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28 Cards in this Set
- Front
- Back
Define normal bleeding |
-duration < 7 days -flow < 80 mL/cycle (< 6 full tampons/pads day) -occurs approx every 21 days -no intermenstrual bleeding -no postcoital spotting |
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define Menorrhagia
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excessive or prolonged menses (>80ml OR >7 days) occuring at normal intervals |
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define metrorrhagia
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irregular episodes of uterine bleeding
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define Menometrorrhagia
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heavy and irregular bleeding
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define polymenorrhea
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abnormally frequent menses at intervals <24 days |
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T/F
Postmenopausal bleeding is always normal. |
FALSE
always ABNORMAL!! |
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T/F
You should give a pt that has a uterus estrogen only hormone replacement |
FALSE
because it increases the risk of endometrial cancer |
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what are the Risk factors for endometrial cancer? |
Obesity |
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what are the two sxs presented in a pt w/ endometrial cancer?
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abnormal vaginal bleeding |
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how do you diagnose endometrial cancer? who do you do it in? what is the gold standard? why? |
endometrial biopsy- sample endometrial tissue
transvaginal US- evaluate endometrial stripe |
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on abdominal/ transvaginal US, what are the three stripe thicknesses? what does each stripe mean? |
Stripe < 4mm |
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what are the complications of dilation and curettage for endometrial cancer? |
perforation of uterus
bleeding infection laceration of the cervix |
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what does Grade mean? Stage? |
grade is how differentiated it is ((1) well-->poor (3)) |
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what are the four patterns of spread of endometrial cancer? which one is MC?
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1. direct extension (through myometrium) *MC |
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how do you tx stage 1 endometrial Cancer?
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E-Lap w/ total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) |
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how do you tx stage 2 endometrial cancer?
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Same as Stage I if cervix grossly normal |
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what is the follow-up for pts w/ endometrial cancer post-op? |
every 3 months x 2yrs |
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what are the signs and sxs of PCOS? |
Presents at puberty |
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how do you tx PCOS? hirsutism in PCOS? insulin resistance? pts who want to concieve? |
PCOS: cyclic medroxyprogesterone- 10 mg for 10-12 days a month concieve: clomid |
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what would you see on EMB in chronic endometritis? what are the possible causes? how do you tx? |
plasma cells on EMB
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what are three other causes of bleeding besides chronic endometritis?
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fibroids, endometrial polyps, adenomyosis |
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What are the risk factors for Polys? |
inc estrogen Tamoxifen Obesity
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Polyps: Sx Dx Tx |
Sx: metrorrhagia or postmenopausal bleeding
dx: visual pelvic exam or pelvic ultrasounds
Tx: polypectomy (removal) (only tx if symptomatic) |
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Pt comes in complaining of menorrhagia (or dysmenorrhea) & chronic pelvic pain. During pelvic exam you notice an enlarged globular uterus. Dx? Tx? |
Adenomyosis
Tx: hysterectomy (if not done having children may try hormone, ablation, or UAE) |
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Adenomyosis risk factors |
parous history of prior uterine surgeries |
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Pt comes in complaining or menorrhagia, pelvic pain/pressure, and she cannot get pregnant (infertility). On pelvic ultrasound the uterus feels slightly asymmetric & you feel a mass underneath the surface. On PUS (pelvic ultrasound) you see multiple masses in the myometrium. Dx? TX? |
Leiomyoma (fibroids)
Tx: Hysterectomy, myomectomy (if still want to have kids), endometrial ablation, uterine artery embolization, or wait for menopause (will shrink) |
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Leiomyoma (fibroids) risk factors |
African american early mencharce (before age 10) red meat/ham beer |
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Young female pt comes in after second period & has to get a blood transfusion (menorrhagia). In past dental procedures she has had to stay after to wait for bleeding to stop & her gums bleed heavily after flossing. Dx? Tx? |
von Willebrand's Disease
Tx: Anti-Fibronolytic, OCP (shortens periods & reduces bleeding), desmopressin |