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3 Reproduction and Sexual Health > Menstrual Disorders > Flashcards

Menstrual Disorders Flashcards

1
Q

what does FSH do?

A

stimulates follicle development

stimulates granulosa cells to make oestrogen

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2
Q

when does FSH rise?

A

start of the cycle

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3
Q

there is a surge in what chemical in ovulation

A

LH

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4
Q

what promotes the formation of a dominant follicle?

A

decrease in FSH

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5
Q

at what stage of the menstrual cycle does the dominant follicle rupture?

A

ovulation

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6
Q

when does the corpus luteum break down?

A

14 days post ovulation

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7
Q

what hormone is produced in the luteal phase?

A

progesterone

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8
Q

name the 2 phases of the menstrual cycle

A

proliferative

secretory

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9
Q

what does oestrogen do in the proliferative phase?

A

promotes growth of the endometrial glands and stroma

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10
Q

what does progesterone do in the luteal phase?

A

promote glandular secretory activity

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11
Q

what happens to arterioles in menstruation?

A

they constrict

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12
Q

scar tissue formation is prevented in menstruation by what?

A

fibrinolysis

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13
Q

normal duration of menstruation?

A

4-6 days

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14
Q

clots are normal in a period T or F

A

T

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15
Q

what is polymenorrhoea?

A

period cycle less than 21 days

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16
Q

define oligomenorrhoea

A

period cycle more than 35 days

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17
Q

amenorrhoea is absence of menstruation > _ months

A

6

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18
Q

define metrorrhagia?

A

regular intermenstrual bleeding

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19
Q

2 types of menorrhagia?

A

organic ie due to pathology

non-organic ie dysfunctional uterine bleeding (diagnosis of exclusion)

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20
Q

benign local causes of menorrhagia?

A

fibroids

polyps

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21
Q

endocervical gland contains what kind of epithelium?

A

columnar epithelium

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22
Q

what foreign bodies can cause menorrhagia?

A

IUD (copper)

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23
Q

main cause of PID in UK?

A

chlamydia

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24
Q

pathological local causes of menorrhagia?

A 
adenomyosis
PID
endometriosis
malignancy
trauma
endometrial hyperplasia
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25
Q

severe pain and heavy bleeding make you think what conditions?

A

PID
endometriosis
adenomyosis

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26
Q

what 2 gynae cancers can cause menorrhagia

A 
cervical carcinoma
endometrial carcinoma (uterus)
27
Q

post-menopausal bleeding….

A

endometrial carcinoma

28
Q

what gynae cancers produce hormones?

A

granulosa cell tumour (ovarian cancer that produces oestrogen)

29
Q

how can you tell laparoscopically if tubes are blocked?

A

inject a dye into the cervix, if it doesnt spill out the end of the fallopian tube its blocked

30
Q

what is endometriosis

A

ectopic endometrium elsewhere in the pelvis

31
Q

gross appearance of endometriosis over time

A

red spot with bleeding that fibroses to become black

32
Q

what happens in untreated endometriosis

A

blood accumulates leading to cyst formation

33
Q

“chocolate cyst”

A

ovarian endometrioma (cyst formation as a result of undiagnosed endometriosis)

34
Q

what endocrine disorders can cause menorrhagia

A

hyper/hypothyroidism
diabetes
adrenal disease

35
Q

prolactin disorders tend to cause what menstrual disorder and why?

A

amenorrhoea (suppresses LH and FSH production)

36
Q

what haematological disorders can cause menorrhagia?

A

haemophilia (carriers)
von willebrand’s disease
thrombocytopaenia
clotting factor deficiency

37
Q

what drugs can cause menorrhagia?

A

anticoagulants

38
Q

what are the main age groups who present with menorrhagia

A

teenagers

women in late 40s

39
Q

obstetric causes of organic menorrhagia?

A

miscarriage
ectopic pregnancy
gestational trophoblastic disease
PPH

40
Q

bleeding in early pregnancy….

A

ectopic pregnancy

41
Q

2 subtypes of dysfunctional uterine bleeding?

A

anovulatory

ovulatory

42
Q

most common subtype of DUB?

A

anovulatory

43
Q

describe anovulatory DUB; who gets it?

A

irregular cycle at extremes of reproductive life
very young and meopausal women
OBESE WOMEN ++++

44
Q

what happens in ovulatory DUB and why?

A

regular heavy periods due to inadequate progesterone production by poor quality corpus luteum

45
Q

why are you most fertile in younger age?

A

release your best quality eggs at the beginning

corpus luteum’s quality decreases

46
Q

haematological Ix of DUB

A 
FBC
Hb (exclude anaemia)
TSH for thyroid dsysfunction
coag screen
renal/LFTs
47
Q

screening Ix of DUB

A

smear
transvaginal USS
endometrial sampling

48
Q

when would you do a transvaginal USS?

A

assess endometrial thickness

detect fibroids and other pelvic masses

49
Q

the ___ the endometrium, the __ likely you are to have an endometrial carcinoma

A

thicker

more

50
Q

mean age for endometrial carcinoma?

A

60 yrs old

51
Q

above what age should you consider endometrial carcinoma?

A

40

52
Q

Ix endometrial carcinoma

A
  1. transvaginal USS to assess endo thickness

2. pipelle biopsy to sample endometrium if USS is abnormal

53
Q

hysteroscopy tends to be done under general anaesthetic T or F

A

T

54
Q

when does FSH rise?

A

start of the cycle

55
Q

there is a surge in what chemical in ovulation

A

LH

56
Q

what non-pharmacological contraceptive can be used to treat DUB?

A

IUS (hormonal)

57
Q

surgical Tx of DUB

A
  1. endometrial resection/ablation

2. hysterectomy

58
Q

what foreign bodies can cause menorrhagia?

A

IUD (copper)

59
Q

“chocolate cyst”

A

ovarian endometrioma (cyst formation as a result of undiagnosed endometriosis)

60
Q

non surgical Tx of DUB

A

progestogens (from day 5-25)
OCP
NSAIDs (minimises prostaglandin production in the corpus luteum breakdown phase)
GnRH analogues

61
Q

why is progestogen used in treatment over progesterone

A

has a longer half life

62
Q

what days in the menstrual cycle count as the period?

A

day 1 to 5

63
Q

surgical Tx of DUB

A

endometrial resection/ablation

hysterectomy

64
Q

3 methods of doing a hysterectomy?

A

vaginally
abdominally
laparoscopically

3 Reproduction and Sexual Health (51 decks)

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