: Cang Fu Dao Tan Wan + Fo Shou San (Dang Gui, Chuan Xiong)

Menopause definition

No period for 1 year | low estrogen

Menopause pathogenesis

Pathogenesis: age/kidney essence deficiency, kidney deficiency constitution, chronic disease, overstrain

Symptoms: dizziness, tinnitus, hot flushes on the head and face, sweating, feverish sensation in the five hearts, soreness and weakness on the lower back and knees, insomnia, irregular menstruation with heavy or little volume, bright red blood, dry skin, dry mouth, constipation, scanty yellow urine, red tongue with little coating, thready and rapid pulse

KIDNEY YIN DEFICIENCY menopause

KIDNEY YIN DEFICIENCY menopause TP

TP: nourish kidney yin and anchor yang (liver or heart yang hyperactive from deficiency)

KIDNEY YIN DEFICIENCY menopause formula

Formula: Zuo Gui Yin + Zhi Shou Wu, Gui Ban

Symptoms: dark complexion, lassitude, cold sensation and cold extremities, soreness and cold on the lower back and knees, poor appetite, abdominal fullness sensation, diarrhea, heavy menstruation, heavy uterine bleeding without cycle, light color or dark, edema, frequent urination, heavy and thin leukorrhea, light red tongue with teethmarks, thin and white coating, deep and thready pulse

KIDNEY YANG DEFICIENCY menopause

KIDNEY YANG DEFICIENCY menopause TP

TP: warm kidney yang, tonify spleen yang

KIDNEY YANG DEFICIENCY menopause formula

Formula: You Gui Wan + Li Zhong Wan

if there is both yin and yang deficiency use

Er Xian Tang + Er Zhi Wan

Leukorrhea pathogenesis

1. DAMP: damp, damp cold, damp heat, damp toxin (five color discharge - refer out) (damp nature is downward, turbid, sticky) can be internal damp or external damp, yeast/fungal infection, related to the spleen and kidney 2. SPLEEN QI/YANG DEFICIENCY 3. KIDNEY YANG DEFICIENCY: can be from spleen yang deficiency, profuse watery discharge, lower back pain 4. KIDNEY YIN DEFICIENCY: low estrogen, burning sensation, dry itchy, small amount, sticky, yellow, odor

Leukorrhea problem diagnosis

Volume: too heavy or too light Color: clear, white, green, red, yellow Quality: watery, sticky Odor: smelly

Symptoms: whitish or light yellow leukorrhea which is thin, pale or sallow complexion, lassitude, cold extremities, poor appetite, swollen limbs, loose stools, pale tongue with white or greasy coating, weak and moderate pulse

SPLEEN DEFICIENCY leukorrhea

SPLEEN DEFICIENCY leukorrhea TP

TP: tonify spleen, raise yang, dispel dampness

SPLEEN DEFICIENCY leukorrhea formula

Formula: Wan Dai Tang

Symptoms: profuse clear and thin leukorrhea which is continual discharge, severe soreness on the lower back, cold sensation in the lower abdomen, frequent and profuse clear urination worse at night, diarrhea, pale tongue, thin white coating, deep and slow pulse, can be from chronic spleen yang deficiency

KIDNEY YANG DEFICIENCY leukorrhea

KIDNEY YANG DEFICIENCY leukorrhea TP

TP: warm kidney yang, stabilize and stop leukorrhea

KIDNEY YANG DEFICIENCY leukorrhea formula

Formula: Nei Bu Wan

Symptoms: yellowish or reddish thick leukorrhea, burning sensation in external genitalia, yin deficiency symptoms

KIDNEY YIN DEFICIENCY leukorrhea

KIDNEY YIN DEFICIENCY leukorrhea TP

TP: nourish kidney yin, clear heat, stop leukorrhea

KIDNEY YIN DEFICIENCY leukorrhea formula

Formula: Zhi Bai Di Huang Tang + Qian Shi, Jin Ying Zi

Symptoms: profuse yellow and thick foul smelling leukorrhea or white thick like bean curd leukorrhea, vaginal itching, damp heat symptoms

DAMP HEAT leukorrhea

DAMP HEAT leukorrhea TP

TP: clear heat and dispel damp

DAMP HEAT leukorrhea formula

Formula: Zhi Dai Fang

Symptoms of uterine bleeding during pregnancy:

bleeding without lower back and abdominal pain

Symptoms of unstable pregnancy:

lower back or abdominal pain with our without bleeding

Uterine bleeding during pregnancy/unstable pregnancy pathogenesis

Pathogenesis: Kidney deficiency (qi, yin, yang, essence), qi and blood deficiency, blood heat, blood stasis, external injury

Symptoms: during pregnancy, small volume bleeding with light dark color, aching on the lower back and bearing down sensation with pain in the lower abdomen, kidney deficiency symptoms, habitual miscarriage, pale tongue with white coating, deep slippery and weak in chi position pulse

*KIDNEY DEFICIENCY uterine bleeding during pregnancy/unstable pregnancy

*KIDNEY DEFICIENCY uterine bleeding during pregnancy/unstable pregnancy TP

TP: tonify kidneys, calm the fetus, tonify qi

*KIDNEY DEFICIENCY uterine bleeding during pregnancy/unstable pregnancy formula

Formula: Shou Tai Wan + Dang Shen, Bai Zhu

Symptoms: slight bleeding during pregnancy which is light red and thin blood, pain on the lower back and abdomen, qi and blood deficiency symptoms

QI AND BLOOD DEFICIENCY uterine bleeding during pregnancy/unstable pregnancy

QI AND BLOOD DEFICIENCY uterine bleeding during pregnancy/unstable pregnancy TP

TP: tonify qi, nourish blood, stabilize kidneys, quiet the fetus

QI AND BLOOD DEFICIENCY uterine bleeding during pregnancy/unstable pregnancy formula

Formula: *Tai Yuan Yin - Dang Gui + Huang Qi, E Jiao

Symptoms: bleeding with bright red blood during pregnancy, pain in the lower back and abdomen, irritability, anxiety, hot sensation, thirsty, dry mouth, dry throat, afternoon fever, short yellow urine, constipation red tongue with yellow dry coating, wiry or slippery rapid pulse

BLOOD HEAT uterine bleeding during pregnancy/unstable pregnancy

BLOOD HEAT uterine bleeding during pregnancy/unstable pregnancy TP

TP: nourish yin, clear heat, nourish blood, quiet fetus

BLOOD HEAT uterine bleeding during pregnancy/unstable pregnancy formula

Formula: Bao Yin Jian

Symptoms: external injury during pregnancy, aching on the lower back, fullness and bearing down sensation in the lower abdomen, bleeding, slippery and weak pulse

EXTERNAL INJURY DURING PREGNANCY/ BLOOD STASIS uterine bleeding during pregnancy/unstable pregnancy

EXTERNAL INJURY DURING PREGNANCY/ BLOOD STASIS uterine bleeding during pregnancy/unstable pregnancy TP

TP: tonify qi, harmonize blood, quiet the fetus

EXTERNAL INJURY DURING PREGNANCY/ BLOOD STASIS uterine bleeding during pregnancy/unstable pregnancy formula

Formula: Shen Yu Tang + Tu Si Zi, Sang Ji Sheng, Xu Duan

Habitual miscarriage formula

Bu Shen Gu Chong Wan

Symptoms: dull postpartum lower abdominal pain which is alleviated when pressed, scanty light color lochia, dizziness, tinnitus, pale complexion, dry stool, pale tongue, thin coating, deficient thready pulse

Blood deficiency postpartum abdominal pain

Blood deficiency postpartum abdominal pain TP

TP: nourish blood, tonify qi

Blood deficiency postpartum abdominal pain formula

Formula: Chang Ning Tang

Symptoms: postpartum abdominal pain aggravated by pressing and relieved by warming, scanty lochia with dark clots, dark tongue with purple spots, deep tight pulse

BLOOD STASIS postpartum abdominal pain

BLOOD STASIS postpartum abdominal pain TP

TP: remove blood stasis, dispel cold, relieve pain

BLOOD STASIS postpartum abdominal pain formula

Formula: Sheng Hua Tang + Yi Mu Cao

Symptoms: heavy deep red and thick lochia with foul smelling lochia and blood heat, red cheeks, dry mouth, thirsty, red tongue, deep thready and rapid pulse

BLOOD HEAT postpartum lochiorrhea

BLOOD HEAT postpartum lochiorrhea TP

TP: nourish yin, clear heat, stop bleeding

BLOOD HEAT postpartum lochiorrhea formula

Formula: Bao Yin Jian + E Jiao, Han Lian Cao, Wu Zei Gu

Symptoms: heavy or continuous small volume lochia which is light red and thin, no clots, no smell, bearing down sensation in lower abdomen, lassitude, pale complexion, dizziness, pale tongue, moderate weak pulse

QI DEFICIENCY postpartum lochiorrhea

QI DEFICIENCY postpartum lochiorrhea TP

TP: tonify qi, stabilize blood

QI DEFICIENCY postpartum lochiorrhea formula

Formula: Bu Zhong Yi Qi Tang + Lu Jiao Jiao, Ai Ye Tan

Symptoms: scanty dark lochia with clots, dark purple color, scanty amount, abdominal pain that dislikes pressure, dark purple tongue with spots, wiry and choppy pulse, or deep and forceful pulse

BLOOD STASIS postpartum lochiorrhea

BLOOD STASIS postpartum lochiorrhea TP

TP: remove blood stasis

BLOOD STASIS postpartum lochiorrhea formula

Formula: Sheng Hua Tang + Yi Mu Cao, Chao Pu Huang

Spleen and stomach deficiency morning sickness formula

Xiang Sha Liu Jun ZI Tang

LV/ST disharmony morning sickness formula

Su Ye Huang Lian Tang