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Year Three - Reproductive System > Heavy Menstrual Bleeding > Flashcards

Heavy Menstrual Bleeding Flashcards

1
Q

What is another name for heavy menstrual bleeding?

A

Menorrhagia

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2
Q

What is the average volume of blood loss during menstruation?

A

40ml

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3
Q

What blood loss volume is defined as excessive?

A

> 80ml

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4
Q

What is the definition of heavy menstrual bleeding?

A

It is defined as an amount of blood loss that the woman considers to be excessive

The volume of blood loss is rarely measured in clinical practice

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5
Q

What are the nine causes of heavy menstrual bleeding?

A

Endometrial Polyp

Adenomyosis & Endometriosis

Leiomyoma (Fibroid)

Endometrial Malignancy

Coagulation Disorders (Von Willebrand Disease)

Polycystic Ovarian Syndrome

Pelvic Inflammatory Disease

Anticoagulant Medications

Intrauterine Contraceptive Devices

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6
Q

What are the three clinical features of heavy menstrual bleeding?

A

Frequent pad changing every one to two hours

Passage of blood clots

Leakage of blood through clothes

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7
Q

What are the five investigations used to detect the underlying cause of heavy menstrual bleeding?

A

Pregnancy Test

Blood Tests

Ultrasound Scan

Vaginal Swab

Hysteroscopy

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8
Q

When do we conduct a pregnancy test when patients present with heavy menstrual bleeding?

A

In all patients of a reproductive age

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9
Q

Why is a pregnancy test used to investigate heavy menstrual bleeding?

A

Vaginal bleeding may indicate miscarriage pregnancy and ectopic pregnancy

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10
Q

What two blood tests used to investigate heavy menstrual bleeding?

A

Full Blood Count

Coagulation Screen

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11
Q

Why is a FBC test used to investigate heavy menstrual bleeding?

A

Anaemia, which is a common complication of heavy menstrual bleeding

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12
Q

Why is a coagulation screening test used to investigate heavy menstrual bleeding?

A

It is used to look for coagulation disorders

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13
Q

When do we conduct a coagulation screening blood test when patients present with heavy menstrual bleeding?

A

Those with a family history

Those that have experienced heavy menstrual bleeding since menarche

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14
Q

What investigation is the most useful for heavy menstrual bleeding?

A

Transvaginal US

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15
Q

When do we conduct an US when patients present with heavy menstrual bleeding?

A

If there is a palpable pelvic mass

If there is pelvic pain on examination

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16
Q

Why do we conduct a vaginal swab to investigate heavy menstrual bleeding?

A

To assess for infection

17
Q

When do we conduct a vaginal swab when patients present with heavy menstrual bleeding?

A

If the patient presents with abnormal discharge

There is a suggestive sexual history

18
Q

When do we conduct a hysteroscopy when patients present with heavy menstrual bleeding?

A

If there is an ultrasound pathology identified

When the results of the ultrasound are inconclusive

19
Q

What are the four pharmacological managements used for heavy menstrual bleeding?

A

Levonorgestrel Intrauterine System

Tranexamic Acid

Mefenamic Acid

Progesterone Only Pill

19
Q

What is the first line treatment option for individuals who have heavy menstrual bleeding and want contraception?

A

Levonorgestrel intrauterine system

20
Q

What class of drug is tranexamic acid?

A

Antifibrinolytic drug

21
Q

What is the role of antifibronyltic drugs?

A

To improve blood clotting

22
Q

How is tranexamic acid prescribed for heavy menstrual bleeding?

A

It is taken only during menses

23
Q

When is tranexamic acid used to treat heavy menstrual bleeding?

A

It is a common treatment option for those who are not experiencing any pain and don’t want contraception

24
Q

What class of drugs is mefenamic acid?

A

NSAID

25
Q

How is mefenamic acid prescribed for heavy menstrual bleeding?

A

It is taken only during menses

26
Q

When is mefenamic acid used to treat heavy menstrual bleeding?

A

It is a common treatment option for those who are experiencing pain and don’t want contraception

27
Q

What specific progesterone only pill is used to treat heavy menstrual bleeding?

A

Norethisterone

28
Q

How is the progesterone only pill prescribed for heavy menstrual bleeding?

A

It can be prescribed three times daily from day 5 – day 26 of the menstrual cycle

This does not work as a contraceptive when taken in this manner

29
Q

What are the two surgical treatments for heavy menstrual bleeding?

A

Endometrial Ablation

Hysterectomy

30
Q

What is endometrial ablation?

A

It is a procedure in which the endometrium lining of the uterus is obliterated

31
Q

When are surgical treatments used to treat heavy menstrual bleeding?

A

When pharmacological management has failed, and the patient no longer wants to conceive

32
Q

What is a hysterectomy?

A

A procedure in which the uterus is removed

33
Q

What is the only definitive treatment option for heavy menstrual bleeding?

A

Hysterectomy

Year Three - Reproductive System (52 decks)

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