Questions With Correct Solutions
Abnormal Uterine bleeding (AUB)
Variability in menstrual cycle's Right Ans - In general menstruation is "28
day" cycle, but there is a plus or minus seven days variability there
Mean duration of menstrual cycle Right Ans - average is 4 days, but don't
expect patients to go beyond 7 days. If bleeding 8, 10,11 days, classified as
abnormal and investigate
Blood loss in Normal menses Right Ans - 35 to 50 cc. 80cc or more is
abnormal
Menorrhagia Right Ans - prolonged bleeding, greater than 7 days or more
than 80 cc/day. This is a very common Gyn disorder, found in 14% of women
otherwise healthy and in their reproductive age (as young as 11-12 yo
sometimes)
Metrorrhagia Right Ans - Uterine bleeding occuring at Irregular, but real
frequent intervals
Mittelschmerz Right Ans - Pain that occurs with ovulation, which would be
about mid cycle
Breakthrough bleeding (ex. of Metrorrhagia) Right Ans - Either w/
ovulation (Mittelschmerz), or Anovulation, pt does not ovulate at all
Menometrorrhagia Right Ans - prolonged uterine bleeding occurring at
irregular intervals (ex. pt spots everyday or bleed every 3-4 days, bleed during
intercourse, exercising)
Anovulation Right Ans - pts who do not ovulate, will have uterine bleeding
occurring in irregular intervals for a long time, which is why they are NOT
having regular cycles
, Oligomenorrhea Right Ans - Reduction in frequency of menses. Not
menstruating every month in a predictable pattern.
Amenorrhea Right Ans - No menses for at least 3-6 months. Part two is that
they need to have had a regular cycle prior to this.
Primary amenorrhea Right Ans - patient has never had a any bleeding
(menses) Ever. No prior first period. If they are 15 or 16, need to think about
structural problems, missing ovaries, etc.)
Secondary Amenorrhea Right Ans - no menses for 3-6 months after the
regular cycle has been established. Cannot be classified as Secondary
amenorrhea in the first 2years of starting menarche.
Hypomenorrhea Right Ans - reduction on number of days. Most of the time
a side effect of medications (birth control pills, birth control patches).
Important to get a good history of what they are taking.
Menopause Right Ans - Absence of cycles for 12 months, average age 51 yo
Menstrual bleeding stops if certain things happen Right Ans - NSAIDS
(block prostaglandins, which cause contractions and expulsion bleeding) and
increasing Estrogen (Cessation of blood with higher estrogen levels)
Etiology of AUD (Abnormal uterine bleeding) Right Ans - coagulation
defects, develop leukemia, problems with thrombocytes and clotting, thyroid
dysfunction
PEARL: Pt w/ coagulation defect Right Ans - you are looking for a patient
who had a very heavy flow w/ the 1st period. Bled all over the sheets, through
their clothing. RED FLAG!!! Looking for a heavy period every month
Von Willebrand's disease Right Ans - Most common inherited bleeding
disorder
Hypothyroidism Right Ans - can also cause bleeding issues. It can cause
Menorrhagia and metrorrhagia
Hyperthyroidism Right Ans - can also cause menstrual issues