REI

Question 1

What are the most common causes of AUB for ages:

1) 13-18 years
2) 19-39 years
3) 40 years to menopause

Answer 1

13-18 years:

1. Anovulatory (immature HPO axis)
2. Pelvic infection
3. Coagulopathy
   * Pregnancy, hormonal contraceptives

19-39 years:

1. Anovulatory (PCOS)
2. Polyps, leiomyoma
3. Endometrial hyperplasia
   * Pregnancy, hormonal contraceptives

40 years to menopause:

1. Anovulation (perimenopause)
2. Leiomyoma
3. Endometrial atrophy
4. Endometrial hyperplasia/cancer

Question 2

What are medical treatment options for endometriosis?

Answer 2

1. NSAIDs
2. Continuous OCPs
3. Progestins (Depo, Provera, IUD)
4. GnRH agonist (Lupron)
5. GnRH antagonist (Orilisssa)
6. Androgens (Danazol)
7. Aromatase inhibitor (Letrozole)

Question 3

What is the hormone replacement dosing for primary ovarian failure/surgical menopause?

Answer 3

1. Oral: 1-2 mg micronized estradiol

2. Transdermal: 100 mcg micronized estradiol

Question 4

What are risk factors for ectopic pregnancy?

Answer 4

1. Tubal ligation
2. Tubal surgery
3. Prior ectopic pregnancy
4. GC infection, PID
5. Infertility
6. Smoking

Question 5

What are the diagnostic criteria for APLS?

Answer 5

Need one clinical and one laboratory

Clinical:

1. Thromboembolism
2. 3 or more losses < 10 weeks
3. One loss > 10 weeks
4. PTD < 34 weeks due to PEC or uteroplacental insufficiency

Laboratory (2 occasions, 12 weeks apart):

1. Lupus anticoagulant positivity
2. Anticardiolipin antibody
3. Anti B2 glycoprotein antibody