Normal/Abnormal uterine bleeding

Question 1

normal cycle interval is how many days?

Answer 1

21-38 days

Question 2

normal duration of flow

Answer 2

4.5-8 days

Question 3

normal amount of flow (in cc total)

Answer 3

5-80cc

Question 4

moliminal

Answer 4

PMS symptoms

Question 5

What increases which causes PMS symptoms?

Answer 5

progestrone

Question 6

acute uterine bleeding

Answer 6

any episode in nonpregnant, reproductive woman who has sufficient bleeding

Question 7

chronic uterine bleeding

Answer 7

bleeding present for 6 months or longer, abnormal in duration, volume and frequency

Question 8

heavy menstrual bleeding

Answer 8

blood loss that interferes with the physical, emotional, social, quality of life and that can occur alone or in combination with other symptoms

Question 9

prolonged menstrual bleeding

Answer 9

bleeding longer than 8 days

Question 10

shortened menstrual bleeding

Answer 10

bleeding shorter than 2 days

Question 11

light menstrual bleeding

Answer 11

reduced volume of bleeding from normal

Question 12

intermenstrual bleeding

Answer 12

bleeding that occurs between menstrual cycles. can be cyclic and predictable or follow no particular pattern

Question 13

PALM (classification for abnormal uterine bleeding)

Answer 13

Polys
Adenomyosis
Leiomyoma (at least 1 submuccosal myoma)
Malignancy and hyperplasia

Question 14

PALM refers to what kind of abnormalities?

Answer 14

structural

Question 15

COEIN refers structural or nonstructural abnormalities?

Answer 15

nonstructural abnormalities

Question 16

COEIN

Answer 16

Coagulopathy
Ovulatory Dysfunction
Endometrial
Iatrogenic
Not yet classified

Question 17

Malignancy/Hyperplasia are rare in which types of women?

Answer 17

reproductive aged women, women with normal BMI

Question 18

Which women are more at risk for Malignancy/Hyperplasia

Answer 18

obese, PCOS, African

Question 19

COEIN: Ovulatory disfunction includes which type of abnormal uterine bleeding?

Answer 19

Ovulatory, anovulatory and amenorrhea

Question 20

when does Ovulatory disfunction occur and is bleeding cyclic, noncylic? PMS symptoms?

Answer 20

occurs in peak reproductive years (period is already established), bleeding is cyclic, PMS symptoms present

Question 21

when does anovulatory dysfunction occur and is it cyclic, noncyclic? PMS symptoms?

Answer 21

occurs more towards end of reproductive age, noncyclic intervals, no PMS symptoms

Question 22

what underlying problems can cause ovulatory disfunction?

Answer 22

Thyroid issues, PCOS, excessive exercise, mental distress

Question 23

what underlying problems can cause anovulatory disfunction?

Answer 23

endometrial hyperplasia, lack of progrestrone in luteal phase (which leads to unstable endometrium)

Question 24

when is the best time to do a transvaginal US

Answer 24

day4-6 of menstraul cycle

Question 25

Sonohystogram

Answer 25

uses NS to visualize uterus better

Question 26

When do you do an Endometrial biopsy if >35 years old

Answer 26

uterine lining >4mm OR any abnormal bleeding.

Question 27

When do you do an Endometrial biopsy if <35 years old

Answer 27

morbid obesity, hx PCOS, chronic anovulation, if they take tamoxifen or at risk for endometrial ca

Question 28

which drugs help suppress the endometrium?

Answer 28

Depo, OC, merina IUD

Question 29

Tranexamic acid (Lysteda) and dosage

Answer 29

drug used to decrease prostaglandins in the uterus. The uterus comes out all at once rather than in pieces. take 2 tabs TIDx5 days

Question 30

Tranexamic acid (Lysteda) puts you at risk for?

Answer 30

blood clots

Question 31

how to correct prostaglandin imbalances?

Answer 31

NSAIDS, start first day of menses x3 days | can start 24 hours prior

Question 32

D and C vs endometrial ablation

Answer 32

D and C=mowing the grass, endometrial ablation=dig out the roots

Question 33

risk factors for endometrial ca

Answer 33

>=40 years old, anovulation, PCOS, bleeding after menopause, nulliparity, overweight, tamoxifen therapy,endometrial lining >4mm

Question 34

secondary amenorrhea

Answer 34

no menses for 3 previous cycles OR 6 months total

Question 35

primary amenorrhea

Answer 35

no menses by 14 AND absence of growth or development of secondary sexual characteristics no menses by 16 regardless of sexualcharacteristics

Question 36

disorders that can lead to amenorrhea involve which organs?

Answer 36

uterus ovaries pituitary hypothalmus

Question 37

primary amenorrhea causes

Answer 37

congenital malformations, testicular feminization, lower genital tract problems, hypergonadism, ovarian enzyme disorder

Question 38

secondary amenorrhea causes

Answer 38

ashermans syndrome (scarring from D and C), cervical stenosis, OC, hyperthyroidism/hypo, PCOS, pituitary tumor

Question 39

which meds can cause amenorrhea (secondary or primary)

Answer 39

Antipsychotics, cancer chemo, antidepressants, BP drugs, allergy meds

Question 40

Endometrial uterine bleeding is cyclic? noncyclic?

Answer 40

predictive, cyclic, heavy bleeding, may have intermenstraul bleeding