Menstrual Disorder

Question 1

What is the function of FSH?

Answer 1

stimulates ovarian follicle development and granulosa cells to produce oestrogen

Question 2

What inhibits FSH production during the follicular phase?

Answer 2

raising oestrogen and inhibin by dominant follicles

Question 3

What does the declining FSH levels during the follicular phase cause?

Answer 3

atresia of all but the dominant follicle

Question 4

What happens during ovulation?

Answer 4

prior LH surge with dominant follicle rutpuring and releasing oocyte

Question 5

What is the main hormone produced during hte luteal phase?

Answer 5

progestrone

Question 6

How long does menstrual loss last?

Answer 6

4-6 dyas

Question 7

When does menstrual flow peak?

Answer 7

days 1-2

Question 8

What volume of blood should be lost during menstruation?

Answer 8

<80ml

Question 9

What should not be present in the blood during menstruation?

Answer 9

no clots

Question 10

What is menorrhagia?

Answer 10

prolonged nad increased menstrual flow

Question 11

What is metorrhagia?

Answer 11

regular intermenstrual bleeding

Question 12

What is polymenorrhoea?

Answer 12

menses occurring at <21 day interval

Question 13

what is polymenorrhagia?

Answer 13

increased bleeding and frequent cycle

Question 14

What is menometrorrhagia?

Answer 14

prolonged menses and intermnstrual bleeding

Question 15

What is oligomenorrhoea?

Answer 15

menses at intervals of >35 days

Question 16

What is ameonrrhoea?

Answer 16

absence of menstruation >6 months

Question 17

What accounts for 50% of menorrhagia?

Answer 17

dysfunctional uterine bleeding- absence of pathology

Question 18

What are fibroids?

Answer 18

benign tumours of the myometrium which are not painful

Question 19

What is cervical eversion?

Answer 19

endocervical epithelium (columnar) pouted out into vagina

Question 20

What is the most common cause of PID?

Answer 20

chlamydia

Question 21

What is adenomyosis?

Answer 21

endometrium is presenti n myometrium- pain

Question 22

What is endometriosis?

Answer 22

endormetrium not conifned to uterus, tissue is found elsewhere

Question 23

What are the endocrine cuases of menorrhagia?

Answer 23

hyper/hypothyroidism; DM; adrenal disease; prolactin disease

Question 24

What sydnrome is molar pregnancy also part of?

Answer 24

gestational trophoblastic disease

Question 25

What is dysfunctional uterine bleeding divided into?

Answer 25

anovultary and ovulatory

Question 26

What is the most common type of dysfunctional uterine bleedings?

Answer 26

anovultary- 85%

Question 27

What causes ovulatory DUB?

Answer 27

inadequate progesterone production by corpus luteum

Question 28

Who is anovulatory DUB more common in?

Answer 28

obese women; extrenes of reproductive life

Question 29

Who is ovulatory more common in?

Answer 29

women aged 35-45

Question 30

How can anovulatory and ovulatory DUB be distinguished?

Answer 30

anovulatory has irregular cycle whereas ovulatory get regular heavy periods

Question 31

What is the cut off for normal endometrial thickness of transvaginal USS?

Answer 31

4 mm

Question 32

What should be done in all women >40 with menorrhagia?

Answer 32

pipelle biopsy to rule out endometrial carinoma

Question 33

What are progestogens?

Answer 33

synthetic analogues of progesterone which has a longer half like

Question 34

What is the problem with GnRH analogues?

Answer 34

stop periods but risk of osteoporosis

Question 35

What are the surgical mx options for DUB?

Answer 35

endometrial resection/ablation; hysterectomy

Question 36

What is the problem with endometrial resection/ablation?

Answer 36

20% chance periods will not change

Question 37

What is the primary cause of distortion in patients?

Answer 37

bayesian reasoning