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Flashcards in Abnormal Uterine Bleeding Deck (34):
1

what is defined as uterine bleeding occurring at regular intervals of less than 21 days?

polymenorrhea

2

what is defined as prolonged (greater than 7 days) or excessive (greater than 80mL) uterine bleeding occurring at regular intervals?

menorrhagia

3

what is defined as uterine bleeding occurring at intervals greater than 35 days?

oligomenorrhea

4

what is defined as bleeding that occurs at frequent, but irregular intervals?

metrorrhagia

5

what is defined as uterine bleeding that is prolonged or excessive but also frequent and irregular ?

menometrorrhagia

6

how much blood loss is necessary to define menorrhagia?

greater than 80 mL

7

what are the two main mechanisms for hemostasis during menstruation?

formation of hemostatic plug; vasoconstriction

8

a pt with postcoital bleeding should be worked up for which two differentials?

cervical cancer and cervicitis

9

what 4 tests should be ordered as part of the workup for abnormal uterine bleeding?

FSH, TSH, PRL, and beta hCG

10

what is the time frame for a normal menstrual cycle?

every 21 to 35 days w/ menstruation lasting 2 to 7 days

11

what are the most common types of cancer associated with reproductive age bleeding?

cervical and endometrial

12

what is the most common cause of hospital admission for menorrhagia in adolescents?

von Willebrand disease

13

t or f: hyperthyroidism causes an ovulation and is frequently associated with menorrhagia and intermenstrual bleeding

FALSE - hyPO

14

t or f: cirrhosis can be a cause of excessive bleeding during menstruation

TRUE - secondary to reduced capacity of the liver to metabolize estrogens

15

t or f: abnormal uterine bleeding is a diagnosis of exclusion

TRUE

16

how is the diagnosis of ovulatory abnormal uterine bleeding made?

endometrial biospy

17

what is the relationship between estrogen and the endometrium? progesterone?

estrogen stimulation leads to constant endometrial proliferation; progesterone is what mediates maturation and shedding

18

what is the treatment of choice for pts with heavy bleeding and hemodynamic instability?

d&c; note: once bleeding is controlled, pt can be placed on medical management

19

t or f: medical management is the first line treatment for pts with abnormal uterine bleeding.

true

20

what is the mainstay of treatment for anovulatory bleeding?

OCP

21

what is the mcc of post menopausal bleeding?

atrophy (vaginal/endometrial)

22

how is post menopausal bleeding defined?

bleeding that occurs after 1 year of amenorrhea

23

what is the most common lethal cause of post menopausal bleeding?

endometrial cancer

24

t or f: HRT for menopausal women with a uterus must contain estrogen only pills

FALSE: must contain progestin ALONG with estrogen to prevent endometrial hyperplasia/carcinoma

25

what is the MOA behind vaginal/endometrial atrophy?

in the uterus, the collapsed endometrial surface contains little or no fluid to prevent intrauterine cavitary friction resulting in micro erosions leading to bleeding

26

why is it that obese women have higher levels of endogenous estrogen?

b/c of the conversion of androstenedione to estrone and the aromatization of androgens to estradiol, both of which occur in peripheral adipose

27

vaginal bleeding plus foul smelling discharge in a post menopausal female is diagnostic of what?

cervical cancer

28

what are the top 4 ddx for thickened endometrial stripe in a post menopausal woman? (stripe is seen of TVUS)

endometrial ca, endometrial hyperplasia, leiomyoma and polyps

29

what is the MOA behind cervical cancer causing bleeding?

the cancer has outgrown its blood supply

30

when should uterine sarcoma be considered part of the differential for post menopause women?

when there's are rapidly growing leiomyomata

31

physical exam, it reveals dry pale vaginal mucosa with lost rugae - what is the diagnosis?

vaginal atrophy

32

how is vaginal atrophy treated?

topical estrogen cream

33

how is endometrial hyperplasia with atypia treated?

as CA as this indicates underlying CA typically; hysterectomy is treatment of choice

34

what is the treatment for endometrial hyperplasia without atypia?

progestin and ongoining monitoring