Amenorrhea (Intrauterine Adhesions) Flashcards Preview

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Flashcards in Amenorrhea (Intrauterine Adhesions) Deck (17):
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Intrauterine adhesions a.k.a.?

Asherman's syndrome

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Secondary amenorrhea?

Absence of menses for 6+ months in a woman with previous menses

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Intrauterine adhesions? Form when?

When scar tissue forms and obliterates the endometrial cavity

Urine curettage following a pregnancy

4

Hysterosalpingogram?

Radiopaque dye injected into the endometrial cavity via transcervical catheter to evaluate endometrial cavity and fallopian tubes

5

Hysteroscopy?

Direct visualization of the endometrial cavity with an endoscope

6

Uterine sounding?

Assessing the depth and direction of the cervical and uterine cavity with a thin blunt probe

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Necessary to form intrauterine adhesions?

Endometrial trauma (especially basalis layer)

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Adhesions consist of? Adhesions with poor prognosis?

Avascular fibrous tissue OR in active endometrium/myometrium

Myometrial adhesions are usually vascular and carry poor prognosis

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Typically found after radiation or tuberculosis endometritis? Prognosis?

Atrophic and sclerotic endometrium without adhesions; poor prognosis

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Risk factors for intrauterine scar formation?

1. Postpartum curettage 2-4 weeks after delivery
2. Hypoestrogenic states (breast-feeding or hypogonadotrophic hypogonadism)

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When to suspect intrauterine adhesions (findings)?

Dx by?

1. Secondary amenorrhea with negative pregnancy test and no progestin-induced withdrawal bleeding

Gold standard – hysteroscopy
Also good – Hysterosalpingogram

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Treatment for intrauterine adhesions?

1. Operative hysteroscopy
2. IUD or pediatric foley catheter to prevent reformation
3. Conjugated estrogens and progesterone

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Patient with amenorrhea. A biphasic basal body temperature suggests?

Normal functioning of the HPG axis

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Patient with secondary amenorrhea. Elevated FSH suggests? At risk for?

Premature ovarian failure; osteoporosis

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Hormonal status with intrauterine adhesions?

Normal

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Patient with amenorrhea but cramping pain every month - suggested diagnosis?

Cervical stenosis (not intrauterine adhesions)

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Describe endometrial response to estrogen in Ashermann syndrome? No risk of?

Endometrium unresponsive to estrogen – no risk for endometrial hyperplasia