NU 664D EXAM 2 QUESTIONS AND
CORRECT ANSWERS
what is the normal volume and characteristics of menstrual blood ANSW✅✅changing pad every 3
hours, seldom change at night, clots less than 1 inch, not anaemic
what is PALM-COEIN? ANSW✅✅classification for abnormal uterine bleeding (heavy menstrual
bleeding, inter menstrual bleeding)
what is PALM and what do they stand for? ANSW✅✅structural causes of uterine bleeding;
Polyp
Adenomyosis
Leiomyoma
Malignancy and hyperplasia
what is COEIN and what do they stand for? ANSW✅✅nonstructural causes of uterine bleeding;
Coagulopathy
Ovulatory dysfunction
Endometrial dysfunction
Iatrogenic: meds, IUD, contraception
Not yet classified: infections
how do people with obesity have an increased risk of heavy bleeding? ANSW✅✅causes
overstimulation of the endometrium
how do we treat acute excessive uterine bleeding? ANSW✅✅tapered progesterone: progestin 10
mg three times per day until bleeding stops and then twice daily for 5 days and every day for 5 days
what is the dose for TXA treatment? ANSW✅✅lysteda 650 mg three times per day
meds that cause hyperprolactinemia ANSW✅✅antipsychotics, antidepressants, opiates,
antihypertensive agents, GI meds, chronic cannabis
, normal menstrual volume ANSW✅✅5-80 ml
what happens during follicular phase ANSW✅✅1. hypothalamus releases gonadotropin releasing
hormone
2. anterior pituitary releases FSH and LH
3. follicles start developing,
4. estrogen increases
5. one follicle dominates and produces more estrogen (other follicles go through atresia)
6. estrogen and LH levels peak 24 hrs before ovulation
7. ovulation occurs
when does the luteal phase begin ANSW✅✅with ovulation
what happens in the luteal phase ANSW✅✅1. shift from estrogen to progesterone dominance
2. follicle ruptures
3. corpus luteum forms
4. progesterone is produced
5. the follicle ceases growth and endometrium secretes
how long is the luteal phase? ANSW✅✅14 days (14-28)
how long/when is follicular phase ANSW✅✅days 1 - 14
what triggers end of luteal phase and beginning of menses? ANSW✅✅drop in progesterone (and
estrogen too but less important)
what phase of the uterine cycle corresponds with the follicular phase of the ovarian cycle?
ANSW✅✅proliferative phase same time as follicular phase
CORRECT ANSWERS
what is the normal volume and characteristics of menstrual blood ANSW✅✅changing pad every 3
hours, seldom change at night, clots less than 1 inch, not anaemic
what is PALM-COEIN? ANSW✅✅classification for abnormal uterine bleeding (heavy menstrual
bleeding, inter menstrual bleeding)
what is PALM and what do they stand for? ANSW✅✅structural causes of uterine bleeding;
Polyp
Adenomyosis
Leiomyoma
Malignancy and hyperplasia
what is COEIN and what do they stand for? ANSW✅✅nonstructural causes of uterine bleeding;
Coagulopathy
Ovulatory dysfunction
Endometrial dysfunction
Iatrogenic: meds, IUD, contraception
Not yet classified: infections
how do people with obesity have an increased risk of heavy bleeding? ANSW✅✅causes
overstimulation of the endometrium
how do we treat acute excessive uterine bleeding? ANSW✅✅tapered progesterone: progestin 10
mg three times per day until bleeding stops and then twice daily for 5 days and every day for 5 days
what is the dose for TXA treatment? ANSW✅✅lysteda 650 mg three times per day
meds that cause hyperprolactinemia ANSW✅✅antipsychotics, antidepressants, opiates,
antihypertensive agents, GI meds, chronic cannabis
, normal menstrual volume ANSW✅✅5-80 ml
what happens during follicular phase ANSW✅✅1. hypothalamus releases gonadotropin releasing
hormone
2. anterior pituitary releases FSH and LH
3. follicles start developing,
4. estrogen increases
5. one follicle dominates and produces more estrogen (other follicles go through atresia)
6. estrogen and LH levels peak 24 hrs before ovulation
7. ovulation occurs
when does the luteal phase begin ANSW✅✅with ovulation
what happens in the luteal phase ANSW✅✅1. shift from estrogen to progesterone dominance
2. follicle ruptures
3. corpus luteum forms
4. progesterone is produced
5. the follicle ceases growth and endometrium secretes
how long is the luteal phase? ANSW✅✅14 days (14-28)
how long/when is follicular phase ANSW✅✅days 1 - 14
what triggers end of luteal phase and beginning of menses? ANSW✅✅drop in progesterone (and
estrogen too but less important)
what phase of the uterine cycle corresponds with the follicular phase of the ovarian cycle?
ANSW✅✅proliferative phase same time as follicular phase
