Abnormal uterine bleeding and contraception Flashcards Preview

Year2 Repro exam II > Abnormal uterine bleeding and contraception > Flashcards

Flashcards in Abnormal uterine bleeding and contraception Deck (48):
1

what can cause abnormal uterine bleeding in nongravid reproductive age women

Polyp
Adenomyosis
Leiomyoma
Malignancy and hyperplasia

Coagulopathy
Ovulatory Dysfunction
Endometrial
Iatrogenic
Not yet classified

2

what is an endometrial polyp

hyperplastic overgrowth of glands and stoma
benign

3

what can endometrial polyp cuase

early uterine bleeding
malignancy highger in post menopausal women

4

most common benign tumor in women

leiomyomas "fibroids"

5

Sx leiomyoma

abnormal painful menses
abdominal pain

6

what are subtypes leiomyomas

pedunculated
subserosal
submucosal
intramural

7

what is triad of adenomyosis

nocyclical pain, menorrhagia, enlarged uterus w/o adenexal tenderness

8

Tx adenomyosis

NSAIDs, OCPs, progestins, ablation, hysterectomy

9

fibroids are sensitive to what hormones

E and P

10

complications of fibroids

torsions and infertility

11

what is adenomyosis

endometrial tissue growth in myometrium

12

risk factors fibroids

african american
early menarche
obesity
diet, alcohol, red meats beer
HTN

13

what type of surgeries can you do for fibroids

myomectomy, endometrial ablation, uterine artery embolization, hysterectomy

14

types of degeneration of leiomyoma

hyaline
cystic
red carneous
myxoid

15

common causes postmenopausal women

atrophic endometrium
endometrial polyps
endometrial CA
endometrial hyperplasia
hormonal effects
cervical CA <1%

16

what causes atrophic endometrium

hypoE
dry vaginal epithelium that is smooth and shiny with loss of most rugation

17

why is endometrial hyperplasia weird in postmenopausal women warranting biopsy

because should not have hyperplasia since lack of E

18

what are classifications of endometrial hyperplasia

simple or complex hyperplasia without atypia
simple or complex hyperplasia with atypia

19

most common genital cancer in women over 45

adenoCA of endometrium

20

Tx atrophy of vagina

vaginal estrogen therapy

21

Tx endometrial polyp

polypectomy

22

Tx endometrial hyperplasia

cyclic progestin therapy

23

Tx endometrial hyperplasia with atypia

hysterectomy

24

Tx CA of endometrium

TAH BSO and LND for staging

25

how to Tx menorrhagia

ibuprofen
transamic acid (expensive)

26

how does the implantable rod of contraception work

thickens uterus making in implantable
progesterone only

27

problems with etonogestrel implant

increase bleeding and spotting
irregularity and unpredictability

28

side effects etonogestrel implant

weight gain

29

CI etonogestrel implant

SLE with anti phospholipid Ab
hepatocellular adenoma
discontinue if have migraines with aura
unexplained vaginal bleeding before evaluation

30

What is paragard

copper IUD
no hormones--- can have heavier bleeding
lasts 10 years

31

what is mirena

levonorgestrel IUD
local progestin
lasts 5 years

32

what disease not use copper IUD

wilsons disease

33

how does copper IUD work

alters uterine and tubal fluid
hinders spermatozoa function
inhibits fertilization! not abortifacient

34

how does mirena work

impaires spermatozoa motility/function
inhibits conception

35

which IUD has no weight gain

mirena

36

contraindications to IUD

current PID or within past 3 mo
current cervicitis
high risk women: screen first for STIs

37

what is depot provera

progesterone shot every 3 mo
thickens cervical mucus

38

side effects depot provera

bleeding irregularities
weight gain
delayed return fertility
decrease in bone mineral density

39

how does depot provera change BMD

loss of BMD
returns to baseline once discontinued

40

few CI to depot provera

severe HTN
DM with vascular disease

41

special populations to use depot provera

sickle cell
epileptics

42

which contraceptive use is weight dependent

the patch
>90 kg doesn't work

43

what is in nuva ring

ethinyl estradiol
etonorgestrel

44

when is back up method for nuva ring needed

taken out for greater than 3 hours

45

what increases weight

depot provera

46

breakthrough bleeding more common in

smokers
cervical infections

47

CI to oral contraception

Hx VTE
known thrombogenic mutation
migraines WITH aura
HTN poorly controlled
lupus with antiphospholipid Ab (hypercoaguable)

48

method for protection from STIs

condoms