The normal cycle length is [blank_start]21 to 35 days[blank_end]. The normal length of menstrual flow is [blank_start]2 to 7 days[blank_end]. The normal amount of menstrual blood loss is [blank_start]20 - 60 ml[blank_end].
21 to 35 days
20 to 30 days
21 to 30
18 to 35
2 to 8 days
1 to 8 days
3 to 9 days
4 to 7 days
20 - 80 ml
10 - 90 ml
20 - 40 ml
10 - 100 ml
Abnormal uterine bleeding is defined as any of the following except
frequency of menses
duration of flow
amount of blood loss
pain with menstruation
bleeding between periods
Broad classifications of Abnormal Uterine Bleeding include Ovulatory and Anovulatory. Accurate terminology includes the following terms: check all that apply
acute uterine bleeding
heavy menstrual bleeding
prolonged menstrual bleeding
All of the following complaints may be classified as Abnormal Uterine Bleeding except:
16 yo dancer who is concerned because she only gets her period every 60 days
49 yo who reports reports heavy uterine bleeding and that her last period before this episode was 18 months ago
25 year old who complains that she has spotting requiring the use of a light pad usually for 1-2 days between periods most months
29 yo who has severe cramps with regular menstrual cycle and menses lasting for 9 days each month
When the etiology of AUB is structural, the most common cause is
Choose all of the risk factors for endometrial cancer:
Age > 35
family hx of endometrial cancer
new onset of heavy, irregular bleeding, particularly after menopause
In the PALM-COEIN classification, PALM stands for:
Polymenorrhea, amenorrhea, Leukorrhea, and Metrorrhagia
Polymenorrhea, amenorrhea, Leukorrhea, and Menorrhagia
Polyps, Adenomyosis, Leiomyoma, Malignant and Premalignant
Polyps, Adenomyosis, Leiomyoma, Menorrhagia
In the PALM-COEIN classification, COIEN stands for:
Coagulapathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not classified
Coagulapathy, Ovulatory dysfunction, Endometrial, Immunologic, Not classified
AUB that is ovulatory is likely the result of endocrine process in which estrogen is stimulating endometrial growth without progesterone opposition, then is sloughed only once the endometrium outgrows its blood supply/loses nutrients.
A 41 yo female presents with a complaint of heavy but regular periods occuring at her usual 29-30 intervals. She states that her last period was very heavy and lasted for 8 days. She has had no problems with abdominal pain, menstrual cramping or pain with sex. She does occasionally feel some pressure in her pubic area. Expected pelvic examination findings with this client would include:
diffusely enlarged uterus
irregularly enlarged uterus
fixed retroverted uterus
You have prescribed your patient the first line therapy for her AUB, you tell her that you are prescribing
continuous COCs and that it can take up to 3 months to be effective.
Cyclic COCs and that she should results after 1 month treatment.
NSAIDS which will help reverse the prostglandin imbalance and be effective within the first 12 hours.
Estrogen therapy to calm the hyperactive growth of her uterine lining.
Progestins are the first line of treatment for an acute bleeding episode due to a denuded endometrium because it will stimulate the synthesis of PgF2 alpha which is vasoconstrictive.
A woman brings her daughter in to see you because she is not menstruating. You would evaluate her for all of the following except:
primary amenorrhea because she is 16 years, 7 months old and has never menstruated
primary amenorrhea because she is 14, has no breast budding, no pubic and has never menstruated
nothing because she is a 17 year old with previous regular periods, but they stopped after joining cross country team six months ago. this is secondary amenorrhea and you know that this is not uncommon for athletes
nothing because she is a 17 year old and had regular periods, but she started taking depo and her periods stopped. Secondary amenorrhea is a normal side effect of depo.
You suspect that your patient's AUB is annovulatory so you order _________ to confirm the diagnosis.
serum progesterone on day 1 of her cycle
serum progesterone on day 22 of her cycle
quantitative serum hCG
The following pts present for AUB. Match their complaints with the supplemental labs you would order:
[blank_start]TSH[blank_end] - hair loss, cold intolerance
[blank_start]Prolactin[blank_end] - headaches and peripheral vision changes
[blank_start]PTT/PT[blank_end] - easy bruising, heavy periods
[blank_start]Progesterone[blank_end] - irregular bleeding
A client comes in asking more about GnRH agonists, you could tell her all of the following except:
They are appropriate for short term use while a woman is awaiting surgical treatment for her heavy bleeding.
They should not be used long term because of menopausal side effects including negative impact on bone density
They are a first line therapy for women who are anemic
There is an estridiol "flare" that occurs around day 5, accompanied by heavy bleeding that lasts for several days.
In evaluating a client for primary amenorrhea, you administer a progesterone challenge test. Check off all the following things that are true for this test
You administer micronized progesterone 400mg daily X10 days, medroxyprogesterone acetate 5-10mg daily for 5-10 days, or progesterone in oil 200mg IM
If the challenge is positive, should should observe a withdrawal bleed while taking the progesterone.
If the challenge is positive, it confirms that the client has functioning ovaries which produce enough circulating endogenous estrogen
If the challenge is positive, it confirms rules out an obstruction of the genital tract
If the challenge is negative, it confirms exercise induced annovulation.
The Rotterdam PCOS Consensus Group requires 2 of the following 3 criteria to diagnose PCOS EXCEPT:
oligo- or annovulation
Clinical and/or biochemical signs of hyperandrogenism
exclusion of other androgen excess or related disorders