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Gynae AM > Vaginal bleeding in non-pregnant > Flashcards

Vaginal bleeding in non-pregnant Flashcards

1
Q

What are the types of causes of bleeding PV?

A

Uterine bleeding
Cervical bleeding
Vaginal bleeding
Vulvar bleeding

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2
Q

What are some causes of uterine bleeding?

A 
Menstruation
PCOS
Endocrine causes
Polyps, Fibroid, cysts
Endometriosis
Adenomyosis
Malignancy
Drugs
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3
Q

What is menorrhagia?

A

Excessive menstrual blod flow >80mls

Deemed excessive by the woman

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4
Q

What are the causes of menorrhagia?

A 
Dysfunctional uterine bleedung
Anovulation
Fibroids
Hypothyroidism
Copper coil
PID
Bleeding disorders
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5
Q

What is anovulation?

A

Ovaries don’t release ovum during menstrual cycle

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6
Q

Who is anovulation commonly seen in?

A

Adolescents

Premenopausal women

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7
Q

What are the features of anovulation?

A

Non cyclical bleeding of variable flow and duration

Monoliminal symptoms usually absent

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8
Q

What is the risk with anovulation?

A

Increased risk endometrial hyperplasia and cancer

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9
Q

What are the endocrine causes of abnormal menstrual bleeding?

A

Pathology- thyroid, Cushing’s
Strenuous exercise
Sudden weight change
Significant stress

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10
Q

What are polyps?

A

Benign endometrial growths

Common in pre and post menopausal women

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11
Q

What are the features of polyps?

A 
Asymptomatic
IMB > menorrhagia
-Irregular bleeding, Bleeding after straining/heavy lifting, PMB
-Breakthrough bleeding
Normal uterus on exam
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12
Q

What are fibroids?

A

Smooth muscle growths

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13
Q

What are the types of fibroids?

A

Submucosal
Intramural
Subserosal

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14
Q

What are the features of fibroids?

A

Asymptomatic
Menorrhagia > IMB
Pressure symptoms
Large/asymmetric uterus

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15
Q

What is adenomyosis?

A

Endometrial glands and stroma present in uterine muscle

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16
Q

What are the features and mx of adenomyosis?

A

Diffusely enlarged and tender uterus
Heavy prolonged, painful periods
GnRH agonists, hysterectomy

17
Q

What are the symptoms of chronic endometriosis?

A 
Heavy prolonged periods
PCB, IMB
Spotting
Crampy lower abdo and back pain- starts several days before period
Uterine tenderness
Dyschezia, dysuria, deep dyspareunia
18
Q

What is acute endometriosis?

A

Postpartum endometriosis with recent complications of pregnancy

19
Q

What are the features of acute endometriosis?

A

Fever
Uterine tenderness
Foul vaginal discharge
Leukocytosis

20
Q

What is post menopausal bleeding a red flat for?

A

Endometrial cancer

21
Q

What drugs can cause abnormal PV bleeding?

A

Contraception
Chemotherapy induced thrombocytopenia
Antipsychotics

22
Q

What are the features of a ruptured ovarian cyst?

A

Pain

Light uterine bleeding

23
Q

What other organ diseases can cause abnormal PV bleeding?

A

Liver
Renal
Pituitary/hypothalamic
Thyroid

24
Q

What is the typical presentation of cervical bleeding?

A

Sporadic spotting, commonly post coitally

25
Q

What are the features of cervical cancer?

A

Sporadic and post coital bleeding

Watery, mucoid, purulent malodorous discharge

26
Q

What are causes of cervical bleeding?

A 
Cervical cancer
Cervicitis
Polyps
Ectropion
Endometriosis
Vasculitis
27
Q

What are the features of cervicitis?

A

Post coital bleeding

Strawberry red cervix that bleeds on contact

28
Q

What are the features of cervical polyps?

A

Post coital and sporadic bleeding

Polyps can be visualised on speculum

29
Q

What is ectropion?

A

Endocervical glandular tissue on cervix

30
Q

What are the features of ectropion?

A

Post coital bleeding
Large transition zone on speculum exam
Bleeding on contact

31
Q

What is the typical presentation pf vaginal bleeding?

A

Sporadic and post coital bleeding

32
Q

What causes vaginal bleeding?

A 
Vaginitis
Ulcers
Malignancy
Radiation
Trauma
33
Q

Who is vaginal cancer seen in?

A

Most commonly post menopausal but can be in children

34
Q

What are the features of vaginal cancer?

A

PMB
PCB
Watery, blood tinged malodorous discharge
Vaginal mass

35
Q

What are the causes of vulvar bleeding?

A

Infection
Benign lesions
Malignancy
Trauma

36
Q

How do you treat cervical ectropion?

A

Diathermy
Cryotherapy
Silver nitrate

Gynae AM (17 decks)

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