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PathophysI_MDO_October1_2012_CaseDiscussion_Class (1)

Dysmenorrhea definition pain typically cramping in

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Dysmenorrhea Definition Pain, typically cramping in character, in the lower abdominal region Occurs in the days just before and during menstrual flow Contributing factors (vs. risk factors) Clinical manifestations / course Accompanying symptoms may include: sweating, weakness and fatigue, insomnia, nausea, vomiting, diarrhea, back pain, headache, dizziness, syncope
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Dysmenorrhea - Pathophysiology Excessive endometrial contraction Ischemia Stimulates uterine pain fibers Excessive production of prostaglandin production (PGF2α) by secretory endometrium of the uterus
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Endometriosis Definition Chronic, recurring disease wherein there is a presence of endometrial tissue located outside of the uterine cavity; most commonly in the peritoneal cavity Risk factors Early menarche; regular periods with shorter cycles (< 27 days), longer duration (> 7 days), or heavier flow; increased menstrual pain; other first- degree relatives with endometriosis
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Endometriosis Clinical Manifestations/Course Gross pathologic changes Endometriomas Hemorrhagic lesions +/- surrounded by scar tissue Signs/symptoms Classic triad = dysmenorrhea, dyspareunia, and infertility Others: pelvic pain, dyschezia, sciatica Diagnosis
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Endometriosis - Pathophysiology Retrograde menstruation Endometrial cells implant and grow elsewhere Coelomic metaplasia and induction Endometrial cells metastasize through lymphatics or vascular system
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Patient Case A 26 year-old women presents for a routine gynecologic exam. She entered menarche at the age of 12. Her LMP was 3 months ago. Her periods are often irregular and occur about every 2- 3 months.
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