Abnormal Uterine Bleeding Flashcards Preview

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Flashcards in Abnormal Uterine Bleeding Deck (24):
1

define dysmenorrhea

pain with menses, often associated with endometriosis

2

define oligomenorrhea

> 35-day cycle (infrequent menstruation)

3

define polymenorrhea

< 21-day cycle (frequent menstruation)

4

define metrorrhagia

frequent or irregular menstruation

5

define menorrhagia

heavy menstrual bleeding; > 80 mL blood loss or > 7 days of menses

6

define menometrorrhagia

heavy, irregular menstruation

7

dx: female 20-40 yo, heavy menstrual bleeding, urinary pressure/urgency, constipation, intermenstrual spotting, pain

leiomyoma (uterine fibroids)

8

which uterine tumor regresses with menopause?

leiomyoma (uterine fibroids; estrogen sensitive)

9

leiomyoma (uterine fibroids): _____ decreases risk and _____ increases risk

parity; obesity

10

dx: uterine tumor, histology shows smooth muscle bundles with well-demarcated borders

leiomyoma (uterine fibroids)

11

dx: uterine tumor, histology shows hyperplasia of basal layer of endometrium

adenomyosis

12

dx: dysmenorrhea, menorrhagia, uniformly enlarged, soft, globular uterus

adenomyosis

13

adenomyosis: pathogenesis

extension of endometrial tissue (glandular) into uterine myometrium

14

pathogenesis of anovulation and abnormal uterine bleeding at extremes of reproductive age spectrum

result of chronic exposure of the endometrium to estrogen without the benefit of cyclic exposure to postovulatory progesterone --> endometrium becomes abnormally thickened and structurally incompetent --> asynchronous shedding of portions of the endometrium unaccompanied by vasoconstriction

15

anovulation and abnormal uterine bleeding at extremes of reproductive age spectrum: overall risk of progression to endometrial cancer based upon _______

duration of unopposed estrogen exposure

16

endometrial ______: often described as spotting, related to _______

atrophy; hypoestrogenism

17

treatment for leiomyoma (uterine fibroids)

leuprolide (GnRH analog, continuous), oral contraceptive pills, surgery

18

endometriosis: pathogenesis

non-neoplastic endometrial glands and stroma outside endometrial cavity

19

dx: cyclic pelvic pain, bleeding, dysmenorrhea, infertility, normal sized uterus

endometriosis

20

chocolate cyst of the ovary: pathogenesis

endometriosis that spread to the ovary

21

treatment for endometriosis

NSAIDS, oral contraceptive pills, GnRH agonists, aromatase inhibitors (decrease inflammation and cause hormonal suppression to minimize stimulation of endometriosis tissue)

22

dx: dysmenorrhea, dypareunia (painful intercourse), infertility

endometriosis

23

how does obesity exacerbate anovulation caused by increased estrogen exposure unopposed by progesterone?

increased circulating estradiol

24

23 yo G0 presents complaining of worsening dysmenorrhea and pelvic pain. she does not desire fertility at this time. what treatment option is INappropriate for her?

clomiphene citrate (because it induces ovulation)