Term
| What % of PMB is associated with benign conditions? |
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Definition
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Term
| What is the most common presenting sx for endometrial CA? |
|
Definition
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Term
| What are the ACOG recommendations regarding AUB? |
|
Definition
| Endometrial evaluation by EMB or US in all women with AUB 35 yrs and older |
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Term
| What are some differentials for postmenopausal bleeding? |
|
Definition
Endometrial atrophy (50%)
Endometrial CA (10%)
Polyps (3%)
Other causes - fibroids, STI, cervicitis, medications, etc. (37%) |
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Term
| What diagnostic tools do we use to evaluate PMB? |
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Definition
Endometrial biopsy (EMB)
Dilation and Curettage
Hysteroscopy (gold standard)
TVUS |
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Term
| What is considered an abnormal finding on TVUS? |
|
Definition
"Stripe" > 5 mm
*96% of women with Endo. CA had a stripe > 5 mm |
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Term
True or False:
HRT can cause postmenopausal bleeding |
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Definition
TRUE
*BTB is very common in the 1st 3-6 months of therapy
*Bleeding is more common if started within 12 months of menopause
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|
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Term
| When should you evaluate the endometrial lining in a woman on HRT? |
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Definition
| If unscheduled bleeding occurs in 2+ cycles |
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Term
| What is endometrial hyperplasia? |
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Definition
| Abnormal thickening and excessive, unusual cellular growth of the uterine glandular lining (the endometrium) |
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Term
| What is the most common cause of endo. hyperplasia? |
|
Definition
| Unopposed estrogen (menopause, PCOS, HRT, obesity, etc) |
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Term
| What are tx options for endo. hyperplasia without atypia? |
|
Definition
1. D & C
2. Cyclic progesterone - Prometrium 200 mg or Provera 10 mg x 10-14 days for 3 months; then re-evaluate the lining
3. Depo for 3 months
4. Mirena IUD
*Keep in mind Prometrium is contraindicated with a peanut allergy |
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Term
| When should APN's refer for endo. hyperplasia? |
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Definition
| Everything beyond Hyperplasia without atypia |
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Term
| What are some other classifications of endometrial hyperplasia? |
|
Definition
1. Simple dilated galnds
2. Complex glands
3. Simple with atypia
4. Complex with atypia |
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