185- abnormal uterine bleeding Flashcards
vulvovaginal atrophy: what? why? who?
thin, friable tissue due to lack of estrogen. Common in post-menopausal women
endometrial hyperplasia: what is it? typical presentation? precursor to? Treatment?
increase in estrogen promoting endometrial proliferation with lack of progesterone. Leads to lack of normal shedding. Usually presents with abnormal uterine bleeding. Precursor to Type 1 endometrial cancer. Hysterectomy when there is complex atypical hyperplasia. Progesterone if they still want to be fertile
what are irregular and heavy menses a hallmark of?
anovulatory bleeding which results in prolonged estrogen exposure without opposing progesterone from ovulation
why does obesity increase risk of endometrial CA?
peripheral conversion of A->E by aromatase
What percent of postmenopausal bleeding is endometrial cancer? what are the two types
15-25%. Type1: estrogen dependent, arise in background of hyperplasia. Type 2: estrogen independent, arise in background of atrophy, more aggressive than type1.
Nonclassical CAH: deficiency of what? what do you test for?
21-hydroxylase deficiency. Test 17-hydroxyprogesterone
why do OCPs improve hirsutism and acne in PCOS?
increase SHBG and therefor decrease free T
clomiphene: mechanism of action? who do you use it on? side effects?
SERM. partial agonist at estrogen receptors in hypothal (prevents feedback inhibition which ^ FSH/LH which stimulates ovulation).
Use for infertility and PCOS.
multiple pregnancies, hot flashes, ovarian enlargement, visual disturbances
uterine fibroids: arise from what cells? how common? Changes with hormones? presentation? Other effects?
SM cells of myometrium. 80% prevalence. Estrogen dependent. Half are asymptomatic but others p/w menorrhagia, pelvic pain, constipation, urinary frequency. Increase risk of miscarriage, breech presentation
