Menopause, Pelvic Organ Prolapse,Vaginal Bleeding, AUB

Question 1

Permanent cessation of menstruation due to loss of ovarian follicular activity

Answer 1

Menopause

Question 2

12 months of amenorrhea after LMP with no attributable cause

Answer 2

Menopause

Question 3

Years prior to menopause that encompasses the change from normal -> cessation of Menses

Answer 3

Perimenopaus

Question 4

Hallmark of Perimenopause

Answer 4

Skipped periods or longer intervals (40-60) days

Question 5

Period of time when a woman passes from reproductive stage to non reproductive stage

Answer 5

Climacteric

Question 6

Mean menopausal age for Filipinos

Answer 6

48 yo

Question 7

Mean perimenopausal age

Answer 7

45.1 y/o

Question 8

Indirect measure of follicle reserve

Answer 8

Dec in inhibin

Question 9

Principal steroid secreted by the ovary post menopause

Answer 9

Androstenedione

Question 10

Hallmark of Female climacteric

Answer 10

Hot Flush/ Flash

Question 11

Protective effects of Estrogen

Answer 11

Inc HDL

Dec Total Cholesterol including LDL

Question 12

M/C Bone changes in Menopause

Answer 12

Vertebral Bone Fracture

Question 13

Absolute contraindication for Hormone Replacement Therapy

Answer 13

Porphyria Cutanei tarda

Question 14

Staging or Pelvic Organ Prolapse: No Descent

Answer 14

0

Question 15

Staging or Pelvic Organ Prolapse: Leading point >1 cm above hymen

Answer 15

1

Question 16

Staging or Pelvic Organ Prolapse: Leading point 1 cm above or 1 cm below the hymen

Answer 16

2

Question 17

Staging or Pelvic Organ Prolapse: Leading point >1 cm below he hymen but less than TVL (-2)

Answer 17

3

Question 18

Staging or Pelvic Organ Prolapse: Leading point is more than TVL (-2). Complete eversion

Answer 18

4

Question 19

Management for Pelvic Organ Prolapse

Answer 19

Pelvic Floor Muscle Training

Pessary

Question 20

Outgrow of distal edge of urethra
Due to chronic irritation or infection
Mostly on postmenopausal women

Answer 20

Urethral caruncle

Question 21

Rare malformations of BVs

Single, 1-2 cm in diameter, flat, soft, brown/red

Answer 21

Hemangioma of Vulva

Question 22

Originates in the apocrine sweat glands

Most on Labia majora (38%)

Answer 22

Hidradenoma

Question 23

Secondary to blunt trauma

Spontaneous formation occurring during pregnancy or post partum

Answer 23

Hematoma

Question 24

Toxic Shock Syndrome

Answer 24

Tampon use - Microulcerations

Question 25

Most frequent cause of Local trauma to the vagina

Answer 25

Coitus

Question 26

Risk Factors of Vaginal CA

Answer 26

History of Cervical CA >5 partners HPV Infection

Question 27

Most common benign neoplastic growth of the Cervix

Answer 27

Polyp

Question 28

Cherry red polyp

Answer 28

Endocervical polyps

Question 29

Grayish white polyps

Answer 29

Grayish white

Question 30

Most common type of cervical polyp

Answer 30

Adenomatous

Question 31

Uterus AUB

Answer 31

``` PALM COEIN Polyp Adenomyosis Leiomyosis Malignancy ``` ``` Coagulopathy Ovulatory Endometrial Iatrogenic Not yet classified ```

Question 32

Localized overgrowths of endometrial glands and stroma that projects beyond endometrium

Answer 32

Endometrial polyps

Question 33

3 components of Endometrial polyps

Answer 33

Endometrial Glands Endometrial stroma Central vascular changes

Question 34

Mgt for Endoometrial polyps

Answer 34

Hysteroscopy with D&C

Question 35

Ectopic endometrial glands and stroma within myometrium | Disruption of barrier between endometrium and myometrium

Answer 35

Adenomyosis: Endometriosis interna

Question 36

Posterior wall mostly involved | Not encapsulated

Answer 36

Diffuse type

Question 37

Asymmetric uterus | Pseudocapsule

Answer 37

Focal type

Question 38

Definitive treatment for Adenomyosis

Answer 38

Hysterectomy

Question 39

Single mutation in single progenitor cells which affects cytokine that affect cell growth which may be affected by estrogen and progesterone

Answer 39

Leiomyoma

Question 40

Most common form and mildest form of leiomyoma

Answer 40

Hyaline

Question 41

Most acute form of leiomyoma

Answer 41

Carnerous (red) degeneration

Question 42

Classic indications for Myomectomy

Answer 42

Persistent AUB Pain/Pressure Asymptomatic mass >8cm

Question 43

Contraindications for myomectomy

Answer 43

``` PAMP Pregnancy Advanced Adnexal Disease Malignancy Possible endometrial damage ```

Question 44

Hysterectomy done in Leiomyoma

Answer 44

Asymptomatic with >14-16 weeks size

Question 45

Menorrhagia + immediately after menarche or late 40s & 50s

Answer 45

Physiologic

Question 46

Menorrhagia + soon after medication

Answer 46

Medication Induced

Question 47

Menorrhagia + Weight gain or symptoms of hyperandrogenism

Answer 47

Anovulation

Question 48

Menorrhagia + Gradual Increase over months, or sudden and non cylcic

Answer 48

Myoma, hyperplasia, malignancy

Question 49

Menorrhagia + Increasing disability from systemic disease

Answer 49

Chronic

Question 50

First line diagnostic tool for AUB

Answer 50

UTZ

Question 51

accurate evaluation tool for intracavitary lesion

Answer 51

Saline Infusion Sonography

Question 52

Endometrial biopsy indicated on:

Answer 52

Post menopausal woman with heavy irregular bleeding Post menopausal women with Endometrial cells Pre Menopausal women with atypical glandular cells Tamoxifen patients with abnormal vaginal bleeding Women still menstruating at age 52

Question 53

AE: Danazol

Answer 53

Lowering of voice

Question 54

Treatment of choice in women with hypovolemia due to DUB

Answer 54

D&C

Question 55

Maybe offered as an initial treatment for HMB Women with medical contraindication against hysterectomy Women with normal uterus and those with small myoma < 3 cm

Answer 55

Endometrial Ablation

Question 56

For failed pharmacological treatment | If HMB is causing anemia and/or serious impact to quality of life

Answer 56

Hysterectomy