Menorrhagia

Card Set Information

Author:
jaz_walker
ID:
274048
Filename:
Menorrhagia
Updated:
2014-05-11 14:36:25
Tags:
obs gynae
Folders:
obs+gynae
Description:
obs + gynae
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  1. 1. A woman presents with menorrhagia. What is your differential?
    uterine: fibroids, polyps, adenomyosis, malignancy. Cervical: polyps, infection, malignancy. Ovarian/tubal: PID, malignancy, endometriosis. Systemic: thyroid, coagulopathy, anticoagulant drugs
  2. 2. Menorrhagia: what do you look for in the history?
    flooding, clots, dysmenorrhoea.
  3. 3. Menorrhagia: what do you look for on examination?
    irregular uterus (fibroids), tender uterus (adenomyosis), ovarian mass, fixed pelvis (endometriosis + infection). Anaemia
  4. 4. Menorrhagia: what investigations would you request?
    FBC, endometrial biopsy if over 35 + irregular bleeding, cervical smear, pelvic US if fibroid, laparoscopy if endometriosis. Coagulation and thyroid function.
  5. 5. What are indications for endometrial biopsy?
    in over 35s: bleeding irregularities (or in under 35 if treatment failed). Or before ablation or acute admission for uterine bleeding.
  6. 6. What medicines are available for menorrhagia?
    Tranexamic acid (antifibrinolytics). NSAIDs (prostaglanding inhibitors). GnRH agonist produces amenorrhoea. Progesterone coil. Combined oral contraceptive (functional bleeding), HRT (during climacteric)
  7. 7. What surgical treatment is available for menorrhagia?
    endometrial ablation / diathermy. Myomectomy (fibroids). Hysterectomy.

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