Postmenopausal vaginal bleeding Flashcards
1
Q
What are the possible causes of PMB?
A
2
Q
Important points to enquire in Hx taking
A
3
Q
Important signs to look out for in PMB
A
4
Q
Further Ix to do, and reasons for doing so in PMB
A
5
Q
Hx taking for PMB
A
- Age
- Menstrual history (duration of menopause)
- When did it start? How much blood is there?
- Are you sure its from the vagina? No related to defecation?
- Any discomfort? Bloating? Pain?
- Any pain on urination or defecation? Frequency? Urgency?
- Any medications? Supplements? TCM (estrogen)?
- Any injury?
- Marriage status? Any sexual life?
6
Q
If speculum exam reveals the following finding, what is your diagnosis? What would you do next?
A
- Cervical polyp
- Avulsion of polyp and send for histopathology
7
Q
If transvaginal U/S shows that endometrial echo is thickened to 10mm, what would you do next?
A
Advise hysteroscopy + curettage to confirm any endometrial lesion or pathology
Endometrium of menopaused women should be thinner (~4mm)
Thickening of endometrium could be caused by polyps and many other things
8
Q
A
- Resect the polyp
- Perform curettage
- Send for histopathology
- Observe for any further bleeding in post-operative visit
