Menstral Cycle and disorders Flashcards Preview

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Flashcards in Menstral Cycle and disorders Deck (21):
1

What does the follicule produce?

Oestrogen and inhibit

2

What happens after the LH surge?

Ovulation

3

Corpus luteum produces what hormone and its action?

Progesterone
Maintains endometrium

4

What is menorrhagia?

Excessive menstraul bleeding which affects her life.
Volume based >80g

5

What causes menorrhagia?

Haematological - Von willibrands
Endocrine - hypothyroidism
Structural - e.g. Fibroids,

Must consider carcinoma in those failing to response to treatment, over 45 years.

6

Irregular bleeding is caused by what 2 main things?

Anovulation
Conditions - benign or malignant
? Contraception

7

Causes of primary and secondary amenorrhea?

1' never bleed- chromosomes, imperforate hymen (haemocoloposcopy), anorexia, athleticism
2' had then stopped - e.g. Pregnancy, PCOS

Pathological or not
Location

8

Causes of post-coital bleeding?

Eptropium - movement of the transformation zone (squamous to columnar)
Sti
Polyps
Cancer -

9

Types of fibroid?

Subserousal
Intramural
Pedunculated....

10

At what age would you starting investigating primary amenorrhea?

16y or 14y if she shows no sign of breast development

11

What treatment can be given for primary dysmenorrhea?

NSAIDs eg Mefenamic acid (they inhibit prostaglandins)
Second line - cocp


Secondary dysmenorrhea - refer to gynea for investigation

12

What investigation must you always do for amenorrhea?

Pregnancy test

13

What are the actions of PGF2a, PGE2, and PGI2 in menstruation?

PGF2a - vasoconstriction
Pge2 and pgi2 (prostacyclin) - vasodilation
Pgi2 - inhibits platelet aggregation

14

What is the first line treatment for menorrhagia?

NSAIDs eg Mefenamic acid

Mirena coil
Antifibrinolytics eg tranexamic acid
Mefenamic acid if also have pain
Cocp
IM progestogens (norethisterone)

Surgery- endometrial ablation
Fibroids - myomectomy or uterine artery embolisation // hysterectomy if not wanting to be fertile

15

What are the different types of HRT? Who should be given what?

Combined HRT - with a uterus (progesterone needed)
- those still having periods - give oestrogen and cyclical progesterone (gives a regular withdrawal bleed)
- postmenopausal - give continuous combined HRT eg kliofem, oestrodial and norethisterone

Oestrogen only - without a uterus

16

What are the alternatives to HRT?

SSRIs- eg. Clonidine for vasomotor symptoms
Calcium and vit d, bisphoshanates or strontium or SERMs - oesoporosis
Oestrogen cream- vaginal dryness

17

What is ashermans syndrome?

Amerrhoa due to uterine adhesions after D&C (leading to cervical stenosis)

18

What is Sheehan syndrome?

Amenorrhea caused by Postpartum infarction of the pituitary gland due to PPH

19

What are the contraindications to HRT?

Endometrial/breast cancer
Undiagnosed vaginal bleeding
/ Breast lump
Previous VTE - due to preg/oestrogen

20

What are the blood tests in PCOS?

Raised testosterone
Elevated LH:fsh ratio
Low SHBG
Raised prolactin

21

What is kallman syndrome?

Failure of hypothalamus to produce gnrh - primary amenorrhea