Abnormal uterine bleeding

Question 1

Classic symptoms of polyp x2

Answer 1

Intermenstrual bleeding
Heavy menstrual bleeding

Question 2

Differential diagnosis for polyp x4

Answer 2

Endocervical polyp
Condylomata acuminata
Fibrinoid carcinoma
Granulation tissue

Question 3

USS findings of adenomyosis x3

Answer 3

Bulky uterus
Heterogenous myometrium
Asymmetric thickness

Question 4

Management of adenomyosis and leiomyoma x3

Answer 4

NSAIDs
Hormonal contraception
Hysterectomy

Question 5

True or false. Leiomyoma causes changes in bowel and bladder habits

Answer 5

True

Question 6

4 types of a leiomyoma

Answer 6

Subserosal
Submucosal
Intramural
Pedunculated

Question 7

Causes of excess estrogen exposure x4

Answer 7

PCOS
Obesity
Early menarche
Late menopause

Question 8

USS feature of endometrial hyperplasia

Answer 8

Endometrial thickness of 4mm+

Question 9

Structural causes of AUB x4

Answer 9

Polyp
Adenomyosis
Leiomyoma
Malignancy/hyperplasia

Question 10

Non structural causes of AUB x5

Answer 10

Coagulopathy
Ovulatory dysfunction
Endometrial
Iatrogenic
Not yet classified

Question 11

Pathophysiology of von Willebrand disease x2

Answer 11

Von Willebrand disease
1. Decreased platelet adhesion in primary hemostasis > increased BT
2. Decreased clotting factor 8 activity in secondary hemostasis > Increased aPTT

Question 12

2 points in history suggestive of coagulopathy

Answer 12

Hx of bleeding with dental procedures
Fam hx of heavy menses

Question 13

Define metrorrhagia

Answer 13

Bleeding between periods
Periods more frequent than normal

Question 14

Endocrine disorders associated with ovarian dysfunction x5

Answer 14

PCOS
Perimenopause
Hyperprolactinemia
Thyroid dysfunction
Hypothalamic hypogonadism

Question 15

Iatrogenic causes of abnormal uterine bleeding x5

Answer 15

Hormonal therapy
Intrauterine devices
Tricyclic antidepressants
Anticoagulants
Corticosteroids

Question 16

Endometrial causes of AUB x4

Answer 16

Endometritis
Cervicitis
PID
Intrauterine AV malformations

Question 17

Management of endometrial causes of AUB x4

Answer 17

Antibiotics
Hormonal therapy
Analgesia
Hysterectomy

Question 18

Unclassified causes of AUB x7

Answer 18

AV malformations
C/S scar defect
Myometrial hypertrophy
Endometrial pseudoaneurysm
Excessiveexercise, stress, anorexia

Question 19

Define oligomenorrhea and 3 causes

Answer 19

Bleeding that occurs less frequently than 35 days
Pregnancy, PCOS, chronic anovulation

Question 20

Define polymenorrhea

Answer 20

Bleeding that occur more often than 21 days

Question 21

Pathophysiology of Depo provera on endometrial hyperplasia x2

Answer 21

Upregulates progesterone receptors on endometrium > decidualization of the endometrial hyperplasia

Question 22

Causes of AUB in a 13-18y/o x5

Answer 22

Persistent anovulation
Hormonal contraceptives
Pelvic infection
Pregnancy
Coagulopathies

Question 23

Causes of AUB in a 19-39y/o x5

Answer 23

Pregnancy
Anovulatory cycles PCOS
Hormonal contraception
Endometrial hyperplasia
Structural lesions -polyps, leiomyoma

Question 24

Causes of AUB in perimenopausal women x4

Answer 24

Endometrial hyperplasia
Endometrial cancer
Endometrial atrophy
Leiomyoma

Question 25

4 causes of AUB/HMB

Answer 25

Endometrial polyp Adenomyosis Leiomyoma PCOS

Question 26

Risk factors of polyps x5

Answer 26

HTN Obesity Tamoxifen Hormonal therapy Post-menopause

Question 27

Define adenomyosis and what causes it

Answer 27

Endometrial tissue appearing in the myometrium Caused by hyperplasia of the endometrial basal layer

Question 28

What causes dysmenorrhea in AUB/A x4

Answer 28

Enlarged uterus> increased secretion of prostaglandins> increased contraction of uterus during menses> dysmenorrhea

Question 29

Women at risk of leiomyomas x4

Answer 29

Nulliparous Pregnant Breastfeeding Perimenopause

Question 30

High risks of infertility in x2

Answer 30

Polyps Leiomyomas

Question 31

Risk factors of endometrial cancer x5

Answer 31

DM Obesity Age>35 Nulliparity Anovulatory cycles

Question 32

4 causes of light menstrual bleeding

Answer 32

Congenital malformations Hypogonadotropic hypogonadism Intrauterine trauma Asherman's syndrome

Question 33

3 causes of coagulopathy

Answer 33

vWF Immune thrombocytopenia Myeloproliferative disorders

Question 34

Describe pathophysiology of endometrial AUB x3

Answer 34

Local disturbance of Hemostasis and vasoconstriction > vasodilation > increased rate of blood loss