Dysfunctional uterine bleeding

438. Dysfunctional uterine bleeding:

A. May be associated with hypothyroidism.
B. May be associated with postmenopausal bleeding.
C. May be associated with functional ovarian cysts.
D. May present as menorrhagia.
E. May present as metropathia hemorrhagica.

438.
A. True
B. False
C. True
D. True
E. True

439. Dysfunctional uterine bleeding:

A. Dysfunctional menorrhagia is usually associated with poor function of the
corpus luteum.
B. Dysfunctional polymenorrhea means excessive but not prolonged menstruation.
C. Dysfunctional polymenorrhea shows tendency to spontaneous correction.
D. Metropathia hemorrhagica is the commonest type of dysfunctional
uterine bleeding.
E. Threshold bleeding occurs when estrogen level reaches high values.

439.
A. True
B. False
C. True
D. True
E. False

440. Treatment of dysfunctional uterine bleeding may include:

A. Progestins.
B. Danazol.
C. GnRH analogues.
D. Hysterectomy.
E. Endometrial ablation.

440.
A. True
B. False
C. False
D. True
E. True

441. Metropathia hemorrhagica:

A. Is the commonest type of DUB.
B. It is usually due to overproduction of gonadotropins by the pituitary.
C. Is commonly associated with theca lutein cysts.
D. Is associated with a variable period of amenorrhea followed by bleeding.
E. Is associated with endometrial hyperplasia.

441.
A. True
B. False
C. False
D. True
E. True

442. Diagnosis of metropathia hemorrhagica:

A. The majority of cases are premenopausal.
B. A common presentation is a variable period of amenorrhea followed by
prolonged bleeding.
C. Ultrasonography usually reveals a follicular cyst.
D. Ultrasonography usually reveals thickened endometrium.
E. The uterus is usually asymmetrically enlarged.

442.
A. True
B. True
C. True
D. True
E. False

443. Management of metropathia hemorrhagica:

A. Some cases require blood transfusion.
B. Fractional curettage.
C. Oral contraceptive pills are contraindicated.
D. Young patients may benefit from induction of ovulation.
E. Some cases require hysterectomy.

443.
A. True
B. True
C. False
D. True
E. True
444. Management of metropathia hemorrhagica:
A. Progestins have no role in treatment.
B. Endometrial ablation is the modern substitute of hysterectomy in all cases.
C. Some cases benefit from thyroxin.
D. Young patients should receive danazol therapy.
E. Antifibrinolytics may be used as adjuvant therapy.

444.
A. False
B. False
C. True
D. False
E. True

445. Endometrial ablation:

A. May be an alternative to surgery in some cases of dysfunctional uterine bleeding.
B. May be an alternative to surgery in cases with asymptomatic fibroids.
C. Does not require any preparation.
D. Does not require anesthesia.
E. Is always followed by amenorrhea.

445.
A. True
B. False
C. False
D. False
E. False

446. Premenopausal bleeding may be a presentation of:

A. Endometriosis.
B. Adenomyosis.
C. Metropathia hemorrhagica.
D. Complications of pregnancy.
E. Thecoma.

446.
A. True
B. True
C. True
D. True
E. False

447. Premenopausal bleeding may be a presentation of:

A. Carcinoma of the cervix.
B. Atrophic endometritis.
C. Fibroids.
D. Cervical erosion.
E. Endometrial carcinoma.

447.
A. True
B. False
C. True
D. True
E. True

448. Postmenopausal bleeding may be a presentation of:

A. Carcinoma of the cervix.
B. Atrophic endometritis.
C. Fibroids.
D. Cervical erosion.
E. Endometrial carcinoma.

448.
A. True
B. True
C. False
D. True
E. True

449. Investigation of a case of postmenopausal bleeding includes:

A. Full history.
B. General examination.
C. Local examination.
D. Vaginal ultrasonography.
E. Fractional curettage.

449.
A. True
B. True
C. True
D. True
E. True

450. Menorrhagia:
A. Is a term describing excessive and/or prolonged menstruation.
B. There may be no organic cause.
C. May be associated with use of combined oral contraceptive pills.
D. May be associated with hypertension.
E. May be associated with hypothyroidism.

450.
A. True
B. True
C. False
D. True
E. True

451. Menorrhagia may be associated with:

A. Intrauterine contraceptive device.
B. Subserous fibroid.
C. Adenomyosis.
D. Chronic PID.
E. Endometrial carcinoma.

451.
A. True
B. False
C. True
D. True
E. False

452. Metrorrhagia:
A. Means irregular bleeding not related to menstruation.
B. The majority of cases are due to local lesions.
C. May be due to irregular use of contraceptive pills.
D. Is not related to dysfunctional uterine bleeding.
E. Is not related to malignant tumors of the genital tract.

452.
A. True
B. True
C. True
D. False
E. False

Dysfunctional uterine bleeding

6- Say true or false.
a- I.U.D. can cause menorrhagia through disturbance in the level of carbonic anhydrase
enzyme.
b- Excessive intake of aspirin and other anti-inflammatory drugs can increase the menstrual
blood flow through coagulation disturbance.
c- Luteal phase defect may present by infertility, habitual abortion or menorrhagia
d- Bleeding in cases of metropathia hemorrhagica is mild following period of amenorrhea.
 e-The cycle length in a patient of menorrhagia is prolonged.
f- Pathological changes of the endometrium in cases of abnormal bleeding include
endometrial polyps.
g-The commonest cause of post-menopausal bleeding is atrophic endometrium
h- Thyroid abnormalities are a very common cause of irregular vaginal bleeding.
i- Dysfunctional uterine bleeding is commonest around the age of 40 years.
j- Curettage of the endometrium in cases of metropathia hemorrhagica shows evidence of
luteal phase defect.
k- Bilateral ovarian corpus luteum cyst is common in cases of metropathia hemorrhagica.
l- Induction of ovulation can be tried in cases of metropathia hemorrhagica in young age
females.
m- Androgens are effective treatment for dysfunctional uterine bleeding.
n- Progestogens are the main line of treatment for cases of dysfunctional uterine bleeding.
o- Estrogen may be used in treatment of cases of severe dysfunctional bleeding to stop the
bleeding by endometrial growth.
p- Cases of delayed shedding are diagnosed by doing curettage postmenstrual on day 7.
q-Hypertension might be a cause of cases of dysfunctional bleeding.
r-the commonest cause of postmenopausal bleeding is malignant tumors.
s-The commonest cause of bleeding at the childbearing period is pregnancy complications.
t- Pelvic congestion may result into menorrhagia and polymenorrhea.

(1)In metropathia hoemorrhagica, the uterine size is:

A) Normal.
B) Decreased.
C) 6 – 8 weeks’ pregnancy size.
D) None of the above.

(2)In metropathia hoemorrhagica there is:

A) Normal ovulation.
B) Anovulation.
C) Defective corpus luteum.

(3)The endometrium, in cases of metropathia

hoemorrhagica, is:
A) Secretory.
B) Shows swiss – cheese appearance.
C) Shows luteal phase defect.

(4)Diagnosis of metropathia hoemorrhagica depends upon

the following, EXCEPT:
A) Clinical examination.
B) Hysteroscopy.
C) Hysterosalpingoraphy.
D) Ultrasonography.

(5)GnRH analogues are used in the following conditions

EXCEPT:
A) Treatment of endometriosis.
B) Treatment of uterine leiomyoma.
C) Treatment of ovarian cystadenoma.
D) Treatment of ovarian polycystic disease.
E) IVF.

(6)Estrogen is used in the following conditions EXCEPT:

A) Postmenopausal syndrome and prevention of osteoporosis.
B) Turner’s syndrome.
C) Fibroadenome of the breast.
D) Atrophic vaginitis.
E) In contraceptive pills.

(7)Progesterone needs oestrogen-priming in the following

condition EXCEPT:
A) Secretory transformation of proliferative endometrium.
B) Alveolr development of glandular-breast tissue.
C) Increased bulk of uterine muscle.
D) Biphasic body temperature.

(8)Progesterone (not progestins) is used in:

A) Contraceptive pills.
B) Injectable contraceptives.
C) Luteal phase defect.
D) Treatment of recurrent cancer endometrium.
E) Treatment of dysfunctional uterine bleeding.

(9)Colposcopy in valuable in detection of epithelial

abnormalities in the following organs, EXCEPT:
A) Vulva.
B) Vagina.
C) Cervix uteri.
D) Corpus uteri.