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ER Exam 2 > Menarche > Flashcards

Menarche Flashcards

(53 cards)

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1
Q

Why can dehydration initiate signs of labor in a pregnant patient?

A

Oxytocin and Vasopressin (ADH) have similar structures, ADH will get upregulated in a dehydrated patient and will bind to oxytocin receptors and simulate labor

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2
Q

If a patient’s ovaries were being visualized by laproscopy and a yellow cyst was seen, what could this be if it was physiologically normal?

A

Corpus Luteum

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3
Q

When would you repeat an ultrasound for an ovarian cyst?

A

6 weeks from initial US to “catch” the patient in a different stage of her cycle

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4
Q

An intact coagulation pathway is important for what phase of the menstrual cycle?

A

Secretory phase

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5
Q

When should females have their initial reproductive health visit?

A

Ages 13-15

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6
Q

When does ACOG recommend 1st Pap test?

A

21 yrs old

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7
Q

What Gardasil HPV genotypes cause genital warts?

A

6, 11

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8
Q

What Gardasil HPV genotypes cause cervical CA?

A

16, 18

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9
Q

What is the median age of menarche?

A

12.43

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10
Q

How long after thelarche does menarche occur?

A

2-3 years

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11
Q

Primary menorrhea is characterized by

A

Absence of menarche by 13 years old w/o secondary sexual development

OR by the age of 15 with secondary sexual development

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12
Q

What is the difference in cycle ranges in the first gynecologic year as compared to the 3rd gynecologic year?

A

21-45 days to 21-35 days

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13
Q

Endocrine causes of menstrual irregularity

A

Poorly controlled DM

PCOS

Cushing’s Dz

THyroid dysfunction

Premature ovarian failure

Late-onset CAH

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14
Q

Acquired causes of menstrual irregularity

A

Stress-related hypothalamic dysfunction

Medication

Exercise

Eating disorders

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15
Q

What is the mean blood loss per menstrual period?

A

30cc

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16
Q

Define: Primary amenorrhea

A

No menstruation by 13 y/o w/o secondary sex development or by age 15 with secondary sex development

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17
Q

Define: Secondary amenorrhea

A

Absence of menses for 6 months or more

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18
Q

Define: Polymenorrhea

A

Abnormally frequent menses at intervals at <21 days

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19
Q

Define: Menorrhagia

A

Hypermenorrhea

>80 mL and >7 days at regular intervals

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20
Q

Define: Metrorrhagia

A

Irregular episodes of uterine bleeding

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21
Q

Define: Menometrorhagia

A

Heavy and irregular uterine bleeding

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22
Q

Define: Intermenstrual bleeding

Study These Flashcards
A

Scant bleeding at ovulation for 1 or 2 days

23
Q

Structural causes for abnormal bleeding in reproductive-aged women

Study These Flashcards
A

P: Polyp

A: Adenomyosis

L: Leiomyoma

M: Malignancy and hyperplasia

24
Q

Nonstructural causes for abnormal bleeding in reproductive-aged women

Study These Flashcards
A

C: Coagulopathy

O: Ovulatory dysfunction

E: Endometrial

I: Iatrogenic

N: Not yet classified

25
How does an endometrial polyp appear on ultrasound?
Focal thickening of endometrial stripe Saline hysterosonography and hysteroscopy
26
What is adenomyosis?
Extension of endometrial glands and stroma into uterine musculature Associated with endometriosis
27
What are uterine leiomyomas?
Fibroids - benign tumors derived from smooth muscle of myometrium Most common neoplasm
28
Risk factors for developing fibroids
Increasing age during reproductive years African American Nulliparity Family hx
29
Sx of leiomyoma
Mostly asymptomatic but may have: Pelvic/low back pain Urinary frequency Prolonged or heavy bleeding Increased incidence of infertility
30
Common causes of endometrial hyperplasia
Persistent unopposed estrogen via: PCOS Granulosa theca cell tumors Obesity Exogenous estrogens w/o progestins Tamoxifen
31
What are the incidences of malignancy secondary to endometrial hyperplasia?
Simple without atypia - 1% Complex w/o atypia - 3% Simple w/ atypia - 9% Complex w/ atypia - 27%
32
What category does Von Willebrand disease fall under for abnormal bleeding?
Non-structural cause - Coagulopathy
33
What category does PCOS fall under for AUB?
Nonstructural cause - ovulatory dysfunction
34
What category do IUDs and exogenous hormones fall under for AUB?
Nonstructural cause - Iatrogenic
35
When is a speculum exam for AUB most strongly indicated?
Post-coital bleeding
36
Lab tests for AUB
Pregnancy (blood or urine) CBC Von willebrand's profile, PTT/PT TSH Chlamydia
37
Diagnostic imaging for AUB
Transvaginal sonography Saline infusion sonohysterography MRI Hysteroscopy
38
Indications for AUB in post menopausal women
Sample with spotting or bleeding Endometrial lining \>4mm
39
Indications for AUB in age 45 to menopause
Any AUB, including intermenstrual bleeding, menorrhagia
40
Indications for AUB \<45y/o
Bleeding in the setting of unapposed estrogen exposure
41
AUB treatment with synthetic progesterone
Have pt take synthetic progesterone to simulate a menstrual cycle and coordinate endometrial sloughing
42
AUB treatment with OCPs
Have pt take OCPs 3 weeks and stop taking 1 week to coordinate regular menstrual cycle
43
What are the surgical options for AUB treatment?
Polypectomy Myomectomy Dilation and Currettage Uterine endometrial ablation Hysterectomy
44
What is Novasure?
Bipolar mesh that uses radiofrequency to perform ablation and burn the uterine lining away Takes 90 seconds
45
Major routes of hysterectomy
Total abdominal hysterectomy Vaginal hysterectomy Laparoscopic assisted vaginal hysterectomy da Vinci assisted hysterectomy
46
What is the average age of puberty onset?
12.4 years
47
Factors determining puberty onset
Race: African American and hispanic girls begin earlier Cities or higher than sea level Obesity (leptin) Must be around 106 pounds
48
What are the stages of normal pubertal development?
Thelarche (breast development) Adrenarche/Pubarche - pubic/axillary hair development Growth: Max height velocity, occurs 2 years older than girls 1 year before menses Me: Menses, pulsatile GnRH from hypothalamus triggering HPO axis
49
What is Tanner stage 1?
Preadolescent Breast development: Elevation of papilla Absent pubic hair
50
Tanner stage 2
Breast: Breast bud stage, elevation of breast and papilla as a small mound with enlargement of areolar region Pubic: Sparse hair along labia, slightly pigmented
51
Tanner stage 3
Breast: Further enlargement of breast and areola without separation of their contours Pubic: Hair spreads sparsely over junction of pubes, dark and coarse
52
Tanner stage 4
Breast: Projection of areola and papilla to form a secondary mound above the level of the breast Pubic: Adult-type hair, no spread to medial surface of thighs
53
Tanner stage 5
Breast: Mature, projection of papilla only, resulting from recession of the areola to the general contour of the breast Pubic: Adult-type hair with spread to medial thighs

ER Exam 2 (16 decks)

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