Shared Flashcard Set

Details

859-III
Postmenopausal Bleeding
13
Medical
Graduate
02/29/2012

Additional Medical Flashcards

 


 

Cards

Term
What % of PMB is associated with benign conditions?
Definition
90%
Term
What is the most common presenting sx for endometrial CA?
Definition
Vaginal bleeding
Term
What are the ACOG recommendations regarding AUB?
Definition
Endometrial evaluation by EMB or US in all women with AUB 35 yrs and older
Term
What are some differentials for postmenopausal bleeding?
Definition

Endometrial atrophy (50%)

Endometrial CA (10%)

Polyps (3%)

Other causes - fibroids, STI, cervicitis, medications, etc. (37%)

Term
What diagnostic tools do we use to evaluate PMB?
Definition

Endometrial biopsy (EMB)

Dilation and Curettage

Hysteroscopy (gold standard)

TVUS

Term
What is considered an abnormal finding on TVUS?
Definition

"Stripe" > 5 mm

 

*96% of women with Endo. CA had a stripe > 5 mm

Term

True or False: 

HRT can cause postmenopausal bleeding

Definition

TRUE

 

*BTB is very common in the 1st 3-6 months of therapy

*Bleeding is more common if started within 12 months of menopause

 

 

Term
When should you evaluate the endometrial lining in a woman on HRT?
Definition
If unscheduled bleeding occurs in 2+ cycles
Term
What is endometrial hyperplasia?
Definition
Abnormal thickening and excessive, unusual cellular growth of the uterine glandular lining (the endometrium)
Term
What is the most common cause of endo. hyperplasia?
Definition
Unopposed estrogen (menopause, PCOS, HRT, obesity, etc)
Term
What are tx options for endo. hyperplasia without atypia?
Definition

1. D & C

2. Cyclic progesterone - Prometrium 200 mg or Provera 10 mg x 10-14 days for 3 months; then re-evaluate the lining

3. Depo for 3 months

4. Mirena IUD

*Keep in mind Prometrium is contraindicated with a peanut allergy

Term
When should APN's refer for endo. hyperplasia? 
Definition
Everything beyond Hyperplasia without atypia
Term
What are some other classifications of endometrial hyperplasia?
Definition

1. Simple dilated galnds

2. Complex glands

3. Simple with atypia

4. Complex with atypia

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