Sannaries & Qs

نزلت نوتس لل menopause و ال على الأرشيف.AUB

Woman ≥45 years with AUB First-line investigation

Endometrial biopsy To Exclude endometrial hyperplasia and endometrial carcinoma before starting treatment.

Definitive diagnosis of endometrial cancer

Endometrial sampling (biopsy) is the gold standard.

Ttt of choice for Atypical endometrial hyperplasia (Premalignant lesion)

Treatment of choice: Hysterectomy, especially if family is complete.

Fibroid causing maximum bleeding

Submucous fibroid Because it distorts the uterine cavity and increases endometrial surface area.

Ttt of Dysmenorrhea (Spasmodic menorrhea)

NSAIDs (Ibuprofen, Mefenamic acid) Norethisterone (progestin)

Drugs for heavy menstrual bleeding

Tranexamic acid NSAIDs Norethisterone "

Swiss cheese" appearance of endometrium characteristics to:

Cystic glandular hyperplasia

Most common pathology in postmenopausal bleeding

Endometrial atrophy or atrophic vulvovaginitis

Criteria for diagnosis Premature menopause (Primary ovarian insufficiency

Amenorrhea before age 40 ↑ FSH ↓ Estradiol

Most common cause of senile (atrophic) vaginitis

Estrogen deficiency

Drug of choice for senile vaginitis

Topical estrogen

Age of senescence as per WHO is عمر الشيخوخة

Above 65 years old

🔴Premature menopause (Premature ovarian insufficiency) = Before 40 years. 🔴First-line drug for osteoporosis ▶️Bisphosphonates (Alendronate). 🔴Best treatment for hot flushes ▶️Estrogen. 🔴Raloxifene does NOT relieve hot flushes. 🔴HRT does NOT prevent coronary heart disease 🔴HRT decreases colorectal cancer risk. 🔴HRT increases DVT, stroke, breast cancer, and cholecystitis risk. 🔴Estrogen alone after hysterectomy to relieve hot flushes. 🔴Vaginal pH increases (>5) in menopause.

Maturation index in menopause= 100:0:0.

In Menopause الإستروجين ينخفض بشدة، لذلك لا تستطيع الخلايا أن تنضج. فتصبح أغلب الخلايا الموجودة هي Parabasal cells. لذلك يكون: Maturation Index = 100 : 0 : 0 أي: Parabasal = 100% Intermediate = 0% Superficial = 0%

Diagnostic Criteria for menopause

Serum FSH > 40 IU/L (most important diagnostic value) Low Estradiol (E2): 10–20 pg/mL Estrone (E1): 30–70 pg/mL E2/E1 ratio <1( normal 2:1 )

Leading Cause of Death in Women Age ≥65 years بالترتيب

1-Heart disease 2-Cancer 3-Cerebrovascular disease (Stroke)

Leading Cause of Death in Women Age 45-55years بالترتيب

1- Cancer 2- Heart disease 3- Accidents

🔴Most common vasomotor Symptom ▶️ Hot flushes. 🔴Common psychological symptom after menopause ▶️ Insomnia. 🔴 Obesity is considered a protective factor against osteoporosis (excess fat ▶️excess estrogen) 🔴Physical activity increases bone mineral content in postmenopausal women.

Osteoporosis Risk Factors

White race. Asian race. Smoking. Thin body habitus. Menopause. Positive family history. Physical inactivity .

Psychological Symptoms of menopause

Insomnia Irritability Frustration Malaise Emotional lability

Causes not directly related to decrease estrogen and progesterone alone but a mixture of

Hormonal factors Environmental factors psychological factors

Absolute Contraindications to Estrogen / Hormone Replacement Therapy (HRT)

Estrogen-dependent tumors (Breast cancer, Endometrial cancer) Active thromboembolic disease (DVT, Pulmonary embolism) Undiagnosed genital tract bleeding Active severe liver disease Malignant melanoma

Relative Contraindication to hormone replacement therapy

Hypertension Diabetes mellitus Gallstones (Biliary stones) يعني postmenopausal female عندها hypertension عادي تاخد HRT لانه relaive contraindications Not absolute

السلام عليكم بالنسبة لعملي الأطفال 66 بنفكركم بالليست اللي نزل فيها 10 حالات لحد دلوقتي: https://youtube.com/playlist?list=PLcqo3UiOrTpSTJQ8MEvnYsBK5ATlfdZBO&si=VKOd7ln2Flca4jy6 بالنسبة لملفات الألترا دفعتنا 65 الملفات بتجهز وهينزل جزء كبير منها يوم السبت بالليل إن شاء الله.

للكويز التاني دي كل الأفكار تقريبا والنوتس اللي في pdf دكتور نجلاء https://t.me/Sanaarchive65/1120 افكار cases اللي كانت في ملف دكتور نجلاء https://t.me/Sanaarchive65/1123 #Gynecology

لا تنسوا قراءة سورة الكهف.

زودنا Special views

Complete ✅

وعشان برضو الهدف من الليست دي انها تتسمع في الطريق للراوند اللي جهز من الليست موجود دلوقتي على سبوتيفاي 😍 https://open.spotify.com/episode/4zZPEQIoLg2DaYfi7jkVSY

السلام عليكم مساء الخير دفعة 66، هنبقا معاكم إن شاء الله في ليست خفيفة جدا في عملي الأطفال هتكون عبارة عن brief سريع الهدف منه انك تكون رايح الراوند فاهم هيتشرحلك إيه ولو هتاخد شيت يبقا ايه المهم فيه. اللي هيجهز مع الوقت هينزل والملفات اللي تقدروا تتابعوا منها هتنزل على الأرشيف هنا https://youtube.com/playlist?list=PLcqo3UiOrTpSTJQ8MEvnYsBK5ATlfdZBO&si=KyuGVaTUseT2t96f

بالنسبة للرسالة اللي اتبعتت عن المقارنتين دول لضيق الوقت: بالنسبة لـ Complications of DVT: - Pulmonary embolism - Phlegmesia Cerula dolens —> Venous gangrene - Phlegmesia alba dolens - Chronic venous insufficiency & Post phlebitic limb. TTT of DVT: - Mainly prophylactic - Bed rest & limb elevation - Anticoagulants - Thrombolytic therapy - Venous thrombectomy - IVC filter is indicated if anticoagulant is contrindicated