OBGYN Oral Boards

Question 1

length of normal cycle? avg?

Answer 1

21-35 days; 28d

Question 2

length of menses? avg blood loss?

Answer 2

3-5d; 30-50mL blood loss

Question 3

what is dysfunctional uterine bleeding?

Answer 3

AUB without a cause

Question 4

what is dysfunctional uterine bleeding usually related to?

Answer 4

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.

Question 5

when (in life) is dysfxn uterine bleeding most common?

Answer 5

during anovulatory times > 1st starting periods, pregnancy, breastfeeding, perimenopause

Question 6

dx of AUB?

Answer 6

r/o thyroid, hyperprolactinemia, premature ovarian failure&raquo_space; pelvic exam, pap, EMB, pelvic u/s, preg test

Question 7

tx of AUB?

Answer 7

NSAIDs and OCPs; surgery

Question 8

definition of menorrhagia? (quantity? duration)

Answer 8

heavy >80mL / cycle or >7d bleeding or >1 pad/hour

Question 9

ddx of menorrhagia?

Answer 9

adenomyosis, fibroids, polyps

Question 10

hypomenorrhea ddx?

Answer 10

HPA dysfunction (exercise, anorexia), birth control

Question 11

polymenorrhea (cycles <21 day apart) ddx?

Answer 11

anovulation

Question 12

metrorrhagia ddx? aka bleeding between periods

Answer 12

cervical cancer, endometrial cancer, polyps

Question 13

2ndary amenorrhea definition?

Answer 13

cessation of cycles for 6mo after previously normal cycles

Question 14

primary amenorrhea definition?

Answer 14

no menses by 16 or 4yrs after breast development

Question 15

tx for polyps?

Answer 15

progesterone to thin out the endometrium

Question 16

tx for adenomyosis?

Answer 16

endometrial ablation, OCPs, hysterectomy

Question 17

____: proliferation of smooth muscle cells of the myometrium, encapsulated

Answer 17

leiomyoma

Question 18

____: thickened overgrowth of endometrial glands

Answer 18

polyps

Question 19

____: endometrium grows into the myometrium

Answer 19

adenomyosis

Question 20

most common type of leiomyoma? location?

Answer 20

submucosal, causes the most bleeding, inside uterine cavity

Question 21

medical management for fibroids?

Answer 21

OCPs, progesterone IUD, GNRH agonists

Question 22

dx of fibroids?

Answer 22

pelvic u/s

Question 23

risk factors for adenocarcinoma of endometrium? 9

Answer 23

inc estrogen exposure, obesity, early menarche, late menopause, HRT, tamoxifen, nulliparity, anovulation, fhxp

Question 24

protection factors for adenocarcinoma of endometrium? 5

Answer 24

combo OCPs, progestin only OCPs, high parity, exercise, smoking

Question 25

labs to get for malignancy of endometrium?

Answer 25

TSH, FSH, prolactin, CBC, CA-125, pap

Question 26

most common cause of ovulatory dysfunction? ration of LH:FSH?

Answer 26

PCOS, 3:1 LH : FSH

Question 27

medical management for AUB?

Answer 27

conjugated equine estrogen, combo OCPs, oral progestins, tranexamic acid

Question 28

surgical options for AUB?

Answer 28

D&C, hysterectomy, endometrial ablation, uterine artery embolization