Medicine an Surgery notes

Apr 24th, 2015
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DIFFERENTIAL DIAGNOSIS OF GENITAL TRACT BLEEDING - It may arise due to problems at multiple anatomic sites including the lower genital tract (vulva, perianal region, vagina, and cervix) and upper genital tract (uterus, fallopian tubes, and ovaries). In addition, the origin of bleeding may include non-gynecologic sites such as the urethra, bladder, and bowel. Pregnancy is an important cause of abnormal bleeding that should be considered in the differential diagnosis of any reproductive-age women with abnormal genital tract bleeding. A number of drugs and systemic illnesses may also cause this complaint.Anovulation - Irregular and anovulatory cycles are common in adolescent girls during the early postmenarchal years due to a slowly maturing hypothalamic-pituitary axis.- Ovulatory cycles and the normal cyclic production of estrogen and progesterone become disturbed as women approach menopause. Ovulation occurs intermittently, interspersed with anovulatory (estrogen only) cycles of varying length. As a result, menses become irregular, and heavy bleeding can occur during longer periods of anovulation. Thus, vaginal bleeding becomes unpredictable in both timing and amount.- Chronic anovulation in reproductive-age women is most likely attributable to an endogenous disorder such as the polycystic ovary syndrome (PCOS). Most hyper androgenic women (including those with PCOS) have an adequate amount of biologically active estrogen, since androgens can be converted peripherally to

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