Menstrual Abnormalities

Question 0

MCC metrorrhagia

Answer 0

Cervical polyps

Endometrial polyps

Question 1

Normal menses
Frequency
Duration
Volume
Regularity

Answer 1

21-35d
4-7d
30-80ml
Monthly

Question 2

AUB classification

Answer 2

Organic - systemic and reproductive

Dysfunctional - non/ovulatory

Question 3

Endometrial biopsy indications

Answer 3

> 35 yo obesity hpn DM

Post menopausal women

Question 4

Occurs in reproductive tears
Due to local endometrial factors
Simultaneous orderly tissue breakdown
Spiral arteriolar constriction
Midcycle rise in body temp
Secretory changes

Answer 4

Ovulatory

Question 5

Occurs in peri and postmenopause
Continued estrogen w/o progesterone
Unstable spontaneous haphazard breakdown
Absence of vasoconstriction and BBT rise
Proliferative changes

Answer 5

Anovulatory

Question 6

Tx for hemodynamically unstable bleeding

Answer 6

IV estrogen

GnRH agonist and D&C

Question 7

DOC for anovulatory bleeding

Answer 7

Progestins

Question 8

Chronic ovulatory bleeding with contraception

Answer 8

OCP and levonorgestrol IUD +/- NSAISs and tranexamic acid

Question 9

Chronic ovulatory bleeding with fertility

Answer 9

NSAIDs and tranexamic acid

Question 10

Chronic anovulatory bleeding
With contraception
With fertility

Answer 10

OCP

Cyclic progestin therapy from D14-25

Question 11

Used prior to surgery

Answer 11

Danazol androgenic steroid

Leuprolide GnRH agonist

Question 12

Surgical for DUB

Answer 12

D&C
Endometrial ablation
Hysterectomy

Question 13

Prostaglandin F2a mediated uterine ischemia

Answer 13

Primary dysmenorrhea

NSAIDs and OCP

Question 14

MCC secondary dysmenorrhea

Answer 14

Endometriosis and adenomyosis

Question 15

Primary amenorrhea

Answer 15

14 w/o sec sexual characteristics

16 w/ sec sexual characteristics

Question 16

Secondary amenorrhea

Answer 16

3 months regular menses

6 months irregular menses

Question 17

Absent breast

Absent uterus

Answer 17

17,20 desmolase deficiency
17 a hydroxylase deficiency
Agonadism

Question 18

Absent breast

Present uterus

Answer 18

Hypogonadotropic hypogonadism
Dec GnRH FSH LH due to HP axis
Dec estrogen
Hypothalamic failure
Pituitary failure

Hypergonadotropic hypogonadism
Inc GnRH FSH LH due to lack of response of ovaries to LH and FSH
No estrogen
Gonadal failure

Question 19

Absent breast
Present uterus
FSH LH<5
CNS imaging: mass

Answer 19

CNS tumor
Pituitary failure
Hypo hypo

Question 20

Absent breast
Present uterus
FSH LH<5
CNS imaging: none
ANOSMIA

Answer 20

Kallman’s syndrome: gonadotropin deficiency
Hypothalamic failure
Hypo hypo
GnRH therapy

Question 21

Absent breast
Present uterus
FSH <40
Karyotyping 45XO

Answer 21

Turner’s syndrome streaky ovaries
Hyper hypo
Estrogen therapy

Question 22

Absent breast
Present uterus
FSH <40
Karyotyping 46XX
MOSAICISM

Answer 22

Premature Ovarian Failure <40 yo

Hyper hypo

Question 23

Absent breast
Present uterus
FSH <40
Karyotyping 46XX
RECEPTOR DEFECT

Answer 23

Savage syndrome

Hyper hypo

Question 48

Present breast | Normal utz of uterus

Answer 48

Outflow tract abnormality

Question 49

Bulging purplish red membranes Hematocolpos Pelvic and abdominal pain

Answer 49

Imperforate hymen | Cruciate incision

Question 50

Failure of Mullerian duct to fuse with urogenital sinus Hematocolpos Pelvic and abdominal pain

Answer 50

Transvaginal septum | Surgical correction

Question 51

Short vaginal pouch

Answer 51

Vaginal agenesis | Neovagina

Question 52

Present breasts Absent or abn uterus on utz 46XX Short vaginal pouch

Answer 52

Mullerian agenesis or Mayer Rokitansjy Kuster Hauser Syndrome Neovagina

Question 53

Present breasts Absent or abn uterus on utz 46XY N testosterone

Answer 53

Androgen Insensitivity

Question 54

Present breast Present uterus MCC

Answer 54

Hyperprolactinemia | Prolactinoma

Question 55

Stein Leventhal triad

Answer 55

Hirsutism Amenorrhea Obesity

Question 56

MC antecedent factor of Asherman's syndrome

Answer 56

Endometrial curettage

Question 57

Withdrawal bleeding within 7 days

Answer 57

Progesterone challenge | Anovulatory

Question 58

No withdrawal nleeding on progesterone challenge test Positive EPCT Negative EPCT

Answer 58

No estrogen low FSH HP failure high FSH ovarian failure Mechanical causes