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Flashcards in AUB Deck (21)
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1
Q

what percentage of gyn office visits are for AUB?

A

33%

2
Q

What’s the prevalence of AUB in women 18-50?

A

53/100

3
Q

what is the epi of AUB?

A

bimodal adolescents and women greater than 40

4
Q

Bleeding Patterns Slide

A

*Note that menorrhagia replaced with HMB

5
Q

What is the FIGO classification system for AUB?

A

PALM - polyp, adenomyosis, leimyoma, malignancy (and hyperplasia)

COEIN - coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, Not Yet Classified

6
Q

What should you check for in the AUB patient first?

A

hemodynamic stability - hemorrhagic shock

7
Q

what should you suspect first in the postmenopausal patient with AUB?

A

endometrial cancer

8
Q

what should you suspect first in the pregnant patient with AUB?

A

ectopic pregnancy

9
Q

What history components are important in AUB?

A

LMP, cycle length, duration, flow

pads used/day (*RF - 2 or more pads/hour for >2 hours)

OB Hx

Sexual Hx

Medication use (anticoags, OCP)

Identification of risk factors for endometrial cancer

10
Q

What labs do you want in a woman with AUB?

A

B-HCG

CBC w/platelets

wet mount

GC/Chlamydia

TSH

PT/PTT

11
Q

what imaging studies allow you to diagnose and treat AUB?

A

hysteroscopy

laproscopy

12
Q

What is pelvic u/s (transvaginal and abd) best for in AUB?

A

uterine disorders

ovarian cysts/neoplasms

endometrial lining thickness or abnormalities

13
Q

What’s the advantage of a sonohysterogram?

A

better visualization of endometrial lining and polyps

14
Q

how do you perform an endometrial biopsy?

A

office-based procedure where speculum is instered and then suction catheter is psuhed through the os to obtain a sample of the endometrium

15
Q

what is a hysterosalpingogram?

A

x-ray of uterus and fallopian tubes using fluroscopy to evaluate patency and architecture of fallopian tubes

It is diagnostic AND THERAPUETIC

16
Q

what are the characteristics of endometrial polyps?

A

hyperplastic overgrowth of endometrial lining that projects from the endometrium

  • usually <1cm
  • mc in women >50 y.o.
  • 95% benign (malignancy highest in post-menopausal women)
  • hormonal influence (estrogen, progesterone)
17
Q

what are the symptoms of endometrial polyps?

A

intermenstrual bleeding

post-coital bleeding

post-menopausal bleeding

18
Q

what should you do with symptomatic endometrial polyps?

A

remove them

19
Q

what should you do with asymptomatic endometrial polyps?

A

remove if they are >1.5 cm in diameter, or there multiple polyps, prolapsed through the cervix, infertility

20
Q

what is adenomyosis?

A

barrier break between endometrium and myometrium, with endometrial cells invade the myometrium

21
Q
A