OBGYN Oral Boards Flashcards
length of normal cycle? avg?
21-35 days; 28d
length of menses? avg blood loss?
3-5d; 30-50mL blood loss
what is dysfunctional uterine bleeding?
AUB without a cause
what is dysfunctional uterine bleeding usually related to?
anovulation; Usually related to anovulation (unsure why they aren’t ovulating). Don’t ovulate → don’t make a corpus luteum → no progesterone → Without progesterone the endometrium continues to proliferate and doesn’t slough. So it just keeps growing and growing until it outgrows its blood supply and then you get a bleed at a random time.
when (in life) is dysfxn uterine bleeding most common?
during anovulatory times > 1st starting periods, pregnancy, breastfeeding, perimenopause
dx of AUB?
r/o thyroid, hyperprolactinemia, premature ovarian failure»_space; pelvic exam, pap, EMB, pelvic u/s, preg test
tx of AUB?
NSAIDs and OCPs; surgery
definition of menorrhagia? (quantity? duration)
heavy >80mL / cycle or >7d bleeding or >1 pad/hour
ddx of menorrhagia?
adenomyosis, fibroids, polyps
hypomenorrhea ddx?
HPA dysfunction (exercise, anorexia), birth control
polymenorrhea (cycles <21 day apart) ddx?
anovulation
metrorrhagia ddx? aka bleeding between periods
cervical cancer, endometrial cancer, polyps
2ndary amenorrhea definition?
cessation of cycles for 6mo after previously normal cycles
primary amenorrhea definition?
no menses by 16 or 4yrs after breast development
tx for polyps?
progesterone to thin out the endometrium
tx for adenomyosis?
endometrial ablation, OCPs, hysterectomy
____: proliferation of smooth muscle cells of the myometrium, encapsulated
leiomyoma
____: thickened overgrowth of endometrial glands
polyps
____: endometrium grows into the myometrium
adenomyosis
most common type of leiomyoma? location?
submucosal, causes the most bleeding, inside uterine cavity
medical management for fibroids?
OCPs, progesterone IUD, GNRH agonists
dx of fibroids?
pelvic u/s
risk factors for adenocarcinoma of endometrium? 9
inc estrogen exposure, obesity, early menarche, late menopause, HRT, tamoxifen, nulliparity, anovulation, fhxp
protection factors for adenocarcinoma of endometrium? 5
combo OCPs, progestin only OCPs, high parity, exercise, smoking
labs to get for malignancy of endometrium?
TSH, FSH, prolactin, CBC, CA-125, pap
most common cause of ovulatory dysfunction? ration of LH:FSH?
PCOS, 3:1 LH : FSH
medical management for AUB?
conjugated equine estrogen, combo OCPs, oral progestins, tranexamic acid
surgical options for AUB?
D&C, hysterectomy, endometrial ablation, uterine artery embolization
