Postmenopausal Bleeding

Question 0

Risk factors for endometrial cancer?

Answer 0

1. Obesity,
2. diabetes,
3. hypertension,
4. Chronic anovulation (Doing it wrong)
5. Early menarche/late menopause (Doing it long)
6. nulliparity (No break)
7. Unopposed estrogen therapy/estrogen secreting tumors

Question 1

Pt with postmenopausal bleeding – next step?

Answer 1

Endometrial biopsy

Question 2

Most common cause of postmenopausal bleeding?

Answer 2

Friable tissue in the endometrium/vagina due to low estrogen levels

Question 3

Endometrial stripe? Abnormal if?

Answer 3

Transvaginal ultrasound assessment of endometrial thickness – abnormal if >5 in postmenopausal women

Question 4

Methods to assess endometrium?

Answer 4

Endometrial sampling, hysteroscopy, vaginal ultrasound

Question 5

Endometrial cancer may affect a 30-year-old woman with this disease?

Answer 5

PCOS

Question 6

Most common female genital tract malignancy?

Answer 6

Endometrial carcinoma

Question 7

Staging procedure for endometrial cancer?

Answer 7

1. Total abdominal hysterectomy, bilateral salpingo-oophorectomy
2. Omentectomy
3. Lymph node sampling
4. Peritoneal washings

Question 8

Effect of smoking on endometrial cancer?

Answer 8

Decreases – smoking creates a lower estrogenic state

Question 9

Atypical glandular cells on PAP smear – Next step?

Answer 9

Colposcopy, endocervical curettage, endometrial sampling