OB/GYN Flashcards
Define Primary Amenorrhea
What are 4 possible causes
Define Secondary Amenorrhea
13y/o, no menses or 2* development
15y/o, no menses w/ 2* development
Pregnancy
HPO abormals
Imperforate hymen
Gonad dysgenesis
No menses x 3mon after previous normal cycles or,
No menses x 6mon w/ Hx of abnormal cycles
MCC of Secondary Amenorrhea
What are four other etiologies
Pregnancy
Endometrial atrophy (Ashermans)
Premature ovary failure (FSH >40)
Pituitary dysfunction (Sheehans)
Drug/Diet/Stress
How is Amenorrhea Tx
Define Dysmenorrhea
Primary Dysmenorrhea usually begins ? and is associated w/ ?
No pregnant wish- OCPs
Cyclic progesterone 10mg x 10 days
Pain w/ or preceding menses x 1-3days, peaks 24hrs after onset, lasts 2-3days
After menarche; prostaglandins
Define Secondary Dysmenorrhea
What is used for First and Second line Tx
Define Dysfunctional Uterine Bleeding
New onset in older women w/ structural cause
1st: NSAIDs
2nd: contraception
Excessive bleeding w/out organic cause
Define Polymenorrhea
Define Hypermenorrhea
Define Menorrhagia
Menses <21d apart
> 7d or >80mL
Prolonged, >7d/>80mL
Define Metrorrhagia
Define Menometrorrhagia
DDx for Dysfunction bleeds in Pts <16y/o
Bleeding frequently and irregularly between menses
More blood loss during menses w/ frequent/irregular bleeding between menses
Pregnancy
Anovulation
OCP break through
Dyscrasis
DDx for Dysfunction bleeds in Pts 16-40y/o
DDx for Dysfunction bleeds in Pts >40y/o
Pregnancy Anovulation OCP break through STI/PID Endometriosis Ca
Pregnancy
Anovulation
OCP break through
Endometrial Ca
? is gold standard to Dx Dysfunctional Uterine Bleeding
What are the two goals of Tx
How is this Tx
Uterine dilation and curettage
Causing cyclic bleeds
Protect endometrium
Progesterone therapy
Estrogen
NSAIDs
GnRH agonists
Define Premenstrual Syndrome
Sxs coincide w/ ? part of cycle
What ACOG criteria is needed for Dx
Imbalance of E/P w/ excess prostaglandins
Luteal phase: 1-2wks prior to menses
1 Sx x 5d before and stops w/in 4d of onset:
Somatic: physical
Affective: mood
? is used as first line PMS Tx
What else can be used
What is 3rd line therapy
What is reserved for last line
SSRIs
Drospirenon/ethinyl estradiol (Yazmin)
GnRH agonist
Surgery: Bo/Bs
? is the MCC of androgen excess and hirsutism
These Pts have ? trifecta of c/c
What causes this condition
PCOS
Bilat-cystic ovaries
Amen/Oligo-rrhea
Infertile
Ant-Pit creating excess LH (double of FSH)
Insulin resistance
Pts w/ PCOS are at risk for ? two future issues
Half of these Pts are ? w/ ? issue
How is PCOS Dx
Endometrial hyperplasia/carcinoma
Hirsute w/ truncal obesity
US w/ string of pearl sign
Inc LH/FSH ratio
Insulin resistance
How is PCOS Tx
? is used for Tx the hirsutism
? is used for infertility
Weight reduction
Androgen lowering: OCPs
Clomiphene citrate
Metformin
What are the two types of ovarian cysts
Functional:
Follicular- MC
Corpus luteum >3cm
Theca lutein; bilateral and cystic d/t hCG
Non-functional:
PCOS
Everything else
Corpus luteum cysts can develop into ? cysts
These usually develop on ? side
What is a common c/c
Hemorrhagic
Right, inc pressure from IVC
Pain after sex
