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Menstrual problems Flashcards

1
Q

What is the average age of menarche?

A

13-14

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2
Q

What is the average age of menopause?

A

51

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3
Q

What is a period triggered by?

A

Fall in progesterone 2 weeks after ovulation if not pregnant

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4
Q

What is the average blood loss during a period?

A

30-40ml

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5
Q

What is a subtotal hysterectomy?

A

Take uterus, but leave cervix

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6
Q

What is a total hysterectomy?

A

Take entire uterus

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7
Q

What is a total hysterectomy with BSO?

A

Take uterus, fallopian tubes and ovaries

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8
Q

What is a Wertheim’s hysterectomy?

A

Take uterus with margins, fallopian tubes and ovaries

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9
Q

What is recommended if removing the ovaries?

A

HRT until age 50

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10
Q

What are the risks of a hysterectomy?

A 
Infection
DVT
Bladder, bowel or vessel injury
Altered bladder function
Adhesions
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11
Q

What should be asked in abhistory with menstrual problems?

A

Clots, flooding, how often changing
Pain
Effect on lifestyle and quality of life

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12
Q

What examinations should be done with menstrual problems?

A

General
Abdo
Bimaual
Speculum

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13
Q

What investigations should be done for heavy periods?

A

FBC
Thyroid function and coagulation if history suggestive
Endometrial biopsy if >45, persistent IMB or obesity

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14
Q

What should be tested for with inter menstrual bleeding and post coital bleeding?

A

Chlamydia

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15
Q

When should a hysteroscopy be carried out?

A

Persistent IMB

Suspected endometrial pathology on US

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16
Q

What are the common causes of menstrual problems in early teens?

A

Anovulatory cycles

Coagulation problems

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17
Q

What are the common causes of menstrual problems in teens-40 yo?

A 
Chlamydia
Contraception related
Endometriosis
Adenomyosis
Fibroids
Endometrial/cervical polyps
Dysfunctional bleeding
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18
Q

What are the common causes of menstrual problems from 40 to the menopause?

A 
Chlamydia
Contraception related
Endometriosis
Adenomyosis
Fibroids
Endometrial/cervical polyps
Dysfunctional bleeding
Perimenopausal an ovulation
Endometrial cancer
Warfarin
Thyroid dysfunction
19
Q

What is dysfunctional uterine bleeding?

A

Abnormal bleeding without known structural, endocrine, neoplastic or infectious cause

20
Q

What is the treatment of dysfunctional uterine bleeding?

A

Reassure
Hormonal- progestogen, Mirena, combined OCP
Non hormonal- tranexamic acid, medanamic acid
Surgical- endometrial ablation, hysterectomy

21
Q

What does tranexamic acid do?

A

Reduces blood loss

22
Q

What does medanamic acid do?

A

Reduced blood loss and pain

23
Q

What is endometriosis?

A

Endometrial type tissue outside uterine cavity

Oestrogen dependent chronic condition

24
Q

Where is endometriosis usually found?

A

Ovary

Pouch of Douglas, pelvic peritoneum

25
Q

What are the signs and symptoms of endometriosis?

A 
Asymptomatic
Premenstrual pelvic pain
Dysmennorhoea 
Deep dyspareunia 
Subfertility
Tender nodules in rectovaginal septum
Limited uterine mobility
Adnexal mass
26
Q

What investigations are done for endometriosis?

A

Laprascopy
MRI for deep disease
US

27
Q

What is the medical treatment of endometriosis?

A

Progestogen
Combined OCP
GnRH analogues

28
Q

What are the surgical treatment options of endometriosis?

A

Excision of deposits
Diathermy/laserablation of deposits
Removal of ovaries with or without hysterectomy

29
Q

What is adenomyosis?

A

Endometrial tissue in myometrium

30
Q

Who is adenomyosis usually sen in?

A

Parous women

31
Q

What are the signs and symptoms of adenomyosis?

A

Heavy, painful periods

Bulky, tender uterus

32
Q

What investigations are done for adenomyosis?

A

MRI

Histology of uterine muscle

33
Q

What is the treatment of adenomyosis?

A

Hormonal- Mirena, progestogens, combined OCP

Hysterectomy

34
Q

What are the types of fibroids?

A

Submucosal- protrude into uterine cavity
Intramural- within uterine wall
Sub serous- project unto peritoneal cavity

35
Q

What are the signs and symptoms of fibroids?

A

Asymptomatic
Pressure symptoms
Menorrhagia
Intermenstrual bleeding

36
Q

What are the signs and symptoms of fibroids in pregnancy?

A

Pain
Malpresentation
Obstruction

37
Q

What investigations are done for fibroids?

A

EXamination
US
Hysteroscopy if inside uterine cavity

38
Q

When are fibroids treated?

A

If symptomatic

39
Q

What are the treatment options for fibroids?

A 
Hormonal
GnRH analogues or ulipristal acetate
Transcervical resection
Myomectomy
Uterine artery embolisation 
Hysterectomy
40
Q

WHt is the use of GnRH analogues and ulipristal acetate in fibroids?

A

Shrink fibroids preoperatively

41
Q

Ammonorrhea causes

A 
Life change (stress, eating disorders, obesity, intense exercise)
Hormonal issues
Primary ovarian insufficiency
Polycystic ovarian syndrome
Hyperprolactineamia
Prolactinomas
Thyroid disorders
Uterine, cervical and/or vaginal blockages
42
Q

What is PALM COEIN?

A

Polyps
Adenomyosis
Leiomyoma
Malignancy

Coagulopathy
Ovulatory disorder
Endometrial dysfunction
Iatrogenic
Not known
43
Q

Mesonephric duct cyst names

A

Epoophoron - under ovary
Paraoophoron - next to ovary
Gartners cyst - close to vagina

44
Q

Paramesonephric duct abnormalities

A 
Duplication
Improper fusion
Bicornate uterus
Septate uterus
Arcuate uterus

Reproduction (29 decks)

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