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Yr 3 - Reproduction > Menstrual Disorders > Flashcards

Menstrual Disorders Flashcards

1
Q

What is “normal” menstruation volume?

A

<80mls over 7 days

2-7 days

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2
Q

What are the common disturbances of menstruation?

A

Disturbed menstrual frequency
Irregular menstrual bleeding
Abnormal duration of flow
Abnormal volume

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3
Q

What is a prolonged menstruation?

A

> 8 days

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4
Q

What is a shortened menstruation?

A

<2 days

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5
Q

What is a frequent menstruation?

A

<24 days

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6
Q

What is a infrequent menstruation?

A

> 38 days

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7
Q

What is heavy menstrual bleeding?

A 
Bleeding >80mls over 7 days
Need to change products every 1/2hrs
Passage of clots >2.5cm
Bleeding through clothes 
"described as very heavy"
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8
Q

What are the types of causes of heavy menstrual bleeding?

A

Uterine/ovarian Pathologies
Systemic Disorders
Iatrogenic causes

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9
Q

What are the Uterine/ovarian Pathologies causing heavy menstrual bleeding?

A 
Uterine Fibroids
Endometrial polyps
Endometriosis/adenomyosis
PID
Endometrial hyperplasia/cancer
PCOS
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10
Q

What are the Systemic disorders causes of heavy menstrual bleeding?

A

Coagulopathy (von Willebrand)
Hypothyroidism
Liver renal disease

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11
Q

What are the Iatrogenic causes of heavy menstrual bleeding?

A

Anticoagulants
Herbal supplements
IUD

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12
Q

How do uterine fibroids present?

A

HMB
Dysmenorrhoea
Pelvic pain

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13
Q

How do endometrial polyps present?

A

HMB

Intermenstrual bleeding

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14
Q

How do endometriosis/adenomyosis present?

A 
HMB
Lower back pain
Dysmenorrhoea 
Dyspareunia 
Pelvic pain
Pain during/after sex
Painful bowel movements
Difficulty conceiving
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15
Q

How does PID present?

A 
HMB
Discharge
Pelvic pain
IM/postcoital bleeding
Fever
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16
Q

How does endometrial hyperplasia present?

A

HMB
Postcoital bleed
IM bleeding
Pelvic pain

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17
Q

Which herbal supplements are associated with HMB?

A

(alter estrogen levels)
Soya
Ginseng
Ginkgo

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18
Q

What are fibroids?

A

Leiomyomae

19
Q

How are fibroids diagnosed?

A

USS

20
Q

How are fibroids managed?

A

Symptomatic
Embolisation
Myomectomy
Hysterectomy

21
Q

What are the stages of endometriosis?

A

1 (minimal) Small patches, surface lesions
2 (mild) More widespread, infiltrating pelvic organs
3 (moderate) peritoneum, scarring, adhesions
4 (severe) Infiltrative, anatomical distortion

22
Q

How is endometriosis diagnosed?

A

Pelvic examination

USS/laparoscopy

23
Q

How is endometriosis managed medically?

A

Analgesia
Mirena IUS
GnRH analogues
Depot provera

24
Q

How is endometriosis managed surgically?

A

Ablation
Hysterectomy
Excision
Hysterectomy

25
Q

Surgical management of endometriosis may be required due to what?

A

Fertility treatment

26
Q

What is adenomyosis?

A

Endometrium embedded within the myometrium

27
Q

How does adenomyosis present?

A

Heavy menstrual bleed

Dysmenorrhoea

28
Q

How is adenomyosis treated?

A

?hormones

Hysterectomy

29
Q

What are endometrial polyps?

A

Overgrowth of endometrial lining

30
Q

How are endometrial polyps diagnosed?

A

USS/Hysteroscopy

31
Q

How are endometrial polyps managed?

A

Polypectomy

32
Q

How is HMB managed?

A 
History
Pelvic exam
Clotting profile
Thyroid function
USS
Laparoscopy (endometrosis)
33
Q

Management of HMB depends on what?

A

Impact on QoL
Underlying pathology
Desire for further fertility

34
Q

Endometrial biopsy is indicated in which women?

A

Women >44y/o with HMB

35
Q

Which non-hormonal therapies are indicated for HMB?

A

Mefenamic acid
Tranexamic acid
GnRH analogues
(Surgery)

36
Q

What risks are associated with hysterectomy?

A

Infection
DVT
Bladder/bowel issues
Adhesions

37
Q

What are the disadvantages of Oophorectomy?

A

Immediate menopause

Recommended HRT til 50

38
Q

What are the causes of amenorrhoea?

A 
Life changes
Hormones
Primary ovarian insufficiency
PCOS
Hyperprolactinaemia
Prolactinomas 
Grave's disease 
Obstructions of uterus/cervix
39
Q

How is PCOS diagnosed?

A

2 of 3:

  • USS ovary
  • Biochemical hyperandrogenism
  • Clinical hyperandrogenism
40
Q

PCOS is associated with what?

A

Infertility
Obesity
Oligo/amenorrhoea

41
Q

How is hyperplasia prevented in PCOS?

A

Minimum 3 withdrawal bleeds per year

COCP, POP, Mirena IUS

42
Q

What is dysfunctional uterine bleeding?

A

Excessive bleeding in premenopausal women not due to any disease

43
Q

What is the cause of dysfunctional uterine bleeding?

A

Ovarian hormonal dysfunction

44
Q

How is dysfunctional uterine bleeding managed?

A

Conservative based on symptoms/patient wishes
GnRH analogues
HRT

Yr 3 - Reproduction (37 decks)

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