Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

reproductive system > uterus > Flashcards

uterus Flashcards

1
Q

dysfunctional uterine bleeding occurs when and why

A

shortly after menarche and during perimenopause d/t increased anovulatory cycles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

main reason for dysfunctional uterine bleeding

A

absence of anatomic lesion; problem with the hypothalmic-pituitary-ovarian hormonal axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

other 3 causes of dysfunctional uterine bleeding

A

PCOS, exogenous obesity, adrenal hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

clinical feature of dysfunctional uterine bleeding

A

abnormal bleeding with an unremarkable physical exam in a very young or perimenopausal woman

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

abnormal bleeding with an unremarkable physical exam in a very young or perimenopausal woman

A

think dysfunctional uterine bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

initial test for abnormal bleeding

A

B-hCG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

postmenopausal bleeding

A

cancer until proven otherwise; do endometrial bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

reasons for these tests for abnormal bleeding

  • CBC
  • pap smear
  • G/C probe
  • TFTs and prolactin
  • Platelet count, PT/PTT
  • Ultrasound
A
  • CBC: anemia
  • pap smear: rule out cervical cancer
  • G/C probe: cervitis
  • TFTs and prolactin: hypo/hyperthyroidism and hyperprolactinemia
  • Platelet count, PT/PTT: Willebrand d/s and factor XI def-primarily in adolescents
  • Ultrasound: uterine masses, PCOS, endometrial thickness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

DUB: do what trial test

A

prolactin. If the bleeding stops, then anovulatory cycles are confirmed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

DUB: who to give oral contraceptives to

A

older women w/out risk factors.

avoid in smokers, HTN, DM, hx of vascular d/s, breast cancer, liver disease, focal headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

DUB: what to use in younger pts

A

cyclic progestins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

DUB: what is diagnostic and curative

A

D and C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

DUB: tx for refractory cases

A

endometrial ablation or vaginal hysterectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

tx for acute heavy bleeding

  • 1st line
  • 2nd line
  • if bleeding is not controlled w/in 12-24 hrs
A
  • high dose estrogen IV stabilizes the endometrial lining and typically stops bleeding w/in 1 hr.
  • if estrogen contraindicated, do high dose progestin therapy alone
  • if bleeding is not controlled w/in 12-24 hrs: Do a D&C
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

tx for ovulatory bleeding

A
  • NSAIDs to decrease blood loss
  • tranexamic acid 5 days during menses
  • if hemodynamically stable, do OCPs, progestin po or inj, or insert a progestin IUD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

tx for anovulatory bleeding

A
  • progestins x 10 days to stimulate withdrawal bleeding
  • OCD
  • progestin IUD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

goal for tx for anovulatory bleeding

A

goal to convert proliferative endometrium to secretory endometrium(to decrease risk of endometrial hyperplasia/cancer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

75% endometrial cancer type and type of women/race too

A

adenocarcinoma; post menopausal women; white more than black women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

worse prognostic factor in endometrial cancer

A

the older the worse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

4th most common malignancy in women in the U.S.

A

endometrial cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is endometrial cancer not related to

A

sexual history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

protective effect in endometrial cancer

A

oral contraceptives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

unopposed estrogen stimulation, chronic tamoxifen use, nulliparity, infertility, late menopause, DM, HTN, gallbladder d/s,

A

all risk factors for endometrial cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

cardinal symptom and 3 other symptoms in endometrial cancer

A
  • 90% will have inappropriate uterine bleeding

- obesity, HTN, DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

testing for postmenopausal bleeding to rule out endometrial cancer

A

pap smear, endocervical curettage, endometrial biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

endometrial biopsy accuracy rate

A

90-95%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

other 2 tests for postmenopausal bleeding to rule out endometrial cancer

A

fractional D&C, transvaginal ultrasonography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

tx of endometrial cancer

1) for basis of tx and staging
2) radiotherapy vs chemo
3) recurrence tx

A

1) total hyst with bil salpingo-oophorectomy with peritoneal lymphnode and tissue sampling
2) radiotherapy maybe. chemo for advanced stages
3) recurrence treated w/ high dose progestins or anti-estrogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

pap smear for endometrial cancer

A

negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

metrorrhagia

A

bleeding which occurs at any time during the menstrual cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

bleeding which occurs at any time during the menstrual cycle

A

metrorrhagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

menometrorrhagia

A

heavy bleeding which occurs at any time during the menstrual cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

heavy bleeding which occurs at any time during the menstrual cycle

A

menometrorrhagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

dysmenorrhea

A

menstrual pain which interferes with ADLs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

menstrual pain which interferes with ADLs

A

dysmenorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

oligomenorrhea

A

menstrual periods which occur at intervals greater than 35 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

endometriosis is usually found where

A

pelvis or ovary(60%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

endometriosis occurs in who and what age

A

nulliparous women in late 20s or early 30s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

infertility and endometriosis

A

infertility is common. It is found in 25-34% of infertile women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

endometriosis symptoms

A

dysmenorrhea, deep thrust dyspareunia, dyschezia, spotting, pelvic pain, infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

dyschezia

A

difficulty passing bowel movement

42
Q

dysmenorrhea, deep thrust dyspareunia, dyschezia, spotting, pelvic pain, infertility

A

endometriosis symptoms

43
Q

endometriosis signs

A

tender nodularity of the cul de sac and uterine ligaments and a fixed uterus

44
Q

tender nodularity of the cul de sac and uterine ligaments and a fixed uterus

A

endometriosis signs

45
Q

endometriosis symptoms and degree of disease

A

they do not correlate

46
Q

endometriosis testing(2)

A

ultrasonography and laparoscopy

47
Q

medical tx of endometriosis

A

NSAIDs, prostaglandin synthetase inhibitors, combined oral contraceptives or progestins, GnRH agonist, danazol

48
Q

surgical tx of endometriosis

A

laparoscopic fulguration(destruction of tissue using high voltage electricity) or total hyst

49
Q

chocolate cysts

A

endometriomas

50
Q

NSAIDs, prostaglandin synthetase inhibitors, combined oral contraceptives or progestins, GnRH agonist, danazol

A

medical tx of endometriosis

51
Q

what is adenomyosis

A

extension of endometrial glands into the uterine musculature

52
Q

adenomyosis and endometriosis relation

A

not related

53
Q

adenomyosis symptoms

A

severe secondary dysmenorrhea OR most pts asymptomatic

54
Q

adenomyosis triad

A

pain, menorrhagia, enlarged-boggy-symmetric uterus

55
Q

adenomyosis tests

A
  • pelvic U/S to detect it, r/o pregnancy.

- endometrial bx, fractional D&C, hysteroscopy all to rule out endometrial cancer

56
Q

avoid what tx in adenomyosis

A

hormonal treatment

57
Q

tx of adenomyosis

  • definitive
  • other tx (3)
A
  • hysterectomy definitive

- others: D&C, GnRH agonist, mifepristone

58
Q
  • hysterectomy definitive

- others: D&C, GnRH agonist, mifepristone

A

tx of adenomyosis

  • definitive
  • other tx (3)
59
Q

uterus is irregular and mobile

A

uterine myomas

60
Q

if a uterine mass continues to grow after menopause

A

consider malignancy

61
Q

fibroids occur at what age, race, FH

A

occur in 4th decade, blacks, +FH

62
Q

fibroids

  • depend on what
  • appear in increased frequency in women who have what (3)
A

depend on estrogen and appear with increased frequency in women who have endometrial hyperplasia, anovulatory states, and estrogen producing ovarian tumors

63
Q

women with fibroids…

  • have how much of an increase of endometrial cancer
  • risk of what is else is increased
A
  • 4 fold

- spontaneous abortion

64
Q

fibroids locations

  • subserous
  • intramural
  • submucous
  • what causes uterine bleeding
A

fibroids locations

  • subserous (deforming external serosa)
  • intramural (w/in uterine wall)
  • submucous (deforming uterine cavity)
  • what causes uterine bleeding- submucous
65
Q

firm, enlarged irregular uterine mass

A

fibroids; could also be asymptomatic

66
Q

menorrhagia, metorrhagia, intermenstrual bleeding, dysmenorrhea

A

fibroids

67
Q

common symptom of fibroid

A

bleeding

68
Q

fibroid dx tests (5)

A

pelvic U/S, pelvic MRI, D&C, hysterectomy, and laparoscopy

69
Q

fibroid symptomatic tx

A

myomectomy, hysterectomy, or D&C

70
Q

what can reduce fibroids tumor size (2)

and length of treatment

A

GnRH agonists and mifepristone; tx limited to 6 months

71
Q

fibroids tx

  • restore fertility
  • no desire of fertility
  • final step
A
  • GnRH agonists
  • uterine arterial embolization or endometrial ablation
  • hysterectomy
72
Q

leuprorelin

A
  • GnRH agonist

- causes a decrease in LH and FSH and thereby a decrease in estrogen

73
Q

cobblestone uterus on exam

A

fibroids

74
Q

fibroids size will increase and decrease with what

A

increase with pregnancy and decrease after menopause

75
Q

endometrial cancer relation to vaginal bleeding

A

vaginal bleeding is present in 80% of women with endometrial cancer
only 5-10% of women with abnormal vaginal bleeding have endometrial cancer

76
Q

when to perform a biopsy for endometrial cancer in postmenopausal women

A

any bleeding or spotting

77
Q

when to perform a biopsy for endometrial cancer in premenopausal women

A

[after initial workup and in the setting of unopposed estrogen- obesity, DM]

  • sustained intermenstrual bleeding
  • menorrhagia
  • amenorrhea
78
Q

when to do a transvaginal and endometrial stripe

A

postmenopausal women. under 4 mm unlikely cancer

79
Q

uterine prolapse

  • increases 50% after what
  • race
A
  • menopause

- less common in asian and black women

80
Q

obesity, asthma, COPD, pelvic tumor, ascities

A

predisposes pts to prolapse

81
Q

cystocele

A

bladder herniating into vagina

82
Q

rectocele

A

rectum herniating into vagina

83
Q

enterocele

A

small intestine herniating into vagina

84
Q

uterine prolapse symptoms

  • worse with what
  • relieved with what
A
  • worse after prolonged standing or late in day

- relieved by lying down

85
Q

uterine prolapse symptoms (3)

A

vaginal fullness, lower abdominal aching, low back pain

86
Q
  • vaginal fullness, lower abdominal aching, low back
  • worse after prolonged standing or late in day
  • relieved by lying down
A

prolapse symptoms

87
Q

uterine prolapse grading

A

0 is no descent; 4 is through the hymen

88
Q

falling out sensation or feeling of sitting on a ball

A

moderate uterine prolapse

89
Q

most uterine prolapses accompanied by what (3)

A

cystocele, rectocele, or enterocele

90
Q

non surgical tx for uterine prolapse

A

wt reduction, smoking cessation, pelvic muscle exercises, vaginal pessary

91
Q

surgical tx for uterine prolapse

A

mesh, hyst, sacrocolpopexy, or uterosacral ligament suspension may also be necessary

92
Q

PID includes what 5 disorders

A

acute salpingitis, IUD related pelvic cellulitis, tuboovarian abscess, pelvic abscess

93
Q

PID definition

A

polymicrobial infection of fallopian tubes and pelvis

94
Q

2 complications of PID

A

ectopic and infertility

95
Q

PID symptoms (4)

A

purulent vaginal discharge, BILATERAL PELVIC/ABD PAIN, n/v, fevers

96
Q

pain sign of PID, next sign

A

cervical motion tenderness; friable cervix

97
Q

cervical motion tenderness/chandelier sign

A

PID or cervicitits

98
Q

purulent vaginal discharge, BILATERAL PELVIC/ABD PAIN, n/v, fevers

A

PID

99
Q

2 main organisms with PID

A

G/C

100
Q

dx PID

  • what to find G/C (2)
  • imaging
  • invasive
  • if no improvement in 48 hrs then order what
A
  • DNA probe and gram stain
  • transvaginal ultrasonography to differentiate acute and chronic inflammation or presence of adnexal masses
  • culdocentesis- needle to transvaginal space to culture fluid
  • laparoscopy to visualize abdominal and pelvic structure

reproductive system (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions