Trigger - menstrual/uterine Flashcards
What is sheehan’s syndrome
postpartum pituitary necrosis 2/2 hypovolemia!!!
leads to HPO axis dysfunction & amenorrhea
congenital absence of the uterus and upper 2/3rd of the vagina is called
mullereian dysgenesis
when do you use chasteberry
PMS/PMDD supplement
when do you use Hormonal contraceptives containing drospirenone
second line tx for severe PMS/PMDD
what needs to be performed with a full bladder
transabdominal ulstrasound
when is hysteroscopy the gold standard
evaluation of dysfunctional uterine bleeding
if you have abnormal prolactin levels in the investigation of secondary amenorrhea what should you order
pituitary imaging
The MCC of a lower GU tract postmenopausal bleed is…
vaginal atrophy
This type of endometrial ablation therapy is NOT able to reach intracaitary lesions but it does have a shorter operatig time and less perforation risk than other 1st gen options
rollerball ablation
This endometrial ablation technique uses a rectoscope with electrical currents to excise strips of endometrium. it has higher rates of perforation than its other 1st gen counterparts
endometrial resection
this endometrial ablation therapy uses uncontained saline solution that is heated and recirculated in the uterus for 10 minutes at a low pressure. it allows direct observation of the endometrium, but has a higher burn risk than other 2nd gen methods
Hysteroscopic thermal
CAN USE W ABNORMAL UTERUS!!!
Which endometrial ablation methods can you use with an anatomically abnormal uterus
- hysteroscopic theramel
- water vapor thermal ablation
which endometrial ablation method MUST have normal uterine anatomy to be effective
- thermal balloon ablation
im assuming most of them! but this one specified that it must be normal!
This endometrial ablation method uses a fan-shaped mesh device that contours to the shape of the endometrial cavity, uses suction to get good contact, and then uses radiofrequency waves through the mesh to desiccate the endometrium
radiofrequency thermal ablation
which endometrial ablation method has been used in patients with small submucosal leiomyomas and polyps
radiofrequency thermal ablation
which endometrial ablation method requires NO endometrial prep
- radiofrequency thermal ablation (novasure)
- thermal + RF thermal ablation (Minerva)
- water vapor thermal ablation (Mara)
this endometrial ablation method uses a silicone device to fill the endometrial cavity with RF-heated argon gas and hot liquid thermal ablation.
Thermal + RF thermal ablation (Minerva)
nodules in the posterior vaginal fornix or uteralsacral ligaments and pain w uterine motion tenderness is suggestive of what
endometriosis
what is the imaging of choice to assess for rectum or rectovaginal septa in endometriosis
TVUS
what is used for treating neuropathic pain in moderate to severe endometriosis
gabapentin
pregablin
TCAs
what is used for mild and moderate/severe tx of endometriosis
two seperate categories
mild - NSAIDS and OCPs
mod/severe - GnRH agonists/antagonists, danazol, aromatase inhibitors
can also use gabapentin, pregablin, and TCAs in mod/severe
cardinal symptom is lower abdominal pain
PID
Classic sign is cervical motion tenderness!
what can specifically aid in reducing the rsk of deveoping PID
barrier contraception
what is PID with associated perihepatitis
fitz-hugh-curtis syndrome
chandeliers sign (cervical motion tenderness) is a classic sign of what
What other signs might you see ?
PID
also fever, BIL abd tenderness, inflamed skene/bartholian glands
what labs and imaging do you order in a patient w lower abdominal pain, fever, and chandeliers sign
Pregnancy test
CBC
ESR/CRP
TVUS
this is PID
what would you see on TVUS that would indicate PID
- thickened, fluid filled fallopian tubes
- free pelvic fluid
- tubo-ovarian complex
- tubal hyperemia
what is the criteria for diagnosing PID
- pelvic/lower abdomen pain with no other cause
- one of the following : cervical motion tenderness, uterine tenderness, adnexal tenderness.
if a pateint has PID with assocaited tubo-ovarian abscess what do you do
ADMIT THEM!!!
rocephin, doxy, metro
which patients with tubo-ovarian abscesses are we worried about malignancy in?
postmenopausal women
just look at this idk
olkie dokje
nearly 90% of cases of this diagnosis are found to be in parous women. 80% of cases are also 40-50yo
adenomyosis
TVUS showing focal thickening and heterogenous texture.
adenomyosis
MC benign neoplasm of the female genital tract
leiomyomas
describe submucous, subserous and intramural leiomyomas
submucous - directly beneath endometrial lining
subserous - directly beneath serosal lining
intramural - completely within myometrium
what diagnoses leiomyomas? what about tells where they are?
US - confirm presence, monitor growth
MRI - deliniates intramural from submucous
Hysterography/hysteroscopy - confirm cervical or submucous
can treat surgiclaly with myomectomy, hysterectomy or uterine artery embolization
leiomyomas
what happens to lieomyomas post menopause
regress spontaneously
what is the prob w tamoxifen
abnormally high levels of estrogen that increases risk of endometrial cancer
Which type of endometrial cancer is independent of estrogen
type 2
which type of endometrial cancer is more favorable and occurs in younger patients. is this more or less common?
type 1. more common than type 2
The MC cell type of endometrial cancer is…
Adenocarcinoma
I feel like everything else ive seen is SCC
