NM 701 EXAM 6 QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS VERIFIED LATEST UPDATE
P
- polyps
A
- adenomyosis
L
- leiomyomata / fibroids
- fibroids usually asymptomatic
M
- malignancy & hyperplasia
C
- coagulopathy
- usually bleeding d/o identified in teen yrs with heavy bleeding
or
- clotting d/o & taking heparin or warfarin
- NOT under I d/t cx being r/t clotting d/o
O
- ovulatory dysfunction
- hormone imbalances --> both excessive anovulatory bleeding & amenorrhea or
,oligomenorrhea --> such as PCOS, pit tumors (prolactinomas), thyroid d/o, amenorrhea
assoc w/ excessive exercise & min. body fat
E
- endometrial
- aka DUB (dysfunctional uterine bleeding)
- Dx of exclusion
- still ovulating
- has no coagulopathies, structural abnormalities --> NONE of PALM
- not taking meds that would cx AUB
I
- iatrogenic
- meds
or
- LNG-IUDs
N
- not yet classified
- catch all
- any other cxes not yet identified or unfinished work up --> ex: elderly woman awaiting
US
normal follicular phase & proliferative phase
- ovarian cycle --> lots follicles being produced & moderate estrogen levels
- uterine cycle --> rapid endometrium proliferation
normal ovulation & secretory phase
,- ovarian cycle --> high estrogen & LH surge & CL formed
- uterine cycle --> lots of progesterone to stablize endometrium cxing lots of vascular
normal luteal phase
- ovarian cycle --> follicle turns into CL producing progesterone & conts to keep
endometrium stable
end of normal menstrual cycle
- ovarian cycle --> CL degenerates producing less progesteron
- uterine cycle --> low progesterone cxes endometrium to become unstable cxing
menses to begin = uterus sloughing & constriction of spiral arteries cxing decreased
blood & O2 cxing cramping
anovulation
- AUB-O
- ovaries do not release egg during menstrual cycle = no ovulation
- very common --> particularly at extremes of reproductive yrs = teens immediately
postmenarche or perimenopause
- can be normal
anovulation menstrual cycle
- follicles making estrogen --> cxing endometrium to build up --> but --> NO ovulation =
NO CL = NO progesterone to keep endometrium stable --> cxing no orderly bleeding
b/c no degeneration of CL keeping things on schedule
anovulation hormones
- high sustained levels of unopposed estrogen = no progesterone
, woman with uterus & anovulation has what risk r/t unopposed estrogen & no
progesterone
- endometrial hyperplasia & CA --> just like if uterus & HT for menopause
anovulation & unpredictable sloughing of uterus & irregular bleeding r/t
- continuously proliferating, fragile endometrium that eventually outgrows it's blood
supply
anovulation & teens
- occurs d/t immature HPO axis --> that isn't yet ovulatory
- don't worry too much about unopposed estrogen d/t eventual ovulation & cycle
regularity
anovulation & perimenopausal
- occurs d/t irregular ovulation or no ovulation --> r/t declining ovarian function -->
ovarian follicles are not receptive to FSH
- physiologic related & no intervention needed unless becoming anemic or inconvience
by heavy bleeding
- do need to to worry about unopposed estrogen, endometrial hyperplasia, & CA
AUB & postmenopause
- any bleeding requires investigation for endometrial hyperplasia & malignancy
amenorrhea
- no period for 6 months
or
- no period for 3 of normal cycles
- would not wait this long to see someone
SOLUTIONS VERIFIED LATEST UPDATE
P
- polyps
A
- adenomyosis
L
- leiomyomata / fibroids
- fibroids usually asymptomatic
M
- malignancy & hyperplasia
C
- coagulopathy
- usually bleeding d/o identified in teen yrs with heavy bleeding
or
- clotting d/o & taking heparin or warfarin
- NOT under I d/t cx being r/t clotting d/o
O
- ovulatory dysfunction
- hormone imbalances --> both excessive anovulatory bleeding & amenorrhea or
,oligomenorrhea --> such as PCOS, pit tumors (prolactinomas), thyroid d/o, amenorrhea
assoc w/ excessive exercise & min. body fat
E
- endometrial
- aka DUB (dysfunctional uterine bleeding)
- Dx of exclusion
- still ovulating
- has no coagulopathies, structural abnormalities --> NONE of PALM
- not taking meds that would cx AUB
I
- iatrogenic
- meds
or
- LNG-IUDs
N
- not yet classified
- catch all
- any other cxes not yet identified or unfinished work up --> ex: elderly woman awaiting
US
normal follicular phase & proliferative phase
- ovarian cycle --> lots follicles being produced & moderate estrogen levels
- uterine cycle --> rapid endometrium proliferation
normal ovulation & secretory phase
,- ovarian cycle --> high estrogen & LH surge & CL formed
- uterine cycle --> lots of progesterone to stablize endometrium cxing lots of vascular
normal luteal phase
- ovarian cycle --> follicle turns into CL producing progesterone & conts to keep
endometrium stable
end of normal menstrual cycle
- ovarian cycle --> CL degenerates producing less progesteron
- uterine cycle --> low progesterone cxes endometrium to become unstable cxing
menses to begin = uterus sloughing & constriction of spiral arteries cxing decreased
blood & O2 cxing cramping
anovulation
- AUB-O
- ovaries do not release egg during menstrual cycle = no ovulation
- very common --> particularly at extremes of reproductive yrs = teens immediately
postmenarche or perimenopause
- can be normal
anovulation menstrual cycle
- follicles making estrogen --> cxing endometrium to build up --> but --> NO ovulation =
NO CL = NO progesterone to keep endometrium stable --> cxing no orderly bleeding
b/c no degeneration of CL keeping things on schedule
anovulation hormones
- high sustained levels of unopposed estrogen = no progesterone
, woman with uterus & anovulation has what risk r/t unopposed estrogen & no
progesterone
- endometrial hyperplasia & CA --> just like if uterus & HT for menopause
anovulation & unpredictable sloughing of uterus & irregular bleeding r/t
- continuously proliferating, fragile endometrium that eventually outgrows it's blood
supply
anovulation & teens
- occurs d/t immature HPO axis --> that isn't yet ovulatory
- don't worry too much about unopposed estrogen d/t eventual ovulation & cycle
regularity
anovulation & perimenopausal
- occurs d/t irregular ovulation or no ovulation --> r/t declining ovarian function -->
ovarian follicles are not receptive to FSH
- physiologic related & no intervention needed unless becoming anemic or inconvience
by heavy bleeding
- do need to to worry about unopposed estrogen, endometrial hyperplasia, & CA
AUB & postmenopause
- any bleeding requires investigation for endometrial hyperplasia & malignancy
amenorrhea
- no period for 6 months
or
- no period for 3 of normal cycles
- would not wait this long to see someone
