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Endo/Repro: Week 4 > LaBarre- Amenorrhea and Dysfunctional Uterine Bleeding > Flashcards

LaBarre- Amenorrhea and Dysfunctional Uterine Bleeding Flashcards

1
Q

Normal flow

A

2-7 days

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2
Q

cycle length

A

24-35 days

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3
Q

MC causes amenorrhea

A

pregnancy
lactation
menopause

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4
Q

no spontaneous uterine bleeding by age 14 and absence of 2 sex characteristics OR by age 16 w/ normal development

A

primary ammenorrhea

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5
Q

absence of mentrual bleeding for 6 mos in a woman w/ prior regular menses for 12 mos

A

secondary amenorrhea

*40% d/t ovaries

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6
Q

Compartment I blockages that cause amenorrhea

A

imperforate hymen
Ashermans
Mulleraian anomalies (absent uterus/tubes)
Testicular feminization

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7
Q

Ashermans

A

destruction of endometrium and scarring prevents bleedingn (D&C, ablation, severe infecdtion)

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8
Q

Compartment II ovarian disorders that cause amenorrhea

A
  1. Turners
  2. MOsaicism
  3. gonadal agenesis
  4. Premature ovarian failure
  5. 17 alpha hydroxylase def
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9
Q

Follicles undergo apoptosis leading to HIGH FSH and LOW estrogen

A

Turners 46 XO

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10
Q

Stress related amenorrhea

A

stress> increased cortisol> decreases FSH/LH

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11
Q

First thing to check for in a F w/ amenorrhea…

A

rule out pregnancy w/ hCG

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12
Q

Amenorrhea w/ high TSH

A

hypothyroid

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13
Q

NO normal withdrawl bleed after progesterone

A

end organ problem

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14
Q

prolonged >7d or excessive bleeding

A

menorrhagia

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15
Q

irregular and more frequent intervals of bledding

A

metrorrhagia

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16
Q

prolonged/variable amts of bleeding occuring irregularly and more frequently than normal

A

Menometrorrhagia

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17
Q

menses at interval GREATER than 35 d

A

oliomenorrhea

18
Q

menses at interval LESS than 21 days

A

polymenorrhea

19
Q

bleeding between regular periods

A

intermenstrual bleeding

20
Q

Midcycle spotting

A

1 day prior to ovulation from decline in estrogen

21
Q

bleeding in a woman at least 1 year after cessation of cycles

A

postmenopausal bleeding

22
Q

lack of bleeding 6 mos or longer

A

amenorrhea

23
Q

Abnormal bleeding in pregnancy

A
  1. 1/4 woman have bleeding in 1st trimester
  2. ectopic pregnancy
  3. miscarriage
  4. placenta previa
  5. gestational trophoblastic disease, molar pregnancy
24
Q

Uterine fibroids

A

float alongside the lining and causes the lining to become unstable and build up leading to shedding at irregular times

25
Q

Teens who have heavy periods

A

evaluate for bleeding disorder if they have heavy bleeding and no other issues

26
Q

MC condition that affects ovulation

A

PCOS

27
Q

MC medications that affect ovulation

A

antiepleptics (valproic acid)

antipsychotics

28
Q

Disturbance of normal HPO axis that leas to a progesterone def, estrogen dominant state

A

Anovulatory bleeding

NO ovulation leaving estrogen high and lining becomes unstable and sheds

29
Q

When do adolescents need evaluation?

A

consistently >3 mos between cycles

irregular cycles > 3 years

30
Q

When do adult women need evaulation?

A

suspected anovulatory cycles

PCOS and increased risk for endometrial cancer w/ HI estrogen

31
Q

When do perimenopausal women need evaluation?

A

increased volume/duration of bleeding
More often than every 21 days
positcoital bleeding> infection/polyps

32
Q

intermenstrual spotting in a perimenopausal woman

A

endometrial cancer

33
Q

Hair growth/acne could be signs of

A

PCOS> check androgen levels and see if there are other signs of verilization

34
Q

Evaluation for perimenopausal woman with a lot of bleeding?

A

endometrial biopsy

35
Q

RF for endometrial cancer?

A 
obesity
nuliparity
previous tamoxifen therapy
unopposed estrogen therapy
diabetes
50-70
36
Q

Obese 17 y/o w/ 2-3 years of untreated anovulatory bleeding

A

endometrial biopsy

37
Q

Endometrial biopsies have a high sensitivity for detecting…

A

carcinoma

*lower for atypical hyperplasia

38
Q

Endometrial ultrasound have high sensitivity for detecitng…

A

endometrial cancer (thick lining)

39
Q

Treatment for acute, heavy bleeding woman that’s hemodynamically unstable

A
  1. high dose IV estrogen
  2. IV fluids
  3. blood products
  4. consider D and C> progress to surgery and take out lining to stop bleeding
40
Q

Treatment for acute, heavy bleeding woman that’s hemodynamically stable

A
  1. OCPS (heavy dose 1 pill twice daily for 7 days then withdrawal bleed)
  2. NSAIDS
  3. GnRH agonist
41
Q

What can decrease the heaviness of a cycle?

A

NSAIDS (give on first day of menses x 5 days

Endo/Repro: Week 4 (14 decks)

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