Abnormal Uterine Bleeding

Question 1

bleeding that occurs more often than every 21 days

Answer 1

Polymenorrhea

Question 2

bleeding that occurs less frequently than every 35 days

Answer 2

Oligomenorrhea

Question 3

bleeding between periods

Answer 3

Metrorrhagia

Question 4

Mean blood loss per normal cycle is

Answer 4

40ml

Question 5

Normal menstrual bleeding lasts an average of _ days

Answer 5

5
(range 2-7 days)

Question 6

Abnormal uterine bleeding was previously called or referred to as

Answer 6

“dysfunctional uterine bleeding” AKA “DUB”

Question 7

AUB
Classified by the descriptive terms denoting the bleeding pattern:

Answer 7

(a) Heavy
(b) Light
(c) Menstrual(d) Intermenstrual

Question 8

Etiologies for AUB (PALM-COEIN)

Answer 8

Polyp
Adenomyosis
Leiomyoma
Malignancy (and hyperplasia)
Coagulopathy
Ovulatory dysfunction (most common anovulation)
Endometrial (commonly hypaplasia)
Iatrogenic
Not yet classified

Question 9

PALM are ______ in nature

Answer 9

“structural”

Question 10

In adolescents, abnormal uterine bleeding (AUB) is usually the
result of what?
What causes this?

Answer 10

anovulation (not yet ovulating)
–Due to immature hypothalamic-pituitary ovarian axis; and is mostly anovulation
–Considered normal

Question 11

Once regular menses is established what is the most common cause of AUB?

Answer 11

ovulatory dysfunction (AUB-O)

Question 12

AUB in women 19-39 is often the result of?

Answer 12

(a) Pregnancy
(b) Structural lesions
(c) Anovulatory cycles
(d) Use of hormonal contraceptives
(e) Endometrial hyperplasia

Question 13

Signs and symptoms of what issue?
(1) May have painful menstrual cramping
(2) May be asymptomatic except for spotting
(3) Depending on the amount of blood, you could have signs of anemia
—(a) Fatigue
—(b) Pallor
—(c) Lightheadedness or dizziness with exertion
—(d) Pica (craving or chewing substances that have no nutritional value, such as ice, clay, soil, or paper) owing to low iron
(e) Weakness
(f) HA

Answer 13

AUB

Question 14

Treatment
All patients with abnormal uterine bleeding should be referred to

Answer 14

OB-GYN

Question 15

Treatment AUB

Answer 15

(1) All patients with abnormal uterine bleeding should be referred to OB-GYN
(2) For premenopausal patients treatment depends on etiology of the AUB
(3) AUB secondary to certain causes may require definitive treatment
(4) AUB-O
—(a) Treated hormonally with progestin to oppose estrogen
—(b) NSAIDS at normal doses can reduce the amount of blood loss

Question 16

Follow up for AUB

Answer 16

As dictated by OB-GYN

Question 17

True/False
Postmenopausal bleeding is cancer until proven otherwise

Answer 17

True

Question 18

What is Vaginal bleeding that occurs 6 months or more following cessation of menstrual cycle?

Answer 18

Postmenopausal bleeding

Question 19

what is an important tool in evaluating the etiology of Postmenopausal bleeding.

Answer 19

Transvaginal ultrasound measurement of the endometrium

Question 20

Complications of AUB
Depends on the underlying cause but can include:

Answer 20

(a) Anemia
(b) Infertility