Heavy Menstrual Bleeding Flashcards Preview

Jason's MD3 Women's > Heavy Menstrual Bleeding > Flashcards

Flashcards in Heavy Menstrual Bleeding Deck (29):
1

Heavy Mentrual Bleeding?

Guided by patient perceived problem
Usually >80ml per cycle

2

Causes of vaginal bleeding, don't ever forget?

Pregnancy
Trauma

3

PALM-COIEN Classification

Palm - structural
COEIN -

4

Polyps are?

Usually asymptomatic

5

Adenomyosis is?

Endometrial glands within myometrium

6

When Adenomyosis?

Late 30s and 40s
Large bulky uterus

7

Fibroids during preg?

May grow in response with hormones
May obstruct delivery

8

Heavy bleeding Rx?

-Suppress the endometrium
-hormones usually.

9

PALM COEIN

Polyps
Adenomyosis
Leiomyoma
Malignancy
-
Coagulopathy
Ovulatory Dysfunction
Endometrial
Iatrogenic
Not yet Classified

10

COEIN is?

Nonstructural causes of HMB

11

What is the constant phase in menstrual cycle?

LuteaL phase (14 days)

12

Endometrial dysfunction, why?

Popular: too much prostacyclin

13

Ovulatory dysfunction?

Long irregular, no ovulation, no signal to menstruate

14

Consequences of ovulatory dysfunction?

Subfertility

15

Endocrine causes?

Thyroid
Pituitary or adrenal disease
PCOS - hormone variation, lifestyle
Weight changes - loss, or gain

16

Break through bleeding with COC why?

Pill causes lining to be too thin.
Or incomplete suppression of HPO axis

17

Other reasons for bleeing?

Endometriosis

18

Most common reason for pain with menstruation

Prostaglandin related

19

Smears and constant bleeding?

Pap smear in case it's cervical cancer
Do a thin prep

20

Ix for HMB?m

Iron studies
BHCG
FBE
Coags
Bleeding profile?
TFTs
FSH, LH, estradiol, androgen screen (PCOS)

21

Imaging for HMB?

U/S

22

What is pipelle?

Small suction device, goes through cervix to take endometrial sample

23

What is gold standard for endometrial sampling?

Hysteroscopy D&C
Distended with saline/C02

24

When do endometrial sampling?
Transvaginal U/S and Pipelle?

Woman >40 with HMB

Or post menopausal bleeding

25

Best way to turn off periods?

Monophasic pills, same dosage and skip sugar pills

26

Total hysterectomy is?

Including cervix

27

Special scenarios?

Teenagers
Vitals
Can decompensate quickly if heavy blood loss

28

Which type of fibroid is most likely to cause heavy bleeding?

Su mucosal

29

Which type of fibroid is most likely to cause heavy bleeding?

Su mucosal