GU-4

Card Set Information

Author:
atmu
ID:
174056
Filename:
GU-4
Updated:
2012-09-28 21:56:17
Tags:
CPP
Folders:

Description:
CPP
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  1. Organic causes of chronic pelvic pain (9)
    • 1. Endometriosis
    • 2. Chronic PID
    • 3. Ovarian cyst
    • 4. Adenomyosis
    • 5. Leiomyomas
    • 6. Pelvic congestion syndrome
    • 7. Cystitis
    • 8. GI
    • 9. Neuromuscular
  2. Management of CPP (5)
    • 1. Physical therapy
    • 2. Trial of menstruation supression
    • 3. NSAIDS
    • 4. Antidepressant
    • 5. Surgery if pathology is found
  3. Abnormalities
    • 1. Menorrhagia - excessive flow
    • 2. Metrorrhagia - bleeding from uterus between menses
    • 3. Menometrorrhagia - prolongation of flow with intermenstrual bleeding
    • 4. Oligomenorrhea - menstrual flow at intervals of > 35 days
    • 5. Polymenorrhea - menstrual flow at intervals of < 21 days
  4. Treatment of DUB
    • A. Younger pt treated w/ OC for 21 days w/ 7 day withdrawel
    • B. Cyclic progestin for first 10 days of month can be used in younger pts w/ sufficient estrogen to prime progesterone receptors
    • C. If pt stable w/ moderate bleeding, treat with cyclic estrogens w/ progesterone added for last 10-15 days of 25 day cycle. Repeach each month for 3-6 months.
  5. Primary Amenorrhea
    no spontaneous uterine bleeding by 15 years old w/ normal secondary sexual characteristics

    OR

    13 years w/ abnormal secondary sexual characteristics
  6. Secondary Amenorrhea
    absence of menstrual periods for 3-6 mnths or 3 cycles
  7. Amenorrhea causes (6)
    • 1. pregnancy (most common)
    • 2. hypothalamic effects
    • 3. pituitary defects
    • 4. ovarian/ovulatory dysfunction
    • 5. uterine causes
    • 6. other
  8. Hypothalamic causes of amenorrhea
    • 1. Congenital deficiency of GnRH (no GnRH secretion)
    • 2. Defect of GnRH transport (prevents flow of GnRH from hypothalamus to pituitary)
    • 3. Defect of GnRH pulse production (LH, FSH not released, follicles do not develop. No ovulation)
  9. Pituitiary causes of amenorrhea
    • 1. Congenital absence of pituitary (rare-lethal)
    • 2. Sheehan's Syndrome (pituitary necrosis from postpartum hemorrhage and severe hypotension)
    • 3. Polycystic Ovary Syndrome (all the Sx)
  10.  Ovarian causes of amenorrhea
    • 1. Turner Syndrome (abnormal X chromosome; webbed neck, streak ovaries, infertility)
    • 2. Premature ovarian failure (depletion of ova before 40, SSX of menopause, dunno why)
  11.  Uterine causes of amenorrhea
    • 1. Congenital absence of malformation of the uterus
    • 2. Unresponsive or atrophic endometrium
    • 3. Imperforate hymen
  12. Pregnancy causes of amenorrhea
    • 1. Rising hCG levels
    • 2. Sx of pregnancy
  13. Causes of secondary dysmenorrhea
    • 1. Endometriosis
    • 2. Fibroids/Adenomyosis

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