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Gyne 4 Menstrual D/O

Menstrual Disorders

QuestionAnswer
A young child presents with thigh m weakness, a waddling gait, and pronounced calf mm. What is the dx? Duchenne's MD
A female neonate who was born in breech position is found to have asymmetric inguinal and gluteal skin folds on her newborn exam. What is the dx and tx? DDH. Tx with Pavlik harness
How is benign paroxysmal positional vertigo diagnosed? How is it tx? Dx with history and Dix-Halpike maneuver. Tx with Epley maneuver.
Tx options for endometriosis? NSAIDs, OCPs dosed contin, GnRH agonist for 6-12mos, armoatase inhibitors (anastrazole or letrozole), or surgery
What ist he first line tx for a young, infertile woman with obvious s/s of endometriosis? Laparoscopy (confirm dx, ablate ectopic endomet tissue and lyse adhesions)
What is the most likely cause of abnormal uterine bleeding (AUB) in the following pts?: MCC of AUB anovulatory bleeding
What is the most likely cause of abnormal uterine bleeding (AUB) in the following pts?: positive beta hCG + intrauterine preg + closed os threatened abortion
What is the most likely cause of abnormal uterine bleeding (AUB) in the following pts?: enlarged uterus + menometrorrhagia for months fibroids, molar pregnancy, or adenomyosis
What is the most likely cause of abnormal uterine bleeding (AUB) in the following pts?: bleeding a/w severe menstrual pelvic pain endometriosis or adenomyosis
What is the most likely cause of abnormal uterine bleeding (AUB) in the following pts?: menorrhagia + perimenopausal endometrial hyperplasia
What is the most likely cause of abnormal uterine bleeding (AUB) in the following pts?: AUB started with menarche bleeding diathesis (prob 2/2 von Willebrand's dz)
What is the most likely cause of abnormal uterine bleeding (AUB) in the following pts?: positive beta hCG + severe pain + no fetus in uterus on US ectopic pregnancy
What is the most likely cause of abnormal uterine bleeding (AUB) in the following pts?: metrorrhagia esp after intercourse + no pain + normal sized uterus polyp (endometrial or cervical)
What is the most likely cause of abnormal uterine bleeding (AUB) in the following pts?: depression + constipation + AUB hypothyroidism
What drug should you prescribe to any pt that you put on high E therapy to control severe menorrhagia? Phenergan aka promethazine (helps with nausea)
What is the MCC of irregular heavy uterine bleeding? Anovulation
When is an endometrial bx a necessary part of the work-up for AUB? Incr bleeding in a woman >35yo, multiple risk factors for endometrial CA
What is the tx of choice for primary dysmenorrhea? NSAIDs, OCPs
What meds are effective in the tx of PMS and PMDD? SSRIs, vit B6, progestins, SSRIs, NSAIDs, OCPs, +/- alprazolam
What is the first-line tx for endometriosis? Monophasic continuous OCPs, laparoscopy (if immediate fertility desired)
Which PCOS tx must be stopped in pregnancy due to risk of anti-androgenic effects in male fetus? Spironolactone
What is the best tx for infertility in a PCOS pt? Clomiphene (better than metformin)
WHat is the MCC of female infertility? Endometriosis
What is the MCC of hirsuitism in the US? What lab findings are used to make the dx? PCOS. Labs: high LH (LH:FSH >3), high total testosterone, high DHEA (normal DHEAS), and high androstenedione
For which type of cancer are women with PCOS at an increased risk and why? Endometrial CA b/c of unopposed E stimulation. Also breast CA
What meds are used in the tx of PCOS? OCPs, progestins, metformin, spironolactone, clomid (if preg desired), statins, exercise and wt loss
What is the MC clotting d/o that can cause menorrhagia? What lab values are abnormal? von Willebrand's dz. Norm platelets, incr bleeding time, norm PT, incr PTT
What are the 3 D's of the presentation of endometriosis? Dysmenorrhea, deep dyspareunia, and dyschezia (painful/difficult defecation)
Created by: sarah3148
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