p.48
Secondary Amenorrhea Causes
What diagnostic methods are used for secondary dysmenorrhea?
Pelvic sonogram and laparoscopy.
p.84
Menopause: Symptoms and Management
How is menopause defined?
No menstrual cycle for 1 year.
p.91
Hormone Replacement Therapy (HRT) Risks and Benefits
What are the most common symptoms treated by Hormone Replacement Therapy (HRT) during menopause?
Hot flushes and vaginal dryness.
p.80
Menopause: Symptoms and Management
What is a rectocele?
Herniation of the rectum into the posterior wall of the vagina.
p.61
Menstrual Cycle Overview
How is PMS usually diagnosed?
PMS is usually diagnosed clinically.
p.15
Primary Amenorrhea Causes
What is the likely physical exam finding in a 14-year-old girl with an XY karyotype who has not had menarche?
Underdeveloped female external genitalia
p.85
Menopause: Symptoms and Management
What changes in menstrual flow are associated with perimenopause?
Change in amount or duration of menstrual flow.
p.79
Menstrual Cycle Overview
What are some lifestyle changes that can help reduce the symptoms of PMS or PMDD?
Regular exercise, a balanced diet, adequate sleep, stress management techniques, and reducing caffeine and alcohol intake.
p.72
Polycystic Ovary Syndrome (PCOS)
During which phase of the menstrual cycle is a transvaginal ultrasound typically performed to diagnose PCOS?
During the follicular phase of the menstrual cycle.
p.26
Abnormal Uterine Bleeding: Definitions and Causes
What receptors are found in leiomyomas?
Estrogen and progesterone receptors.
p.2
Hormonal Regulation: FSH and LH
What are the two main functions of FSH in the menstrual cycle?
FSH causes the egg to mature and promotes estrogen secretion.
p.80
Menopause: Symptoms and Management
What is a cystocele?
Prolapse of the bladder into the anterior wall of the vagina.
p.91
Hormone Replacement Therapy (HRT) Risks and Benefits
What are the current indications for starting HRT?
Significant hot flashes and vaginal dryness within 5 years of cessation of menses, and no family history of cancer.
p.47
Abnormal Uterine Bleeding: Definitions and Causes
What are some symptoms of secondary dysmenorrhea besides pelvic pain?
Infertility and dyspareunia (painful intercourse).
p.49
Endometriosis: Diagnosis and Management
What are some risk factors for developing endometriosis?
Family history, early menarche, long menstrual flow each month, and heavy menses.
p.56
Abnormal Uterine Bleeding: Definitions and Causes
What is the most likely finding on physical exam for a 41-year-old female with intermittent vaginal bleeding for 3 months?
a) Enlarged, irregular uterus
p.87
Menopause: Symptoms and Management
What are common signs of menopause?
Decreased size of uterus and ovaries, and breasts.
p.91
Hormone Replacement Therapy (HRT) Risks and Benefits
Besides treating hot flushes and vaginal dryness, what other conditions can HRT help prevent?
Osteoporosis and colon cancer.
p.51
Endometriosis: Diagnosis and Management
What are the three components of the classic triad of endometriosis?
Dysmenorrhea, dyspareunia, and infertility.
p.7
Primary Amenorrhea Causes
What happens in hypothalamic-pituitary dysfunction when GnRH is produced but the pathway is blocked?
Tumors or destruction of the transport path or pulsation mechanism can block the pathway.
p.66
Polycystic Ovary Syndrome (PCOS)
What are nonfunctional ovarian cysts?
Cysts that do not arise from normal ovarian function and are not neoplastic.
p.66
Endometriosis: Diagnosis and Management
How are endometriomas typically managed?
Through surgical incision.
p.47
Abnormal Uterine Bleeding: Definitions and Causes
What is secondary dysmenorrhea?
Excessive menstrual pain arising in mid-reproductive years, usually pathologic.
p.80
Menopause: Symptoms and Management
What is uterine prolapse?
Prolapse of the uterus down the vaginal canal.
p.72
Polycystic Ovary Syndrome (PCOS)
What are the characteristic appearances of ovaries in PCOS on a sonogram?
Ovaries appear enlarged with smooth, pearl-white surfaces without indentations, often described as 'oyster ovaries' or 'string of pearls'.
What are some common disorders found in younger individuals aged 4 to 8?
The text does not specify, but common disorders in this age group can include ADHD, autism spectrum disorders, and learning disabilities.
p.87
Menopause: Symptoms and Management
What are some late changes associated with menopause?
Osteoporosis and cardiovascular disease.
p.61
Menstrual Cycle Overview
What aspects of a patient's history are important for diagnosing PMS?
Current medications, history of mental disorders, and history of substance abuse.
p.61
Menstrual Cycle Overview
How can the cyclic pattern of PMS be determined?
By using a menstrual diary or app.
p.7
Primary Amenorrhea Causes
What is the most common cause of hypothalamic-pituitary dysfunction leading to primary amenorrhea?
Abnormal GnRH production with no pathology.
p.46
Menstrual Cycle Overview
What alternative treatments might help with primary dysmenorrhea?
Vitamin B or magnesium supplements, and acupuncture.
p.70
Polycystic Ovary Syndrome (PCOS)
What aspects of a patient's history are important for diagnosing PCOS?
History of onset/duration of signs, menstrual history, and history of infertility.
p.30
Abnormal Uterine Bleeding: Definitions and Causes
Why is breast cancer not considered a gynecological cancer?
Because it can affect men as well.
p.85
Menopause: Symptoms and Management
What is a common pattern in menstrual periods during perimenopause?
Skipping menstrual periods.
p.63
Pharmacotherapy for PMDD
Name two SSRIs commonly used for PMDD.
Fluoxetine (Prozac) and sertraline (Zoloft).
p.43
Abnormal Uterine Bleeding: Definitions and Causes
What are the primary goals in managing abnormal uterine bleeding?
Control current bleeding and reduce loss in subsequent cycles.
p.62
Menstrual Cycle Overview
What are some lifestyle management strategies for premenstrual syndrome (PMS)?
Stress management, exercise, yoga, regular sleep, and dietary changes.
p.86
Menopause: Symptoms and Management
What vaginal symptom is commonly associated with menopause?
Decreased vaginal lubrication.
p.69
Polycystic Ovary Syndrome (PCOS)
What is a potential reproductive consequence of hormone irregularity in PCOS?
Recurrent spontaneous abortion.
p.21
Abnormal Uterine Bleeding: Definitions and Causes
What is the most common type of abnormal uterine bleeding (AUB)?
Heavy menstrual bleeding.
p.58
Menstrual Cycle Overview
What is Premenstrual Syndrome (PMS)?
PMS is a group of symptoms that occur in women, typically between ovulation and a period. Symptoms can include mood swings, tender breasts, food cravings, fatigue, irritability, and depression.
p.25
Abnormal Uterine Bleeding: Definitions and Causes
What are the treatment options for adenomyosis?
Oral contraceptives, endometrial ablation, and hysterectomy.
p.1
Menstrual Cycle Overview
What is the normal frequency range of the menstrual cycle?
24 - 38 days, with an average of 28 days.
p.16
Secondary Amenorrhea Causes
How can thyroid dysfunction affect menstruation?
It can cause secondary amenorrhea.
p.42
Abnormal Uterine Bleeding: Definitions and Causes
Which blood tests are included in the lab workup for abnormal uterine bleeding?
CBC, type and screen, TSH, Luteinizing hormone, prolactin.
p.52
Endometriosis: Diagnosis and Management
What is a classic finding in the physical exam for diagnosing endometriosis?
Retroverted uterus with uterosacral ligament nodularity.
p.57
Abnormal Uterine Bleeding: Definitions and Causes
What did the cervical exam reveal in the case of the 41-year-old female with intermittent vaginal bleeding?
A dark red lesion coming out of the os.
p.72
Polycystic Ovary Syndrome (PCOS)
What imaging technique is commonly used for diagnosing PCOS?
Sonogram (transvaginal ultrasound).
p.26
Abnormal Uterine Bleeding: Definitions and Causes
What type of tumor is a leiomyoma?
A benign smooth muscle tumor.
p.46
Menstrual Cycle Overview
What is the first line of treatment for primary dysmenorrhea?
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs).
p.26
Abnormal Uterine Bleeding: Definitions and Causes
In which demographic are leiomyomas most commonly found?
Multiparous individuals in their 40s.
What causes a rectocele?
A rectocele is often caused by childbirth, heavy lifting, chronic constipation, or other activities that put strain on the pelvic floor muscles.
How is a rectocele diagnosed?
A rectocele is diagnosed through a pelvic exam, and sometimes imaging tests like MRI or ultrasound may be used for further evaluation.
p.22
Abnormal Uterine Bleeding: Definitions and Causes
What conditions are represented by the 'PALM' part of the PALM-COEIN classification?
'PALM' stands for Polyp, Adenomyosis, Leiomyoma, and Malignancy and hyperplasia.
p.93
Menopause: Symptoms and Management
What are some alternative treatments for vaginal dryness during menopause?
Commercial lubricants (e.g., K-Y) and topical estrogen.
p.68
Polycystic Ovary Syndrome (PCOS)
What menstrual pattern is observed in patients with PCOS?
Normal menses followed by episodes of amenorrhea that become progressively longer.
p.35
Abnormal Uterine Bleeding: Definitions and Causes
How can hormone replacement therapy in menopause lead to abnormal uterine bleeding?
It can cause iatrogenic abnormal uterine bleeding.
p.76
Polycystic Ovary Syndrome (PCOS)
What is the third-line treatment for inducing pregnancy in women with PCOS?
Metformin (alone or with clomiphene citrate), which increases ovulation and pregnancy rates and improves insulin sensitivity.
p.62
Menstrual Cycle Overview
What role does exercise play in managing premenstrual syndrome (PMS)?
Exercise can help alleviate PMS symptoms by improving mood and reducing stress.
p.92
Hormone Replacement Therapy (HRT) Risks and Benefits
Why is liver dysfunction or disease an absolute contraindication to HRT?
Because the liver metabolizes hormones, and dysfunction can lead to improper hormone processing and increased risk of side effects.
p.58
Menstrual Cycle Overview
How do the symptoms of PMS and PMDD differ?
While both PMS and PMDD include physical and emotional symptoms, PMDD symptoms are more severe and can significantly interfere with daily life and relationships.
p.50
Endometriosis: Diagnosis and Management
Name three common locations where endometriosis lesions can be found.
Ovary, cul-de-sac, and broad ligaments.
p.89
Menopause: Symptoms and Management
What is Hormone Replacement Therapy (HRT) used for?
HRT is used for the management of menopause symptoms.
p.64
Polycystic Ovary Syndrome (PCOS)
Do many benign ovarian cysts resolve on their own?
Yes, many resolve spontaneously.
p.40
Abnormal Uterine Bleeding: Definitions and Causes
What should you look for during the physical examination for abnormal uterine bleeding?
Growths/masses and trauma to the area.
p.68
Polycystic Ovary Syndrome (PCOS)
What is the #1 cause of androgen excess and hirsutism?
Polycystic Ovarian Syndrome (PCOS).
What are the potential complications of ovarian torsion?
Occlusion of blood supply leading to necrosis, peritonitis, loss of ovary, and fertility.
p.63
Pharmacotherapy for PMDD
Which supplements are mentioned as part of PMDD treatment?
Calcium, B6, magnesium, and St. John’s wort.
p.81
Abnormal Uterine Bleeding: Definitions and Causes
How is a cystocele typically diagnosed?
A cystocele is typically diagnosed through a pelvic exam and may be confirmed with imaging tests like a cystourethrogram.
p.27
Abnormal Uterine Bleeding: Definitions and Causes
What is a subserous leiomyoma?
A type of leiomyoma that deforms the external serosa.
p.35
Abnormal Uterine Bleeding: Definitions and Causes
What are the most common symptoms of iatrogenic abnormal uterine bleeding?
Spotting and intermittent bleeding.
p.62
Menstrual Cycle Overview
How can light therapy be beneficial for premenstrual syndrome (PMS)?
Light therapy can help improve mood and reduce PMS symptoms.
p.20
Abnormal Uterine Bleeding: Definitions and Causes
What are some causes of metrorrhagia?
Endometrial polyps, endometrial/cervical carcinoma, oral contraceptives.
p.17
Secondary Amenorrhea Causes
What are the symptoms of thyroid dysfunction that can lead to secondary amenorrhea?
Weight loss or gain, sleeping irregularity.
p.17
Secondary Amenorrhea Causes
What can cause secondary amenorrhea due to hypothalamic-pituitary-ovarian feedback system disruption?
Weight loss, eating disorder, excessive exercise.
p.54
Endometriosis: Diagnosis and Management
What is Leuprolide and how is it used in endometriosis management?
Leuprolide is a GnRH agonist administered IM or nasally every 3 months to create a pseudomenopause state.
p.10
Primary Amenorrhea Causes
What reproductive structures are absent in Mullerian Dysgenesis?
The uterus and the upper 2/3 of the vagina.
p.73
Polycystic Ovary Syndrome (PCOS)
What is a common sonogram finding in the diagnosis of Polycystic Ovary Syndrome (PCOS)?
A 'string of pearls' appearance.
p.8
Primary Amenorrhea Causes
How does increased prolactin affect the menstrual cycle in the context of primary amenorrhea?
Increased prolactin stops the normal feedback system.
p.66
Endometriosis: Diagnosis and Management
What is an endometrioma?
A unilateral hemorrhagic or 'chocolate cyst' that is a type of nonfunctional ovarian cyst.
p.89
Hormone Replacement Therapy (HRT) Risks and Benefits
What is the risk associated with using estrogen alone in HRT?
Using estrogen alone increases the risk of endometrial cancer.
p.47
Abnormal Uterine Bleeding: Definitions and Causes
What type of pain is associated with secondary dysmenorrhea?
Pelvic pain that is dull and aching, related to the menstrual cycle but timing depends on the cause.
p.40
Abnormal Uterine Bleeding: Definitions and Causes
What should you consider in the patient's history when diagnosing abnormal uterine bleeding?
Age, sexual history, risk factors, good menstrual history, and other bleeding history.
p.26
Abnormal Uterine Bleeding: Definitions and Causes
What symptom is commonly associated with leiomyomas?
Heavy and/or prolonged bleeding.
p.67
Polycystic Ovary Syndrome (PCOS)
What does anovulation refer to in the context of PCOS?
The absence of ovulation.
What is ovarian torsion?
Ovarian torsion is when the ovary flips on the fallopian tube.
What are common symptoms of a rectocele?
Common symptoms include a feeling of pressure or fullness in the rectum or vagina, difficulty with bowel movements, and discomfort during sexual intercourse.
p.67
Polycystic Ovary Syndrome (PCOS)
What characterizes polycystic ovaries in PCOS?
The presence of multiple cysts in the ovaries.
What are the most common causes of ovarian torsion?
Most commonly due to a cyst or neoplasm, but sometimes idiopathic, especially in premenarchal girls (10-15 years old).
p.65
Polycystic Ovary Syndrome (PCOS)
What are the characteristics of follicular cysts?
They are unilateral and typically resolve within 60 days.
p.22
Abnormal Uterine Bleeding: Definitions and Causes
What does the acronym PALM-COEIN stand for in the context of abnormal menstrual bleeding etiology?
PALM-COEIN stands for Polyp, Adenomyosis, Leiomyoma, Malignancy and hyperplasia, Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, and Not yet classified.
p.6
Primary Amenorrhea Causes
What type of dysfunction is associated with primary amenorrhea related to the brain's regulatory centers?
Hypothalamic-pituitary dysfunction.
p.75
Polycystic Ovary Syndrome (PCOS)
How does PCOS affect the risk of miscarriage during pregnancy?
PCOS increases the risk of miscarriage.
p.2
Hormonal Regulation: FSH and LH
What are the two main functions of LH in the menstrual cycle?
LH causes the egg to be released and regulates estrogen and progesterone secretion.
p.87
Menopause: Symptoms and Management
What conditions can result from weakened pelvic floor muscles during menopause?
Cystocele, rectocele, and uterine prolapse.
p.57
Abnormal Uterine Bleeding: Definitions and Causes
What are the characteristics of the vaginal bleeding described by the 41-year-old female?
Intermittent vaginal bleeding for 3 months, regular cycles with average flow for 4 days, and random spotting.
p.89
Hormone Replacement Therapy (HRT) Risks and Benefits
Which hormones are commonly used together in Hormone Replacement Therapy (HRT)?
Estrogen and Progesterone.
p.47
Abnormal Uterine Bleeding: Definitions and Causes
What are some common causes of secondary dysmenorrhea?
Endometriosis, pelvic adhesions, fibroids, and polyps.
p.80
Menopause: Symptoms and Management
How common are cystocele, rectocele, and uterine prolapse after menopause?
They are common, occurring in about 50% of postmenopausal women.
p.34
Abnormal Uterine Bleeding: Definitions and Causes
What are the nonstructural causes of AUB related to the endometrium?
Infection and inflammation.
p.61
Menstrual Cycle Overview
What lab tests are commonly conducted when diagnosing PMS?
CBC, basic chemistry, and TSH.
p.28
Abnormal Uterine Bleeding: Definitions and Causes
What are common symptoms of leiomyomas?
Abnormal menstrual bleeding, pain, pressure, and infertility.
p.67
Polycystic Ovary Syndrome (PCOS)
Who first described Polycystic Ovary Syndrome (PCOS) and when?
Stein and Leventhal in 1935.
p.67
Polycystic Ovary Syndrome (PCOS)
What are the three components of the classic triad of PCOS?
Anovulation, Polycystic ovaries, Androgen excess (hyperandrogenism).
p.51
Endometriosis: Diagnosis and Management
What type of backache is associated with dysmenorrhea in endometriosis?
Low sacral backache premenstrually that resolves with menses.
p.45
Menstrual Cycle Overview
What is primary dysmenorrhea?
Primary dysmenorrhea is menstrual pain without a pathologic cause.
p.85
Menopause: Symptoms and Management
How does the menstrual cycle length change during perimenopause?
There is a change in the length of the menstrual cycle.
p.45
Menstrual Cycle Overview
When is primary dysmenorrhea most common?
It is most common within 2 years of menarche but can occur at any age.
p.65
Polycystic Ovary Syndrome (PCOS)
How are functional ovarian cysts diagnosed?
Using a sonogram that shows mobile, simple, fluid-filled cysts.
p.63
Pharmacotherapy for PMDD
What type of medication is generally used for PMDD pharmacotherapy?
Nonsteroidal anti-inflammatory drugs (NSAIDs).
p.65
Polycystic Ovary Syndrome (PCOS)
What is the initial management strategy for functional ovarian cysts?
Observation for 30-60 days.
p.71
Polycystic Ovary Syndrome (PCOS)
Which test is preferred for assessing insulin resistance in PCOS diagnosis?
Oral glucose tolerance test.
p.45
Menstrual Cycle Overview
What are the findings on a physical exam for someone with primary dysmenorrhea?
The physical exam is normal.
p.75
Polycystic Ovary Syndrome (PCOS)
How does PCOS influence the likelihood of developing preeclampsia during pregnancy?
PCOS increases the risk of preeclampsia.
p.49
Endometriosis: Diagnosis and Management
What is endometriosis?
Endometriosis is the presence of endometrial tissue outside the uterine cavity.
p.7
Primary Amenorrhea Causes
What are some causes of hypothalamic-pituitary insufficiency leading to primary amenorrhea?
Eating disorders, extreme weight loss (anorexia), excessive exercise (The Female Triad), stress, and idiopathic causes.
p.7
Primary Amenorrhea Causes
What physical characteristics might be observed in individuals with hypothalamic-pituitary dysfunction leading to primary amenorrhea?
Delayed secondary sex characteristics and short stature.
p.68
Polycystic Ovary Syndrome (PCOS)
Why do patients with PCOS most commonly present to a healthcare provider?
Because of hirsutism or infertility.
p.49
Endometriosis: Diagnosis and Management
What are some proposed etiologies of endometriosis?
Retrograde reflux of menstrual tissue during menses, altered immune response, and a possible genetic link.
p.85
Menopause: Symptoms and Management
What vasomotor symptoms are associated with perimenopause?
Hot flashes and day/night sweats.
p.5
Secondary Amenorrhea Causes
What is secondary amenorrhea?
No menses for 3 months if previous cycles were normal, or no menses for 6 months if previous cycles were irregular.
p.75
Polycystic Ovary Syndrome (PCOS)
What is the impact of PCOS on the risk of gestational diabetes?
PCOS increases the risk of gestational diabetes.
p.19
Amenorrhea: Types and Etiology
What should be done in addition to treating amenorrhea in individuals not desiring pregnancy?
Treat underlying medical conditions and provide reassurance.
p.81
Abnormal Uterine Bleeding: Definitions and Causes
What are some treatment options for a cystocele?
Treatment options include pelvic floor exercises, pessary devices, and in severe cases, surgical repair.
p.41
Abnormal Uterine Bleeding: Definitions and Causes
What are some common causes of abnormal uterine bleeding (AUB) in non-pregnant reproductive age women?
Pituitary, polycystic ovaries, thyroid, and ovarian dysfunction.
p.53
Endometriosis: Diagnosis and Management
What are some conditions included in the differential diagnosis of endometriosis?
Ectopic pregnancy, acute appendicitis, PID, adhesions, irritable bowel syndrome, fibroids, ovarian cysts.
p.74
Polycystic Ovary Syndrome (PCOS)
What are some treatments for hirsutism in PCOS patients?
Hair removal, bleaching, combination oral contraceptives with anti-androgenic component, spironolactone, shaving, electrolysis, and laser.
p.54
Endometriosis: Diagnosis and Management
What is the purpose of using continuous progesterone in endometriosis management?
To create a pseudopregnancy state.
p.17
Secondary Amenorrhea Causes
What symptoms are associated with ovarian failure that can cause secondary amenorrhea?
Hot flashes, vaginal dryness, low libido.
p.29
Abnormal Uterine Bleeding: Definitions and Causes
What is the purpose of using GnRH agonists like Lupron in the management of leiomyomas?
To reduce the size of leiomyomas, but usage is limited to 6 months.
p.16
Secondary Amenorrhea Causes
What is premature ovarian failure and how does it relate to secondary amenorrhea?
Premature ovarian failure is menopause before the age of 40, leading to secondary amenorrhea.
p.46
Menstrual Cycle Overview
What are Cox-2 inhibitors, and why might they be used for primary dysmenorrhea?
Cox-2 inhibitors, such as celecoxib (Celebrex), are equally effective as other NSAIDs but have fewer gastrointestinal side effects, although they are more expensive.
p.65
Polycystic Ovary Syndrome (PCOS)
What characterizes functional ovarian cysts?
An excessive response to otherwise normal function.
p.83
Cystocele/Rectocele/Uterine Prolapse
What are common symptoms of cystocele, rectocele, and uterine prolapse?
Vaginal fullness, pressure, and feeling of incomplete voiding or defecation.
What are the treatment options for a rectocele?
Treatment options include pelvic floor exercises, lifestyle changes, pessary devices, and in severe cases, surgical repair.
p.45
Menstrual Cycle Overview
What causes primary dysmenorrhea?
It is caused by increased prostaglandins and increased leukotriene levels.
p.6
Primary Amenorrhea Causes
How can ovarian and ovulation dysfunction contribute to primary amenorrhea?
They can prevent the normal menstrual cycle from occurring.
p.35
Abnormal Uterine Bleeding: Definitions and Causes
Name two types of antidepressants that can cause iatrogenic abnormal uterine bleeding.
Tricyclic antidepressants and SSRIs.
p.62
Menstrual Cycle Overview
What dietary changes can help manage premenstrual syndrome (PMS)?
Eating small frequent meals, more complex carbs, fruits and vegetables, more calcium/low-fat dairy, and decreasing caffeine, alcohol, tobacco, chocolate, and sodium.
p.62
Menstrual Cycle Overview
How can stress management help with premenstrual syndrome (PMS)?
Stress management can help reduce the severity of PMS symptoms.
p.92
Hormone Replacement Therapy (HRT) Risks and Benefits
What type of carcinoma is an absolute contraindication to HRT?
Breast or estrogen-dependent carcinoma.
p.86
Menopause: Symptoms and Management
What urinary symptoms are commonly associated with menopause?
Urinary frequency, dysuria, nocturia, and increased UTIs.
p.54
Endometriosis: Diagnosis and Management
What are the management options for endometriosis if the patient has mild symptoms?
Observation, OTC NSAIDs, oral contraceptives, continuous progesterone (DepoProvera IM or Provera PO).
p.53
Endometriosis: Diagnosis and Management
Which condition characterized by infection of the female reproductive organs is part of the differential diagnosis for endometriosis?
Pelvic Inflammatory Disease (PID).
p.58
Menstrual Cycle Overview
What are common symptoms of PMS?
Common symptoms of PMS include mood swings, tender breasts, food cravings, fatigue, irritability, and depression.
p.3
Menstrual Cycle Overview
What phase is characterized by high levels of progesterone?
Proliferative/Follicular Phase.
p.24
Abnormal Uterine Bleeding: Definitions and Causes
What type of bleeding do both cervical and endometrial polyps cause?
Intermenstrual bleeding or spotting.
p.13
Primary Amenorrhea Causes
What is the karyotype and lab finding for pituitary microadenomas in primary amenorrhea?
Karyotype: 46, XX; Lab finding: High prolactin
p.60
Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)
What are some of the emotional symptoms listed in Column 1 for PMS and PMDD according to DSM-5 criteria?
Depression or hopelessness, anxiety/tension, mood swings (sudden sadness, sensitivity to rejection), anger or irritability.
p.28
Abnormal Uterine Bleeding: Definitions and Causes
How does the uterus typically present on examination in a patient with leiomyomas?
The uterus is enlarged, firm, nontender, and asymmetrical.
What is a rectocele?
A rectocele is a condition where the rectum bulges into the vagina due to a weakening of the pelvic floor muscles.
p.49
Endometriosis: Diagnosis and Management
Which age group is most commonly affected by endometriosis?
Women of reproductive age.
p.68
Polycystic Ovary Syndrome (PCOS)
What is the #1 cause of ovulatory dysfunction?
Polycystic Ovarian Syndrome (PCOS).
p.49
Endometriosis: Diagnosis and Management
What factors are associated with a lower risk of endometriosis?
Regular exercise (> 4 hours per week), higher parity, and longer duration of lactation.
p.75
Polycystic Ovary Syndrome (PCOS)
What are some pregnancy-related risks associated with Polycystic Ovary Syndrome (PCOS)?
Increased risk of miscarriage, preterm labor, preeclampsia, and gestational diabetes.
p.63
Pharmacotherapy for PMDD
Which class of drugs is considered best for treating depressive symptoms in PMDD?
Selective serotonin reuptake inhibitors (SSRIs).
p.83
Cystocele/Rectocele/Uterine Prolapse
What exercises can help treat cystocele, rectocele, and uterine prolapse?
Pelvic strengthening exercises.
p.19
Amenorrhea: Types and Etiology
What is the first choice of treatment for amenorrhea in individuals not desiring pregnancy?
Oral contraceptive pills.
p.43
Abnormal Uterine Bleeding: Definitions and Causes
What are some hormonal treatments for abnormal uterine bleeding?
Birth control pills and progesterone-only treatments.
p.12
Primary Amenorrhea Causes
What are some physical characteristics of individuals with Androgen Insensitivity Syndrome (AIS)?
Slightly longer limbs, larger hands and feet, and typical female external genitalia.
p.62
Menstrual Cycle Overview
Why is regular sleep important in managing premenstrual syndrome (PMS)?
Regular sleep helps regulate mood and reduce PMS symptoms.
p.17
Secondary Amenorrhea Causes
What are common symptoms of pregnancy that can indicate secondary amenorrhea?
Fatigue, nausea, breast tenderness.
p.58
Menstrual Cycle Overview
What is Premenstrual Dysphoric Disorder (PMDD)?
PMDD is a severe form of PMS characterized by significant mood disturbances, such as severe irritability, depression, or anxiety, that occur in the week or two before menstruation.
p.25
Abnormal Uterine Bleeding: Definitions and Causes
What physical change does adenomyosis cause in the uterus?
It causes an enlarged uterus.
p.58
Menstrual Cycle Overview
How is PMDD diagnosed?
PMDD is diagnosed based on the severity and impact of symptoms on daily life, typically requiring a detailed medical history and symptom tracking over at least two menstrual cycles.
p.16
Secondary Amenorrhea Causes
What ovarian dysfunction can lead to secondary amenorrhea?
Hormonal imbalances in the ovaries.
p.42
Abnormal Uterine Bleeding: Definitions and Causes
When is an endometrial biopsy recommended in the diagnosis of abnormal uterine bleeding?
For women over 35 with obesity, hypertension, diabetes, and all women after menopause.
p.24
Abnormal Uterine Bleeding: Definitions and Causes
How can cervical polyps appear in terms of color?
They can appear red, purple, or flesh-colored.
p.93
Menopause: Symptoms and Management
What are some alternative therapies to HRT for managing hot flashes during menopause?
SSRIs (Paxil most common), yoga, acupuncture, black cohosh, and soy.
p.67
Polycystic Ovary Syndrome (PCOS)
What is hyperandrogenism in the context of PCOS?
An excess of androgens (male hormones) in females.
p.51
Endometriosis: Diagnosis and Management
Does the extent of endometriosis disease correlate with the severity of symptoms?
No, the extent of disease does not equal the severity of symptoms.
p.45
Menstrual Cycle Overview
What are the symptoms of primary dysmenorrhea?
Symptoms include lower abdominal-pelvic cramping/pain 1-3 days around the start of menses, nausea/vomiting, diarrhea, and headache.
p.35
Abnormal Uterine Bleeding: Definitions and Causes
What does 'iatrogenic' mean in the context of abnormal uterine bleeding (AUB)?
Caused by a medical treatment.
p.35
Abnormal Uterine Bleeding: Definitions and Causes
Which contraceptive method can cause iatrogenic abnormal uterine bleeding?
Oral contraception pills.
p.19
Amenorrhea: Types and Etiology
What are the treatment options for amenorrhea in individuals who want to become pregnant?
Treatment varies by cause, including dopamine agonists (bromocriptine, cabergoline), surgery, clomiphene citrate (Clomid), and referral to a fertility specialist.
p.43
Abnormal Uterine Bleeding: Definitions and Causes
What surgical options are available for patients with abnormal uterine bleeding who do not desire future fertility?
Uterine artery embolization, endometrial ablation, and hysterectomy.
p.41
Abnormal Uterine Bleeding: Definitions and Causes
What are some non-structural causes of abnormal uterine bleeding (AUB) in reproductive age women?
Anovulation and hormonal abnormalities.
p.86
Menopause: Symptoms and Management
What psychological symptoms are commonly associated with menopause?
Depression, mood swings, irritability, and insomnia.
p.41
Abnormal Uterine Bleeding: Definitions and Causes
What medication-related factor can cause abnormal uterine bleeding (AUB) in postmenopausal women?
Hormone replacement therapy.
p.69
Polycystic Ovary Syndrome (PCOS)
What type of diabetes is a long-term consequence of PCOS?
Type 2 Diabetes Mellitus (DM).
p.29
Abnormal Uterine Bleeding: Definitions and Causes
What is the general management approach for leiomyomas?
Most leiomyomas do not require treatment and can be managed conservatively.
p.24
Abnormal Uterine Bleeding: Definitions and Causes
What are the two types of polyps associated with abnormal uterine bleeding (AUB)?
Cervical polyps and endometrial polyps.
p.90
Hormone Replacement Therapy (HRT) Risks and Benefits
How does Hormone Replacement Therapy (HRT) affect sexual desire?
HRT increases sexual desire.
p.71
Polycystic Ovary Syndrome (PCOS)
What lab test is used to rule out pregnancy in the diagnosis of PCOS?
B - hCG (pregnancy test).
p.70
Polycystic Ovary Syndrome (PCOS)
What physical signs are commonly assessed in the diagnosis of PCOS?
Acne, hirsutism, distribution of body hair, obesity, and palpable ovaries on pelvic exam.
p.68
Polycystic Ovary Syndrome (PCOS)
What are some common associations with PCOS?
Truncal obesity, acne, and insulin resistance.
p.93
Menopause: Symptoms and Management
What type of commercial product can be used to alleviate vaginal dryness?
Commercial lubricants such as K-Y.
p.75
Polycystic Ovary Syndrome (PCOS)
What is the relationship between PCOS and preterm labor?
PCOS increases the risk of preterm labor.
p.9
Primary Amenorrhea Causes
What is a common height characteristic of individuals with Turner's Syndrome?
They are typically short, around 4'8".
p.43
Abnormal Uterine Bleeding: Definitions and Causes
What considerations should be taken into account when managing abnormal uterine bleeding?
Treat the underlying problem and consider whether the patient is trying to get pregnant or maintain fertility.
p.35
Abnormal Uterine Bleeding: Definitions and Causes
How can an IUD contribute to abnormal uterine bleeding?
It can cause iatrogenic abnormal uterine bleeding.
p.76
Polycystic Ovary Syndrome (PCOS)
What lifestyle changes are recommended for women with PCOS trying to get pregnant?
Diet and exercise (weight loss).
p.69
Polycystic Ovary Syndrome (PCOS)
What is a common cause of abnormal bleeding in PCOS?
Hormone irregularity due to anovulation.
p.92
Hormone Replacement Therapy (HRT) Risks and Benefits
Why is undiagnosed abnormal vaginal bleeding an absolute contraindication to HRT?
Because it could indicate a serious underlying condition that needs to be diagnosed before starting HRT.
p.25
Abnormal Uterine Bleeding: Definitions and Causes
How is adenomyosis usually diagnosed?
It is usually diagnosed after a hysterectomy.
p.53
Endometriosis: Diagnosis and Management
Which gastrointestinal condition is part of the differential diagnosis for endometriosis?
Irritable bowel syndrome.
p.74
Polycystic Ovary Syndrome (PCOS)
What non-pharmacological methods can be used to manage hirsutism in PCOS?
Shaving, electrolysis, and laser.
p.20
Abnormal Uterine Bleeding: Definitions and Causes
What is dysfunctional uterine bleeding?
Bleeding due to an anovulatory cause.
p.54
Endometriosis: Diagnosis and Management
What is the treatment of choice for endometriosis if the patient is trying to get pregnant?
Surgical treatment, specifically adhesion lysis.
p.54
Endometriosis: Diagnosis and Management
When is surgical treatment indicated for endometriosis?
When the patient is trying to get pregnant or when medical treatment is contraindicated or has failed.
p.13
Primary Amenorrhea Causes
What is the management for Hypothalamic-Pituitary Dysfunction in primary amenorrhea?
Surgery or cyclic estrogens and progestins
p.13
Primary Amenorrhea Causes
What is the management for androgen insensitivity in primary amenorrhea?
Remove testes, start estrogen
p.6
Primary Amenorrhea Causes
What are the main causes of primary amenorrhea?
Hypothalamic-pituitary dysfunction, pituitary defects, ovarian and ovulation dysfunction, anatomic abnormalities, and 46, XY karyotype.
p.83
Cystocele/Rectocele/Uterine Prolapse
What is a treatment option specifically for cystocele?
Topical estrogen therapy.
p.22
Abnormal Uterine Bleeding: Definitions and Causes
What conditions are represented by the 'COEIN' part of the PALM-COEIN classification?
'COEIN' stands for Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, and Not yet classified.
p.30
Abnormal Uterine Bleeding: Definitions and Causes
What factors increase the risk of endometrial hyperplasia?
Aging, obesity, and diabetes.
p.27
Abnormal Uterine Bleeding: Definitions and Causes
What are the three types of leiomyomas?
Subserous, Intramural, and Submucous.
p.19
Amenorrhea: Types and Etiology
What medications are used to treat elevated prolactin levels in individuals with amenorrhea who want to become pregnant?
Dopamine agonists such as bromocriptine and cabergoline.
p.76
Polycystic Ovary Syndrome (PCOS)
What is the second-line medication for inducing pregnancy in women with PCOS?
Clomiphene citrate (Clomid) with a 19% pregnancy rate.
p.12
Primary Amenorrhea Causes
When do symptoms of Androgen Insensitivity Syndrome (AIS) typically appear?
Symptoms do not appear until puberty.
p.41
Abnormal Uterine Bleeding: Definitions and Causes
What is a common cause of abnormal uterine bleeding (AUB) in postmenopausal women?
Trauma, such as vaginal atrophy.
p.92
Hormone Replacement Therapy (HRT) Risks and Benefits
What type of disorders are absolute contraindications to HRT?
Thromboembolic disorders.
p.17
Secondary Amenorrhea Causes
What condition is associated with symptoms such as overweight, hirsutism, acne, and infertility?
Polycystic Ovarian Syndrome (PCOS).
p.54
Endometriosis: Diagnosis and Management
What are the side effects of Danazol, a testosterone used in endometriosis management?
Hot flashes, acne, weight gain, and deepening of voice (which can be permanent).
p.21
Abnormal Uterine Bleeding: Definitions and Causes
What is postmenopausal bleeding?
Bleeding after 1 year of no menses.
p.58
Menstrual Cycle Overview
What treatments are available for PMS?
Treatments for PMS may include lifestyle changes, dietary adjustments, exercise, stress management, and over-the-counter pain relievers.
p.10
Primary Amenorrhea Causes
What is an imperforate hymen?
A structural cause of primary amenorrhea where the hymen completely covers the vaginal opening.
p.16
Secondary Amenorrhea Causes
What is Asherman's syndrome?
A condition characterized by adhesions or scarring of the endometrial lining, often due to complicated D&C.
p.90
Hormone Replacement Therapy (HRT) Risks and Benefits
What impact does Hormone Replacement Therapy (HRT) have on mood swings?
HRT stabilizes mood swings.
p.90
Hormone Replacement Therapy (HRT) Risks and Benefits
What cerebrovascular risk is increased by Hormone Replacement Therapy (HRT)?
HRT increases the risk of stroke.
What are the common symptoms of ovarian torsion?
Pain (90%), mass (85-95%), nausea/vomiting (40-70%), and fever (less than 20%).
p.65
Polycystic Ovary Syndrome (PCOS)
When is surgical evaluation recommended for functional ovarian cysts?
If the cysts are present without change for greater than 60 days.
p.81
Abnormal Uterine Bleeding: Definitions and Causes
What are potential causes of a cystocele?
Potential causes include childbirth, heavy lifting, chronic coughing, and aging.
p.76
Polycystic Ovary Syndrome (PCOS)
What is the first-line medication for inducing pregnancy in women with PCOS?
Letrozole (off-label) with a 27.5% pregnancy rate.
p.69
Polycystic Ovary Syndrome (PCOS)
Why might individuals with PCOS experience infertility?
Due to hormone irregularity and anovulation.
p.20
Abnormal Uterine Bleeding: Definitions and Causes
What is metrorrhagia?
Irregular bleeding between cycles.
p.25
Abnormal Uterine Bleeding: Definitions and Causes
What age group is most commonly affected by adenomyosis?
Women between the ages of 40 and 50.
p.21
Abnormal Uterine Bleeding: Definitions and Causes
What is prolonged menstrual bleeding?
Menstrual bleeding that exceeds 8 days.
p.3
Menstrual Cycle Overview
What happens during days 1-7 of the menstrual cycle?
FSH begins to rise, waking up the follicle.
p.58
Menstrual Cycle Overview
What treatments are available for PMDD?
Treatments for PMDD may include antidepressants, hormonal treatments, lifestyle changes, dietary adjustments, and cognitive-behavioral therapy.
p.29
Abnormal Uterine Bleeding: Definitions and Causes
What is endometrial ablation and when is it used?
A procedure to destroy the lining of the uterus, used in the management of leiomyomas for women who do not desire future fertility.
p.3
Menstrual Cycle Overview
What is another name for the secretory phase of the menstrual cycle?
Progestational phase or luteal phase.
p.60
Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)
Is social impairment required for a diagnosis of PMS?
No, but it may be present.
p.55
Abnormal Uterine Bleeding: Definitions and Causes
What imaging techniques are used to diagnose adenomyosis?
Ultrasound and MRI are commonly used to diagnose adenomyosis.
p.9
Primary Amenorrhea Causes
Why do individuals with Turner's Syndrome experience primary amenorrhea?
They have no functioning ovaries.
p.81
Abnormal Uterine Bleeding: Definitions and Causes
What is a cystocele?
A cystocele is a condition where the bladder prolapses into the vagina.
p.81
Abnormal Uterine Bleeding: Definitions and Causes
What are common symptoms of a cystocele?
Common symptoms include a feeling of fullness or pressure in the pelvis and vagina, discomfort when straining, and urinary incontinence.
p.9
Primary Amenorrhea Causes
What are some facial features associated with Turner's Syndrome?
Downslanting eyes, droopy eyelids, prominent earlobes, and crowding of teeth.
p.43
Abnormal Uterine Bleeding: Definitions and Causes
What is Dilation and Curettage (D&C) used for in the context of abnormal uterine bleeding?
It is a surgical treatment option to manage abnormal uterine bleeding.
p.69
Polycystic Ovary Syndrome (PCOS)
What causes amenorrhea in individuals with PCOS?
Hormone irregularity due to anovulation.
p.18
Secondary Amenorrhea Causes
What imaging tests might be performed depending on symptoms in the diagnostic workup for secondary amenorrhea?
MRI of the head, pelvic ultrasound, and hysteroscopy.
p.20
Abnormal Uterine Bleeding: Definitions and Causes
What are common causes of menorrhagia?
Ectopic pregnancy, Von Willebrand’s Disease, submucous myomas, endometrial hyperplasia, IUDs, tumors.
p.69
Polycystic Ovary Syndrome (PCOS)
What cardiovascular risk factors are associated with PCOS?
Dyslipidemias and hypertension.
p.29
Abnormal Uterine Bleeding: Definitions and Causes
What imaging studies are used to diagnose leiomyomas?
Sonogram and hysterosalpingogram.
p.16
Secondary Amenorrhea Causes
What syndrome associated with androgen excess can cause secondary amenorrhea?
Polycystic ovary syndrome (PCOS).
p.3
Hormonal Regulation: FSH and LH
What is the result of the LH surge during the menstrual cycle?
The follicle bursts, leading to ovulation.
p.24
Abnormal Uterine Bleeding: Definitions and Causes
In which group of women are endometrial polyps common?
Post-menopausal women on tamoxifen.
p.23
Abnormal Uterine Bleeding: Definitions and Causes
What is leiomyoma and its role in abnormal uterine bleeding?
Leiomyoma, also known as fibroids, are benign tumors of the uterus that can cause abnormal uterine bleeding.
p.60
Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)
What are some of the physical and behavioral symptoms listed in Column 2 for PMS and PMDD according to DSM-5 criteria?
Decreased interest in activities, sleep changes, appetite changes, decreased concentration, feeling overwhelmed, bloating/breast tenderness, lethargy, fatigue.
p.59
Menstrual Cycle Overview
When do the symptoms of Premenstrual Syndrome (PMS) occur?
During the second half of the menstrual cycle.
p.9
Primary Amenorrhea Causes
What skin feature is commonly seen in individuals with Turner's Syndrome?
Several moles on the skin.
p.59
Menstrual Cycle Overview
What conditions are linked to an increased risk due to PMS?
Perimenopausal depression and postpartum depression.
p.74
Polycystic Ovary Syndrome (PCOS)
What is the increased risk associated with menstrual irregularity in PCOS?
Increased risk of endometrial cancer.
p.20
Abnormal Uterine Bleeding: Definitions and Causes
What is menometrorrhagia?
Irregular frequency of bleeding plus heavy and prolonged flow.
p.21
Abnormal Uterine Bleeding: Definitions and Causes
Name two causes of postmenopausal bleeding.
Vaginal atrophy and hormone replacement therapy (HRT).
p.90
Hormone Replacement Therapy (HRT) Risks and Benefits
What is one of the skeletal benefits of Hormone Replacement Therapy (HRT)?
HRT reduces the risk of osteoporosis.
p.13
Primary Amenorrhea Causes
What is the management for Mullerian dysgenesis in primary amenorrhea?
Surgery to create vaginal elongation
p.55
Abnormal Uterine Bleeding: Definitions and Causes
What is adenomyosis?
Adenomyosis is a condition where the inner lining of the uterus breaks through the muscle wall of the uterus, causing heavy periods and pain.
p.55
Endometriosis: Diagnosis and Management
What is endometriosis?
Endometriosis is a condition where tissue similar to the lining inside the uterus grows outside the uterus, causing pain and potentially infertility.
p.12
Primary Amenorrhea Causes
Why do individuals with Androgen Insensitivity Syndrome (AIS) exhibit female physical traits?
They are genetically male but resistant to male hormones.
p.27
Abnormal Uterine Bleeding: Definitions and Causes
What is a submucous leiomyoma?
A type of leiomyoma that deforms the uterine cavity.
p.86
Menopause: Symptoms and Management
How does menopause typically affect sexual activity?
Decreased interest in sexual activity.
p.25
Abnormal Uterine Bleeding: Definitions and Causes
What is adenomyosis?
A condition where endometrial glands grow within the myometrium (uterine musculature).
p.21
Abnormal Uterine Bleeding: Definitions and Causes
How is heavy menstrual bleeding subjectively defined?
Excessive blood loss that interferes with physical, social, or emotional quality of life.
p.20
Abnormal Uterine Bleeding: Definitions and Causes
What are some causes of menometrorrhagia?
Molar pregnancy, malignant endometrial tumors, premenopause.
p.21
Abnormal Uterine Bleeding: Definitions and Causes
What is intermenstrual bleeding?
Irregular episodes of bleeding between normal periods.
p.58
Menstrual Cycle Overview
What are common symptoms of PMDD?
Common symptoms of PMDD include severe irritability, depression, anxiety, mood swings, and physical symptoms similar to PMS but more intense.
p.3
Menstrual Cycle Overview
What significant event occurs on day 14 of the menstrual cycle?
Ovulation, where the egg is released.
p.90
Hormone Replacement Therapy (HRT) Risks and Benefits
How does Hormone Replacement Therapy (HRT) affect platelet aggregation?
HRT reduces platelet aggregation.
p.13
Primary Amenorrhea Causes
What is the karyotype and lab finding for Mullerian dysgenesis in primary amenorrhea?
Karyotype: 46, XX; Lab finding: Normal hormone levels/MRI
p.13
Primary Amenorrhea Causes
What is the karyotype and diagnostic method for anatomic imperforate hymen in primary amenorrhea?
Karyotype: 46, XX; Diagnostic method: Physical examination
p.59
Menstrual Cycle Overview
When must PMS symptoms be absent?
During the first 2 weeks of the menstrual cycle.
p.19
Amenorrhea: Types and Etiology
What is a common medication used to induce ovulation in individuals with amenorrhea who want to become pregnant?
Clomiphene citrate (Clomid).
p.86
Menopause: Symptoms and Management
What is dyspareunia and how is it related to menopause?
Dyspareunia is painful intercourse, which can occur due to decreased vaginal lubrication during menopause.
p.92
Hormone Replacement Therapy (HRT) Risks and Benefits
Why is thrombophlebitis an absolute contraindication to HRT?
Because HRT can increase the risk of blood clots, worsening thrombophlebitis.
p.25
Abnormal Uterine Bleeding: Definitions and Causes
What are the common symptoms of adenomyosis?
Heavy and painful prolonged periods.
p.29
Abnormal Uterine Bleeding: Definitions and Causes
What are the management options for leiomyomas in peri-menopausal women who do not desire fertility?
GnRH agonists (e.g., Lupron, limited to 6 months), uterine artery embolization, endometrial ablation, and hysterectomy.
p.3
Menstrual Cycle Overview
What happens during days 7-14 of the menstrual cycle?
Estrogen increases, causing proliferation of follicles and some endometrial growth.
p.42
Abnormal Uterine Bleeding: Definitions and Causes
What is the purpose of a progestin trial in the context of abnormal uterine bleeding?
To determine if the bleeding stops, indicating an ovulatory problem.
p.24
Abnormal Uterine Bleeding: Definitions and Causes
What receptors do endometrial polyps have that allow them to behave like endometrial tissue?
Estrogen and progesterone receptors.
p.23
Abnormal Uterine Bleeding: Definitions and Causes
What is adenomyosis and how does it relate to abnormal uterine bleeding?
Adenomyosis is a condition where the inner lining of the uterus breaks through the muscle wall of the uterus, leading to abnormal uterine bleeding.
p.13
Primary Amenorrhea Causes
What is the management for gonadal dysgenesis (Turner's syndrome) in primary amenorrhea?
Cyclic estrogen and progestins
p.90
Hormone Replacement Therapy (HRT) Risks and Benefits
What pulmonary risk is increased by Hormone Replacement Therapy (HRT)?
HRT increases the risk of pulmonary embolism.
p.55
Abnormal Uterine Bleeding: Definitions and Causes
What are leiomyomas?
Leiomyomas, also known as fibroids, are benign tumors of the uterus that can cause heavy menstrual bleeding, pelvic pain, and pressure symptoms.
p.55
Abnormal Uterine Bleeding: Definitions and Causes
What are common treatments for leiomyomas?
Treatments for leiomyomas include medication, non-invasive procedures, and surgical options such as myomectomy or hysterectomy.
p.16
Secondary Amenorrhea Causes
What is prolactinoma and how does it relate to secondary amenorrhea?
Prolactinoma is a benign pituitary tumor that produces excess prolactin, leading to secondary amenorrhea.
p.29
Abnormal Uterine Bleeding: Definitions and Causes
What is uterine artery embolization used for in the context of leiomyomas?
To reduce blood flow to the leiomyomas, causing them to shrink.
p.23
Abnormal Uterine Bleeding: Definitions and Causes
What are polyps in the context of abnormal uterine bleeding?
Polyps are growths that occur in the inner lining of the uterus and can cause abnormal uterine bleeding.
p.23
Abnormal Uterine Bleeding: Definitions and Causes
How do malignancy and hyperplasia contribute to abnormal uterine bleeding?
Malignancy and hyperplasia involve abnormal growth of the uterine lining, which can lead to abnormal uterine bleeding.
p.55
Abnormal Uterine Bleeding: Definitions and Causes
What type of bleeding is associated with polyps?
Polyps often cause irregular or heavy menstrual bleeding.
p.3
Hormonal Regulation: FSH and LH
What effect does increased estrogen have on the pituitary gland during days 7-14?
It causes the pituitary to increase LH levels.
p.3
Menstrual Cycle Overview
What role does progesterone play in the menstrual cycle?
It works on the endometrium to convert it to thickly vascularized tissue.
p.33
Abnormal Uterine Bleeding: Definitions and Causes
How does the transition into menopause affect ovulation?
The transition into menopause can cause ovulatory dysfunction.
p.90
Hormone Replacement Therapy (HRT) Risks and Benefits
What are some risks associated with Hormone Replacement Therapy (HRT)?
Increased risk for cardiac disease, breast cancer, stroke, pulmonary embolism, irregular bleeding, bloating, and weight gain.
p.55
Menstrual Cycle Overview
What is primary dysmenorrhea?
Primary dysmenorrhea refers to common menstrual cramps that are recurrent and not due to other diseases.
p.13
Primary Amenorrhea Causes
What is the karyotype and lab finding for Hypothalamic-Pituitary Dysfunction in primary amenorrhea?
Karyotype: 46, XX; Lab finding: Low FSH, LH
p.90
Hormone Replacement Therapy (HRT) Risks and Benefits
What type of cancer risk is increased by Hormone Replacement Therapy (HRT)?
HRT increases the risk of breast cancer.
p.60
Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)
Is prospective charting required for diagnosing PMS?
No, but it is recommended.
p.90
Hormone Replacement Therapy (HRT) Risks and Benefits
What are some benefits of Hormone Replacement Therapy (HRT)?
Improves vaginal atrophy, hot flashes, increases sexual desire, stabilizes mood swings, enhances insulin sensitivity, reduces risk of osteoporosis, and reduces platelet aggregation.
p.90
Hormone Replacement Therapy (HRT) Risks and Benefits
How does Hormone Replacement Therapy (HRT) affect insulin sensitivity?
HRT enhances insulin sensitivity.
p.13
Primary Amenorrhea Causes
What is the karyotype and lab finding for gonadal dysgenesis (Turner's syndrome) in primary amenorrhea?
Karyotype: 45, X; Lab finding: High FSH
p.60
Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)
How many symptoms are required to diagnose PMS according to DSM-5 criteria?
At least 1 symptom from each column (minimum 2 total).
p.90
Hormone Replacement Therapy (HRT) Risks and Benefits
What cardiovascular risk is increased by Hormone Replacement Therapy (HRT)?
HRT increases the risk of cardiac disease.
p.55
Abnormal Uterine Bleeding: Definitions and Causes
What is a polyp in the context of gynecology?
A polyp is a growth that protrudes from the lining of the uterus, often causing irregular bleeding.
p.90
Hormone Replacement Therapy (HRT) Risks and Benefits
What are some side effects of Hormone Replacement Therapy (HRT) related to weight and digestion?
HRT can cause irregular bleeding, bloating, and weight gain.
p.13
Primary Amenorrhea Causes
What is the karyotype and lab finding for androgen insensitivity in primary amenorrhea?
Karyotype: 46, XY; Lab finding: High testosterone
p.55
Abnormal Uterine Bleeding: Definitions and Causes
How does age affect the likelihood of developing polyps, adenomyosis, leiomyomas, or endometriosis?
Polyps and adenomyosis are more common in women over 40, leiomyomas are common in women of reproductive age, and endometriosis often affects women in their 30s and 40s.
p.55
Endometriosis: Diagnosis and Management
Where and when is pain typically experienced in endometriosis?
Pain in endometriosis is often experienced in the pelvic region, especially during menstruation.
