Abnormal uterine bleeding, endometriosis, and fibroid workup and management scenarios tested on USMLE Step 2 CK.
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- In the PALM-COEIN system for abnormal uterine bleeding, what does the P stand for?
- Polyp
- In the PALM-COEIN system for abnormal uterine bleeding, what does the A stand for?
- Adenomyosis
- In the PALM-COEIN system for abnormal uterine bleeding, what does the L stand for?
- Leiomyoma
- In the PALM-COEIN system for abnormal uterine bleeding, what does the M stand for?
- Malignancy and hyperplasia
- In the PALM-COEIN system for abnormal uterine bleeding, what does the C stand for?
- Coagulopathy
- In the PALM-COEIN system for abnormal uterine bleeding, what does the O stand for?
- Ovulatory dysfunction
- In the PALM-COEIN system for abnormal uterine bleeding, what does the E stand for?
- Endometrial
- In the PALM-COEIN system for abnormal uterine bleeding, what does the I stand for?
- Iatrogenic
- In the PALM-COEIN system for abnormal uterine bleeding, what does the N stand for?
- Not otherwise classified
- How is abnormal uterine bleeding (AUB) defined in a reproductive-age woman?
- Bleeding from the uterus that is abnormal in frequency, regularity, duration, or volume
- What is the first-line imaging study for evaluating AUB?
- Transvaginal ultrasound
- At what age should a woman with AUB routinely receive an endometrial biopsy?
- 45 years or older
- How does PCOS raise the risk of endometrial hyperplasia in a patient with AUB?
- Chronic anovulation leads to unopposed estrogen stimulation of the endometrium
- What is the first-line medical treatment for heavy AUB with no structural cause identified?
- Combined hormonal contraceptives or a levonorgestrel-releasing IUD
- What is the mechanism of action of tranexamic acid in treating heavy menstrual bleeding?
- It is an antifibrinolytic that blocks plasminogen activation