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Gynae > Period Problems > Flashcards

Period Problems Flashcards

1
Q

What is Oligomenorrhoea?

A

Prolonged period cycle, with each period lasting >35 days

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2
Q

What are some causes of Oligomenorrhoea?

A

Constitutional

Anovulation

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3
Q

What are some conditions that can lead to Anovulation?

A

PCOS
Thyroid Disease
Prolactinoma
CAH

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4
Q

What is Primary Amenorrhoea?

A

Patient presents with no menarche by age 16

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5
Q

What are some causes of Primary Amenorrhoea?

A 
Delayed Puberty
Imperforate Hymen
Absent Vagina
Mullerian Agenesis
Gonadal Dysgenesis
PCOS
CAH
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6
Q

What is Secondary Amenorrhoea?

A

Absent periods for:
3m if regular periods
6m if irregular periods

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7
Q

What are some causes of Secondary Amenorrhoea?

A 
Pregnancy
PCOS
Premature Menopause
Prolactinoma
Thyroid disease
Cushings
Eating Disorder
Exercise-Induced 
Asherman Syndrome
Sheehan Syndrome
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8
Q

What is PCOS?

A

A heterogenous endocrine disorder presenting with multiple ovarian cysts and reduced fertility as a result

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9
Q

What are some features of PCOS?

A

Hyperandrogenism - Acne, Hirsuitism, Obesity
Anovulation - Oligo/Amenorrhoea, Multiple follicles on USS, increased Ovarian Volume
Infertility
Increased insulin resistance

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10
Q

Which criteria is used to diganose PCOS?

A

Rotterdam Criteria

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11
Q

What factors are found in the Rotterdam Criteria for PCOS?

A

Clinical/Biochemical signs of Hyperandrogenism
Oligo/Amenorrhoea
USS Features of PCOS

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12
Q

Which investigations are appropriate for suspected PCOS?

A 
USS
Free Androgen index
FSH, LH
TFTs
Prolactin
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13
Q

How should confirmed PCOS be managed?

A

Weight loss if pregnancy is desired
COCP for regular periods
Acne Treatment

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14
Q

What are some long-term complications of PCOS?

A 
T2DM
CV Disease
Obstructive sleep apnoea
Infertility
Recurrent Miscarriage
Pregnancy Complications - PET, GDM
Endometrial Cancer
Anxiety and Depression
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15
Q

What is the median blood loss expected during a period?

A

37-43ml

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16
Q

What affects the mean blood lost during a Period?

A

Increasing Age
Genetics
Parity

17
Q

What is Menorrhagia?

A

Heavy Regular Bleeds

18
Q

What is Metrorrhagia?

A

Irregular Heavy Bleeds

19
Q

What is Dysfunctional Uterine Bleeding?

A

Heavy menstrual bleeding in the absence of any uterine pathology

20
Q

Which Pathologies can contribute to Heavy Menstrual bleeding?

A 
Fibroids
Adenomyosis
Endometriosis
IUCD
PID
Polyps
21
Q

Which Medical Disorders can contribute to Heavy Menstrual Bleeding?

A

Hypothyroidism

Liver Disease

22
Q

Which clotting disorders can lead to Heavy Menstrual Bleeding?

A 
von Willebrands
Thrombocytopenia
Platelet disorders
Coagulation disorders
Leukaemia
23
Q

How can the impact of HMB on QoL be assessed?

A

Work and Social life impact
Bleeding through clothing
Bed soiling
Sleep disruption

24
Q

When should HMB only recieve basic investigations?

A

<45y
No IMB
No risk factors for Endometrial Cancer

25
Q

When should HMB receive detailed investigation?

A

> 45
IMB
Suspected Pathology
Risk Factors for Endometrial Cancer

26
Q

Which investigations are appropriate for those with HMB at high risk of a pathology?

A

USS

Hysteroscopy +/- Biopsy

27
Q

What medical management is available for HMB?

A

Tranexamic Acid
Mefenamic Acid
Ullipristal Acetate if Fibroids
Hormonal - POP, Mirena

28
Q

How does Tranexamic Acid work?

A

Reduces Fibrinolysis

29
Q

How does Mefenamic Acid work?

A

NSAID

30
Q

What surgical management is available for HMB?

A

Hysteroscopic removal of Polyps
Myomectomy for Fibroids
Hysterectomy if family complete

Gynae (2 decks)

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