Heavy Menstrual Bleeding Assessment and Management (NG88)
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Questions and Answers

What is the estimated prevalence of adenomyosis according to most studies?

  • 20 to 25%
  • 35 to 40%
  • 25 to 30%
  • 30 to 35% (correct)

Why is it important to optimize treatment for adenomyosis?

  • To complicate patient satisfaction
  • To reduce unnecessary investigations and treatments (correct)
  • To avoid studying the impact of adenomyosis
  • To increase the prevalence of the condition

What type of registry is suggested for recording long-term clinical outcomes in women with adenomyosis?

  • Prospective clinical registry (correct)
  • Pharmacological registry
  • Retrospective clinical registry
  • Surgical registry

What is the estimated percentage of women in whom submucosal fibroids cause heavy menstrual bleeding?

<p>15% (B)</p> Signup and view all the answers

Which condition is thought to be caused by submucosal fibroids in around 15% of women?

<p>HMB (C)</p> Signup and view all the answers

How can understanding the impact of adenomyosis help in improving patient outcomes?

<p>Improve patient satisfaction and treatment efficacy (A)</p> Signup and view all the answers

Which imaging technique is recommended as the first-line diagnostic tool for women with heavy menstrual bleeding who have significant dysmenorrhea or a bulky, tender uterus on examination?

<p>Transvaginal ultrasound (D)</p> Signup and view all the answers

What is the recommended approach if a woman declines transvaginal ultrasound or it is not suitable for her?

<p>Consider transabdominal ultrasound or MRI, explaining the limitations of these techniques (A)</p> Signup and view all the answers

Which of the following diagnostic tools should NOT be used as a first-line diagnostic tool for heavy menstrual bleeding?

<p>Saline infusion sonography (D)</p> Signup and view all the answers

Which of the following is the LEAST recommended approach for diagnosing heavy menstrual bleeding according to the text?

<p>Performing dilatation and curettage (A)</p> Signup and view all the answers

Which of the following conditions may cause pain associated with heavy menstrual bleeding, according to the text?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following factors may indicate the need for a pelvic ultrasound in women with heavy menstrual bleeding?

<p>All of the above (D)</p> Signup and view all the answers

What should be considered if further information about fibroid position, size, number, and vascularity is needed?

<p>MRI (D)</p> Signup and view all the answers

In what scenario should second-generation endometrial ablation be considered as a treatment option?

<p>For fibroids of 3 cm or more in diameter in women with HMB (A)</p> Signup and view all the answers

What should be considered if initial treatment for heavy menstrual bleeding (HMB) is unsuccessful?

<p>Additional investigations to reassess the cause of HMB (C)</p> Signup and view all the answers

When should pretreatment with a gonadotrophin-releasing hormone analogue be considered?

<p>Before hysterectomy and myomectomy for uterine fibroids causing an enlarged uterus (D)</p> Signup and view all the answers

What should be done when discussing the route of hysterectomy with the woman?

<p>Carry out an individual assessment and consider her preferences (C)</p> Signup and view all the answers

What is recommended if uterine fibroids are causing an enlarged or distorted uterus?

<p>Hysterectomy or myomectomy (A)</p> Signup and view all the answers

What is the primary aim of this guideline?

<p>To help healthcare professionals investigate the cause of heavy periods and offer appropriate treatments based on the woman's preferences. (B)</p> Signup and view all the answers

Who is the intended audience for this guideline?

<p>Both healthcare professionals and women with heavy menstrual bleeding, their families, and carers. (B)</p> Signup and view all the answers

What is the significance of the guideline being the basis for QS47?

<p>QS47 is a quality standard that is derived from the recommendations in this guideline. (C)</p> Signup and view all the answers

What principle is emphasized in the last sentence of the text?

<p>The importance of shared decision-making between healthcare professionals and patients. (C)</p> Signup and view all the answers

What is the significance of the guideline replacing CG44?

<p>CG44 was an outdated guideline, and this new guideline provides updated recommendations. (B)</p> Signup and view all the answers

What is the significance of the Royal College of Obstetricians and Gynaecologists' guidance for gynaecological services during the COVID-19 pandemic?

<p>It is not directly relevant to the guideline on heavy menstrual bleeding and is mentioned as additional context. (B)</p> Signup and view all the answers

Which of the following diagnostic techniques is recommended for detecting submucosal fibroids, polyps, or endometrial pathology in women with heavy menstrual bleeding (HMB)?

<p>Hysteroscopy (C)</p> Signup and view all the answers

What potential impact is mentioned in the text regarding the recommendation for hysteroscopy over pelvic ultrasound?

<p>It will require changes to service organization and training, as hysteroscopy is not as readily available as pelvic ultrasound. (D)</p> Signup and view all the answers

Which of the following strategies could be employed to address the resource impact of the hysteroscopy recommendation?

<p>Specialists could offer more services in the community, or GPs and nurses could be trained to perform hysteroscopy in primary care. (B)</p> Signup and view all the answers

Based on the information provided in the text, which of the following statements is true regarding the potential cost implications of the hysteroscopy recommendation?

<p>The recommendation is expected to result in overall cost savings due to a reduction in unnecessary investigations and more effective treatment. (D)</p> Signup and view all the answers

Which of the following statements is NOT supported by the information provided in the text?

<p>The recommendation for hysteroscopy is expected to lead to an increase in the number of unnecessary investigations. (D)</p> Signup and view all the answers

Which of the following diagnostic techniques can be considered for women with HMB, provided that they understand and accept the limitations of these techniques?

<p>Transabdominal ultrasound and MRI (D)</p> Signup and view all the answers

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