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reproduction > menstrual disorders > Flashcards

menstrual disorders Flashcards

1
Q

What is a menstrual cycle

A

time from the first day of period to the day before her next period

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2
Q

What is the normal blood loss in menstruation

A

less than 80ml over 7 days

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3
Q

How long does a cycle last

A

28 days

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4
Q

When is the menarche (first menstrual period)

A

10-16 years - 12 years average

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5
Q

When is menopause usually

A

Lat period - 50-55 years

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6
Q

Describe the menstrual cycle with regards to hormones

A

FSH which is released from the pituitary gland which then causes the production of estrogen

The follicles of the ovary start to develop but only one begins to mature – the dominant follicle

There is a LH surge which causes ovulation

Following the LH surge, the estrogen starts to decrease while the progesterone begins to increase

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7
Q

What is a sign that someone is having heavy menstrual bleeding

A

Clots are seen in the menstrual bleeding

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8
Q

What are the causes of heavy menstrual bleeding

A

Uterine fibroids

Endometrial polyps

Endometriosis and adenomyosis
Pelvic inflammatory disease or infections e.g chlamydia

Endometrial hyperplasia or carcinoma

Polycystic ovary syndrome

Coagulation disorders

Hypothyroidism

Renal or liver disease

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9
Q

What are fibroids

A

Non cancerous growths made of muscle or fibrous tissue - also known as a myoma

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10
Q

What are the symptoms caused by fibroids

A

Heavy menstrual bleeding, Pelvic pain, urinary symptoms, pressure symptoms, backache, infertility and miscarriage

Asymptomatic

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11
Q

How are fibroids diagnosed

A

Ultrasound

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12
Q

What is the treatment for large fibroids with preservation of fertility desired

A

Fibroid embolisation or myomectomy

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13
Q

What is the treatment for submucosal fibroids

A

Hysteroscopic fibroid resection

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14
Q

What is the treatment for Heavy menstrual bleeding and small fibroids

A

COCP

POP

Mirena

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15
Q

What is a myomectomy

A

Surgery to remove uterine fibroids

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16
Q

What is endometriosis

A

Endometrial tissue present outside the lining of the uterus - this tissue behaves like the endometrium during menstruation and bleeds

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17
Q

What are the symptoms of endometriosis

A

Heavy menstrual bleeding, painful menstrual clamps that progressively get worse, infertility, fatigue and systemic symptoms, painful bowel movements or urination, pain during or after intercourse, abnormal bleeding or spotting in between menstrual periods, diarrhoea, nausea and bloating, lower back pain

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18
Q

Describe the stage 1 of endometriosis

A

Minimal - surface lesions or inflammation around pelvic organs in the pelvic cavity

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19
Q

Describe stage 2 of endometriosis

A

Mild - infiltrating pelvic organs and more widespread than stage 1

20
Q

Describe stage 3 endometriosis

A

Moderate - Peritoneum (pelvic side walls) and other structures affected - sometimes there is scarring

21
Q

Describe stage 4 endometriosis

A

Infiltrative and affecting many pelvic organs and ovaries often with distortion of the anatomy

22
Q

What is the treatment for endometriosis

A

Analgesia

COCP, POP, Mirena IUS, GnRH analogues

Surgical - ablation, hysterectomy endometrioma excision, pelvic clearance, hysterectomy

23
Q

What is adenomyosis

A

Condition in which the endometrium becomes embedded in the myometrium

24
Q

What are the symptoms of adenomyosis

A

Heavy menstrual bleeding

Dysmenorrhoea

Partial response to hormones

25
Q

What is the definitive treatment for adenomyosis

A

Hysterectomy

26
Q

What are endometrial polyps

A

Overgrowth of endometrial lining leading to pediculated structures called polyps which extend into the endometrium

27
Q

How are endometrial polyps diagnosed

A

Mainly ultrasound

28
Q

What is the management of polyps

A

Polypectomy

29
Q

What is the function of tranexamic acid

A

Reduces blood loss by 60%

30
Q

What is the function of mefenamic acid

A

Reduces blood loss 30% and pain

31
Q

What is the function of the combined oral contraceptive pill (COCP) with regards to periods

A

Makes periods lighter, regular and less painful

32
Q

What is the function of LNG IUS and Depo-provera

A

Reduces bleeding but can cause irregular bleeding and make some women amenorrhoeic

33
Q

What is the function of oral progesterone with regards to periods

A

reduce bleeding and regulate period

34
Q

What is hysterectomy

A

Surgical removal of the uterus

35
Q

What does hysterectomy guarantee with regards to periods

A

Amenorrhoea

36
Q

What is a salpingo-oophorectomy

A

Removal of tubes and ovaries

37
Q

What are the advantages and disadvantages of oophorectomy

A

Disadvantage - Immediate menopause

Advantage - reduced risk ovarian cancer

38
Q

What is oligomenorrhoea

A

Infrequent periods

39
Q

What is amenorrhoea

A

Absent periods

40
Q

What is polycystic ovary syndrome

A

2/3 of the following:

Ultrasound appearance of ovary

Clinical hyperandrogegism e.g excess facial hair

Biochemical hyperandrogegism

41
Q

What is polycystic ovarian syndrome linked with

A

Infertility and obesity

42
Q

What is the treatment for polycystic ovarian syndrome

A

Symptom based treatment:

COCP, POP, Mirena IUS

43
Q

Why are 3 periods required a year at least for polycystic ovarian syndrome

A

To prevent endometrial hyperplasia

44
Q

What is dysfunctional uterine bleeding

A

Common disorder of excessive uterine bleeding affecting premenopausal women that is not due to pregnancy or systemic disease

45
Q
A

reproduction (16 decks)

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