Menstrual Disorders Flashcards Preview

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Flashcards in Menstrual Disorders Deck (30):
1

What happens in the Follicular phase?

FSH stimulates pvarian follicle and granulosa cells to produce oestrogens raising oestrogen and inhibin by dominant follicles inhibit FSH production
Declining FSH levels cause atresia of but dominant follicle

2

What happens at ovulation?

Prior LH surge
Dominant follicle ruptures and release oocyte

3

What happens in the Luteal phase?

Formation of corpus luteum
Progesterone production
Luteolysis 14 days post-ovulation

4

What other 3 things happen at the luteal phase?

Progesterone-induced glandular secretory activity
Decidualisation in late secretory phase
Endometrial apoptosis and subsequent menstruation

5

What happens at the proliferative phase?

Oestrogen-induced growth of endometrial glands and stroma

6

What happens at menstruation?

Arteriolar constriction and shedding of functional endometrial layer
Fibrinolysis inhibits scar tissue formation

7

Describe menstrual loss

Usually lasts 4-6 days
Menstrual flow peaks at day 1-2
<80ml per menstruation
No clots

8

What is the normal menstrual cycle?

Average 28 day cycle
Between 21-35 day cycle
No IMB or PCB

9

What is Menorrhagia?

Prolonged and increased menstrual flow

10

What is Metorrhagia?

Regular intermenstrual bleeding

11

What is Polymenorrhoea?

Menses occuring at <21 day interval

12

What is Polymenorrhagia?

Increased bleeding and frequent cycle

13

What is Menometrorrhagia?

Prolonged menses and intramenstrual bleeding

14

What is Amenorrhoea?

Absence of menstruation >6 months

15

What is Oligomenorrhoea?

Menses at intervals of >35 days

16

What is the non-organic cause of menorrhagia called?

Dysfunctional uterine bleeding

17

What are the local disorders leading to organic menorrhagia?

There's loads, look at lectures

18

What endocrine disorders can cause organic menorrhagia?

Hyper/hypothyroidism
Diabetes mellitus
Adrenal disease
Prolactin disorders

19

What disorders of haemostasis can cause organic menorrhagia?

von Willebrand's disease
ITP
Factor II, V, VII and XI def

20

What drugs can cause organic menorrhagia?

Anticoagulants

21

What issues regarding pregnancy cause organic menorrhagia?

Miscarriage
Ectopic
Gestational trophoblastic disease
Postpartum haemorrhage

22

What are the two subcategories of Dysfunctional Uterine Bleeding?

Anovulatory
and
Ovulatory

23

Describe the Anovulatory Dysfunctional Uterine Bleeding?

85% of cases
Occurs at extremes of reproductive life
Irregular cycle
More common in obese women

24

Describe the ovulatory Dysfunctional Uterine Bleeding?

More common aged 35-45
Regular heavy periods
Due to inadequate progesterone production by corpus luteum

25

How do you investigate Dysfunctional Uterine Bleeding?

FBC
Cervical smear
TSH
Coagulation screen
Renal/Liver function tests
Transvaginal ultrasound

26

What would be seen on a transvaginal ultrasound scan of Dysfunctional Uterine Bleeding?

Endometrial thickness
Presence of fibroids and other pelvic masses

27

What would be looked for with endometrial sampling with Dysfunctional Uterine Bleeding?

Pipelle biopsies
Hysteroscopic directed
Dilation and cutterage

28

What are non-surgical therapies for Dysfunctional Uterine Bleeding?

Progestogens
Combined oral contraceptive pill
Danazol
GnRH analogues
NSAIDs
Anti-fibrolytics
Capillary wall stabilisers

29

What is surgical management of Dysfunctional Uterine Bleeding?

Transverse endometrial resection (TCRE)
Rollerball endometrial ablation (REA)
Bipolar mesh endometrial ablation (Novasure)
Thermal balloon ablation (Thermachoice)
Thermal hydroablation (Hydroblate)

30

What types of hysterectomy are available?

Sub-total
Total abdominal
Vaginal
LASH/LAVH/TLH