Episode 61 - Abnormal Uterine Bleeding

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EMplify - September 2021

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Abnormal Uterine Bleeding in the Emergency Department

Authors:

Tazeen Abbas, MD

Abbas Husain, MD, FACEP

• Physiology review
• Terminology
• Differentiating Causes: PALM-COEIN
• Structural: Polyp, Adenomyosis, Leiomyoma, Malignancy/Hyperplasia
• Non-structural: Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not otherwise specified
• Other causes: thyroid disease, hyperprolactinemia, stress, weight loss and anorexia, heavy exercise
• Age Based Differential
• 12-18
• Immaturity of the hypothalamic-pituitary- ovarian axis
• Sexually transmitted infections
• Coagulopathies, and bleeding disorders (von Willibrand disease)
• 19-39
• polyps
• fibroids
• malignancy
• PCOS
• Age 40 and older
• endometrial atrophy
• malignancy
• History
• Physical Exam
• Diagnostic Studies
• Treatment
• Unstable
• Stable
• Special Cases
• DOACs
• Prepubescent girls
• genital injuries