Disorders Of The Menstrual Cycle Flashcards
(20 cards)
HMB definition (high menstrual bleeding)
> 80mL blood per cycle
How do we predict that the patient has HMB?
“flooding” changing tampons more frequently, low ferritin, and clots greater than an inch in diameter
We ask the patient how often she changes pads, what are we looking for in her answer?
Changing more than 2 pass an hour.
Explain the initial workup for patients
History, physical exam like speculum and pelvic exams. Pap smear, endometrial biopsy, pelvic US, and labs. CBC and Ferritin levels
What pelvic US approach do we do for a non-sexually active patient?
Transabdominal
What pelvic US approach do we do for sexually active/emotionally mature patients
Transvaginal
If a bleeding disorder is suspected, what labs do we order
PT, aPTT, and fibrinogen levels
If periods irregular, what labs do we order
Pregnancy test, TSH and Prolactin
What does Primary Amenorrhea mean
Lifelong absence of menstrual cycle/period
At what age, should we refer a woman to a gyno if she’s yet to develop puberty?
by age 15 if period hasn’t come, or 13 if no signs of puberty occurred
What does Secondary Amenorrhea mean
Cessation of previously regular period for 3 months or more
What is Dysmenorrhea
Painful menstruation
Primary Dysmenorrhea cause
Occurs in the absence of pelvic pathology
Cause of Primary Dysmenorrhea
Mediated by elevated prostaglandins and leukotrine levels
Most common cause of Secondary Dysmenorrhea
Endometriosis
Dysmenorrhea clinical presentation
cramping pain in the lower abdomen beginning at the onset of menstrual flow and lasting eight to 72 hours. Accompanied with nausea and so on
Patient presents with primary dysmenorrhea, what is first course of treatment
NSAIDs if patient desires fertility, or hormonal therapy if she desires contraception
Which investigation is the gold standard for quantifying menstrual blood loss but is rarely used clinically?
Alkaline hematin method
Secondary Amenorrhea and history of D&C is most suggestive of what
Asherman’s syndrome
