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Questions and Answers
What determines the sex of the child during conception?
What determines the sex of the child during conception?
What is the morula stage characterized by?
What is the morula stage characterized by?
When does the primitive streak become visible during embryonic development?
When does the primitive streak become visible during embryonic development?
What is the role of the somites during development?
What is the role of the somites during development?
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What happens during the zona hatching process?
What happens during the zona hatching process?
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At what age of the embryo can the fetal heartbeat be easily heard?
At what age of the embryo can the fetal heartbeat be easily heard?
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What significant development occurs for the fetus at 26 weeks?
What significant development occurs for the fetus at 26 weeks?
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Which of the following is a characteristic of the fetus at 22 weeks?
Which of the following is a characteristic of the fetus at 22 weeks?
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What is the estimated survival rate for babies born at 27 weeks of embryo development?
What is the estimated survival rate for babies born at 27 weeks of embryo development?
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What crucial feature is present on the fetus's skin starting at 20 weeks?
What crucial feature is present on the fetus's skin starting at 20 weeks?
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Which developmental milestone occurs at 28 weeks of the embryo?
Which developmental milestone occurs at 28 weeks of the embryo?
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What change in the embryo can be observed by mothers as early as 22 weeks?
What change in the embryo can be observed by mothers as early as 22 weeks?
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What is a likely risk for babies born at 26 weeks of embryo development?
What is a likely risk for babies born at 26 weeks of embryo development?
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What is the initial method to induce withdrawal bleeding before administering oral contraceptives?
What is the initial method to induce withdrawal bleeding before administering oral contraceptives?
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Which diagnostic evaluation may be performed to assess abnormalities of the genital tract?
Which diagnostic evaluation may be performed to assess abnormalities of the genital tract?
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What is one of the common symptoms of premenstrual syndrome (PMS) experienced by women?
What is one of the common symptoms of premenstrual syndrome (PMS) experienced by women?
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What should be monitored in women experiencing amenorrhea if initial tests are inconclusive?
What should be monitored in women experiencing amenorrhea if initial tests are inconclusive?
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How long do common PMS symptoms typically last before menstruation starts?
How long do common PMS symptoms typically last before menstruation starts?
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What type of tumors may require surgical intervention or radiation therapy?
What type of tumors may require surgical intervention or radiation therapy?
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What physical examination may help in diagnosing amenorrhea?
What physical examination may help in diagnosing amenorrhea?
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What type of imaging study is performed to look for intrauterine adhesions?
What type of imaging study is performed to look for intrauterine adhesions?
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What is the primary hormone that is deficient during anovulation, leading to possible menorrhagia?
What is the primary hormone that is deficient during anovulation, leading to possible menorrhagia?
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How might uterine fibroids affect menstrual bleeding?
How might uterine fibroids affect menstrual bleeding?
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Which condition is characterized by endometrial glands embedded in the uterine muscle, often causing heavy bleeding?
Which condition is characterized by endometrial glands embedded in the uterine muscle, often causing heavy bleeding?
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What is a common effect of using a nonhormonal intrauterine device (IUD)?
What is a common effect of using a nonhormonal intrauterine device (IUD)?
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What can be a clinical manifestation of menorrhagia?
What can be a clinical manifestation of menorrhagia?
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In addition to anatomical changes, what other factors can contribute to heavy menstrual bleeding?
In addition to anatomical changes, what other factors can contribute to heavy menstrual bleeding?
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Which of the following statements regarding uterine polyps is accurate?
Which of the following statements regarding uterine polyps is accurate?
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What symptom may indicate a severe case of menorrhagia, particularly suggesting anemia?
What symptom may indicate a severe case of menorrhagia, particularly suggesting anemia?
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What is a likely recommendation if an IUD causes excessive menstrual bleeding?
What is a likely recommendation if an IUD causes excessive menstrual bleeding?
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What condition might a blood test evaluate for when excessive menstrual bleeding is present?
What condition might a blood test evaluate for when excessive menstrual bleeding is present?
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What is an ectopic pregnancy?
What is an ectopic pregnancy?
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Which of the following tests examines cells from the cervix?
Which of the following tests examines cells from the cervix?
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What does a hysteroscopy involve?
What does a hysteroscopy involve?
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Which condition can rare cases of excessive menstrual bleeding indicate?
Which condition can rare cases of excessive menstrual bleeding indicate?
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What is the purpose of a sonohysterogram?
What is the purpose of a sonohysterogram?
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What might be a likely next step if menorrhagia continues after an initial treatment?
What might be a likely next step if menorrhagia continues after an initial treatment?
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Study Notes
Diagnostic Evaluation for Menorrhagia
- History collection
- Physical examination
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Blood tests
- To determine levels of hormones produced by the pituitary gland (FSH, LH, TSH and prolactin) and the ovaries (estrogen)
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Ultrasonography of the pelvis
- To assess abnormalities of the genital tract or look for polycystic ovaries.
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CT Scan or MRI of the head
- To exclude pituitary and hypothalamic causes of amenorrhea.
Additional Tests for Menorrhagia
- Determination of prolactin levels
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Hysterosalpingogram (x-ray test)
- To examine the uterus
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Hysteroscopy
- To examine the endometrium, which is shed during menstruation.
Menorrhagia Causes
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Hormone imbalance
- The endometrium develops in excess and eventually sheds via heavy menstrual bleeding.
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Dysfunction of the ovaries
- Ovaries may not release an egg (ovulate) during a menstrual cycle (anovulation). This can lead to hormone imbalance.
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Uterine fibroids
- Noncancerous tumors of the uterus that can cause heavier than normal or prolonged menstrual bleeding.
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Polyps
- Small, benign growths on the lining of the uterus (uterine polyps) that can cause heavy or prolonged menstrual bleeding.
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Adenomyosis
- Glands from the endometrium become embedded in the uterine muscle, often causing heavy bleeding and painful menses.
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Intrauterine device (IUD)
- A common side effect is menorrhagia, which may require removal of the IUD.
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Pregnancy complications
- Heavy bleeding can be due to a miscarriage.
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Cancer
- In rare cases, uterine, ovarian, and cervical cancer can cause excessive menstrual bleeding.
Clinical Manifestations of Menorrhagia
- Soaking through one or more sanitary pads or tampons every hour for several consecutive hours.
- Needing to use double sanitary protection to control menstrual flow.
- Needing to wake up to change sanitary protection during the night.
- Bleeding for longer than a week.
- Passing blood clots with menstrual flow for more than one day.
- Restricting daily activities due to heavy menstrual flow.
- Symptoms of anemia, such as tiredness, fatigue or shortness of breath.
Diagnostic Evaluation for Menorrhagia
- History collection
- Physical examination
-
Blood test
- To check for iron deficiency (anemia) and other conditions, such as thyroid disorders or blood-clotting abnormalities.
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Pap test
- To test for infection, inflammation, or changes that may be cancerous or lead to cancer.
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Endometrial biopsy
- To examine tissue from the lining of the uterus.
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Ultrasound scan
- To produce images of the uterus, ovaries, and pelvis.
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Sonohysterogram
- A fluid is injected into the uterus to look for problems in the lining.
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Hysteroscopy
- This procedure examines the cervix and the lining of the uterus.
Treatment Options for Menorrhagia
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Hormonal therapy
- Birth control pills, progestin-only pills, or other hormone medications can help regulate the menstrual cycle.
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Nonsteroidal anti-inflammatory drugs
- These drugs can help reduce pain and inflammation.
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Iron supplements
- To treat anemia.
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Dilation and curettage (D&C)
- This procedure widens the cervix and then scrapes or suctions tissue from the lining of the uterus to reduce menstrual bleeding.
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Uterine artery embolization
- This procedure shrinks fibroids by blocking blood flow to them.
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Description
This quiz covers the diagnostic evaluation techniques for menorrhagia, including history collection, physical examination, and various imaging tests. It also explores the potential causes of menorrhagia, such as hormone imbalances and ovarian dysfunction. Test your knowledge on identifying the underlying factors of this condition.