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Women's Health Clin med > abnormal uterine bleeding > Flashcards

abnormal uterine bleeding Flashcards

1
Q

What is the average length of menses

A

3-5 days

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2
Q

What is the normal range of cycle length

A

21-35 days

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3
Q

What is the average blood loss during menstruation

A

30mL (can be up to 80mL)

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4
Q

What is primary amenorrhea

A

lack of primary sex characteristics without a period

age 14 w/o onset of puberty
age 16 w/o menses

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5
Q

What is secondary amenorrhea

A

w/ sex characteristics but w/o period

Absence of menses for 3 menstrual cycles

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6
Q

What is oligomenorrhea

A

> 35 days

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7
Q

What is polymenorrhagia

A

<21 days

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8
Q

What is a sign of androgen insensitivity in regards to amenorrhea

A

breast development with no pubic/axillary hair

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9
Q

What is

A
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10
Q

What is the most common cause of secondary amenorrhea

A

pregnancy

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11
Q

What is Asherman’s syndrome

A

intrauterine adhesions or PCOS leading to secondary amenorrhea (normal estrogen present)

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12
Q

what is metrorrhagia

A

uterine bleeding at irregular intervals, esp between expected menstrual periods

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13
Q

What is menometrorrhagia

A

excessive uterine bleeding both at expected time of menses and at irregular intervals

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14
Q

what is the cause of mid-cycle spotting

A

Spotting just before ovulation from a decline in estrogen

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15
Q

What is the primary concern with post-menopausal bleeding

A

malignancy

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16
Q

when is AUB most common

A

At the beginning and end of reproductive years

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17
Q

What is the most common cause of AUB

A

ovulatory dysfunction (anovulation)

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18
Q

What is the primary concern with AUB

A

endometrial cancer

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19
Q

what is the most common gynecological malignancy

A

endometrial cancer

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20
Q

what put someone at an increased risk for endometrial cancer

A

obesity
DM
infertility
tamoxifen
>35 years
nulliparity

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21
Q

What is the treatment for endometrial cancer

A

Total hysterectomy
bilateral salpingo-oophorectomy

*reoccurance tx w/ high dose progestins

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22
Q

what is an anovulatory cycle

A

corpus luteum does not form

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23
Q

What is ovulatory AUB

A

progesterone secretion is prolonged

24
Q

What is the most common cause of anovulatory AUB

A

PCOS

25
Q

How does ovulatory AUB present clinically

A

Excessive bleeding during regular menstrual cycles

26
Q

How does anovulatory AUB present

A

unpredictable times and patterns

no accompanied by cyclic changes in basal body temp

27
Q

What are structural causes of AUB

A

fibroids
polyps
adenomyosis

28
Q

What are non-structural causes of AUB

A

coagulopathy
ovulatory dysfunction
malignancy

29
Q

What are the main considerations for AUB

A
  1. Pregnancy
  2. Iatrogenic
  3. systemic disease
  4. Genital tract infection
30
Q

When is a TVUS done for workup of AUB

A
  • risk for endometrial cancer
  • Age>35
  • Bleeding despite empiric hormone therapy
  • pelvic organs difficult to exmine
  • suspected ovarian / uterine abnormalities
31
Q

with is the AUB diagnosis if al clinically indicated tests are normal

A

AUB due to ovulatory dysfunction

32
Q

what is a saline infused sonohysterography

A

5-10mL sterile saline in the endometrial cavity to enhance diagnostic power of TVUS

33
Q

What is hysteroscopy

A

Scope into the uterus
*generally done with guided biopsy

34
Q

When is an MRI done for AUB

A

Planning surgery
best for adenomyosis

35
Q

what is the most common pelvic tumor in women

A

uterine leiomyoma

36
Q

What ethnicity is at higher risk of uterine fibroids

A

African american

37
Q

when in life do fibroids usually present

A

middle/later reproductive years

38
Q

If a woman has fibroids, what are they at an increased risk for

A

endometrial cancer

39
Q

What is the most common presenting symptoms for uterine fibroids

A

bleeding

40
Q

What is the first imaging choice for uterine fibroids

A

TVUS

41
Q

What is the only real cure for fibroids

A

hysterectomy

42
Q

What is adenomyosis

A

extension of endometrial glands into uterine musculature

43
Q

What is the definitive therapy for adenomyosis

A

hysterectomy

44
Q

What is the typical presentation of adenomyosis

A

middle aged
parous
severe dysmenorrhea / menorrhagia
enlarged globular uterus

45
Q

What is the first like treatment for endometriosis

A

NSAIDs + OCP

46
Q

How do you diagnose a dysfunctional uterine bleed

A

Diagnosis of exclusion

47
Q

What is the most common cause of DUB

A

Ovulation failure shortly after menarche or during perimenopause

48
Q

What occurs in anovulatory DUB

A

estrogen is continually secreted but egg never ripens in follicle

49
Q

What is an endometrial biopsy used for

A

r/o hyperplasia / cancer

50
Q

What is the treatment for endometrial hyperplasia in postmenopausal women

A

D&C with strong consideration for hysterectomy

51
Q

What is the treatment for endometrial hyperplasia in premenopausal women

A

Medroxyprogesterone acetate PO QD 3-6 months
*if resolved -> cyclic admin each month for 10-14 days

52
Q

What is the first like treatment for AUB

A

Hormone therapy if contraception is wanted or pt. is premenopausal

53
Q

What ist he most common hormone therapy for AUB

A

oral contraceptives

54
Q

What hormone therapy is preferred if pregnancy is desired

A

clomiphene

55
Q

What is the most common cause of AUB

A

Ovulatory dysfunction

56
Q

What is the main treatment for PMDD

A

SSRI (prozac)

Women's Health Clin med (13 decks)

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