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Menstrual disorders Flashcards

1
Q

What is the menstrual cycle?

A

From first day of period to day before next period

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2
Q

What is normal for blood loss during period?

A

Less than 80 ml over 7 days

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3
Q

What is menarche?

A

The first menstrual cycle

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4
Q

What considered abnormal menstruation?

A 
Outwith:
24-38 days frequency
20 days variation in regularity in a 12 month period
2-8 days duration
5-80ml volume
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5
Q

What are some systemic causes of HMB?

A

Coagulation disorders like Willebrand disease
Hypothyroidism
Liver or renal disease

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6
Q

What are some iatrogenic causes of HMB?

A

Anticoagulant treatment
Ginseng, gingko, soya
IUD

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7
Q

How do herbal remedies like ginseng, gingko, soya affect menstruation?

A

Can cause irregularities by altering oestrogen levels

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8
Q

What are some uterine causes of HMB?

A 
Uterine fibroids
Endometrial polyps
Endometriosis
Adenomyosis
Pelvic inflammatory disease
Endometrial hyperplasia
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9
Q

Name an ovarian cause of HMB?

A

Polycystic ovary syndrome

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10
Q

How might fibroids present?

A 
May be asymptomatic
HMB
Pelvic pain
Urinary symptoms
Pressure
Backache
Infertility
Miscarriage
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11
Q

How are fibroids usually diagnosed?

A

Ultrasound

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12
Q

How are fibroids treated?

A

Fibroid embolisation or myomectomy for fertility preservation
Hysterectomy if fertility not a factor or medical treatment has declined

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13
Q

What is endometriosis?

A

Endometrial tissue present outside the lining of uterus

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14
Q

What are some symptoms of endometriosis?

A 
Painful menstrual cramps
Lower back pain
Pain during sex
Painful bowel movements and urination
Abnormal bleeding pattern
Diarrhoea, nausea, blotting
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15
Q

How is endometriosis diagnosed?

A

Pelvic exam
US
Diagnostic laparoscopy

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16
Q

What are some medical options to treat endometriosis?

A

Combined contraceptive pill
POP
Mirena IUS
GnRH analogues

17
Q

What are some surgical treatments for endometriosis?

A

Ablation
Hysterectomy
Endometrioma excision
Pelvic clearance

18
Q

What is adenomyosis?

A

Endometrium becomes embedded in myometrium

19
Q

How do endometrial polyps occur?

A

Overgrowth of endometrial lining can lead to formation of pediculated structures called polyps which extend into endometrium

20
Q

How are endometrial polyps diagnosed?

A

Ultrasound

Hysteroscopy

21
Q

What are some key tests to perform for management of HMB?

A

Clotting profile
Thyroid function
Laparoscopy

22
Q

What does tranexamic

acid do?

A

Antifibrinolytic

Reduces blood loss by 60%

23
Q

What does mefenamic acid do?

A

Prostaglandin inhibitor

Reduces blood loss 30% and pain

24
Q

Is mefenamic acid safe to use for those trying to conceive?

A

Yes

25
Q

How do LNG IUS and depo-provera affect menstruation?

A

Reduce bleeding

May cause irregular bleeding

26
Q

What are some pre-requisites for endometrial ablation?

A

Uterine cavity <11 cm long
Sub mucous fibroids <3cm
Normal endometrial biopsy

27
Q

What are the different degrees of hysterectomy?

A

Subtotal hysterectomy
Total hysterectomy
Total hysterectomy with bilateral salpingo-oophorectomy
Wertheim’s hysterectomy

28
Q

What is salpingo-oophorectomy?

A

Removal of tubes and ovaries

29
Q

What is a drawback of salpingo-oophorectomy?

A

Immediate menopause

30
Q

What is oligomenorrhoea?

A

Irregular and inconsistent menstruation

31
Q

What is dysfunctional uterine bleeding?

A

Excessive uterine bleeding affecting premenopausal women that is not due to pregnancy or any recognisable uterine or systemic diseases

Reproduction (25 decks)

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