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| {{CMG}}{{AE}}[[User:AroojNaz|Arooj Naz]] ,{{VVS}} | | {{CMG}}{{AE}}[[User:AroojNaz|Arooj Naz]] ,{{VVS}} |
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| ==Overview==
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| There are many differential diagnosis' for dysfunctional uterine bleeding, many of them resulting in abnormal presentation of bleeding. Some prevalent conditions include anatomical or structural defects, [[coagulation]] disorders, [[Pregnancy complications|pregnancy]] related complications, [[endometrial cancer]] and [[hyperplasia]], as well as [[Polycystic Ovarian Syndrome]].
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| ==Differential Diagnosis==
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| {| class="wikitable"
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| !Condition
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| !Common Underlying Causes
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| !Workup
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| |-
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| |Anatomic or structural lesions
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| *Uterine or [[cervical polyp]]s
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| *[[Uterine leiomyoma]]
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| *Foreign body
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| |Pelvic or transvaginal [[Ultrasonography]]
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| |-
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| |[[Coagulation]]<nowiki/>disorders
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| *Clotting factor disorder: [[Hemophilia]], hepatic disease, anticoagulant use, renal disease, [[Von Willebrand's Disease]]
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| *Platelet dysfunction: [[Leukemia]], [[Thrombocytopenia]], and related medications
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| |[[Coagulation]] studies; [[PT]], [[aPTT]], [[Bleeding time|Bleeding Time]], and [[Clotting factors|clotting factor studies]]
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| |-
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| |[[Pregnancy complications]]
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| *[[Placental abruption]]
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| *[[Ectopic Pregnancy]]
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| *[[Miscarriage]]
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| *[[Spontaneous abortions|Spontaneous abortion]]
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| *[[Placenta previa]]
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| |[[Human chorionic gonadotropin|B-hCG]] should be the first test to detect the presence of pregnancy. Visualization of the defect requires pelvic or transvaginal [[ultrasonography]]
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| |-
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| |[[Endometrial cancer]] <ref name="pmid30252237">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=30252237 | doi= | pmc= | url= }}</ref>
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| |Risk factors include:
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| *[[Diabetes Mellitus]]
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| *Unopposed [[estrogen]]
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| *[[Obesity]]
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| *Older age
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| *Chronic [[anovulation]]
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| *[[Ddx:Hypertension|Hypertension]]
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| |Upon [[transvaginal ultrasonography]], endometrial cancer will present as a [[thicked endometrial strip]]. Confirmation requires an [[endometrial biopsy]].
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| |[[Endometrial hyperplasia]]
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| *Exogenous extrogen
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| *Excess of endogenous estrogen
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| *DUB (dysfunctional uterine bleeding) is a diagnosis of exclusion
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| |Endometrial hyperplasia realted changes may be seen on [[ultrasonography]]. Obtaining a detailed history of medication use may be of assistance in coming to a diagnosis.
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| |[[Polycystic Ovarian Syndrome]] ([[Stein Leventhal Syndrome]]) <ref name="pmid24379699">{{cite journal| author=Sirmans SM, Pate KA| title=Epidemiology, diagnosis, and management of polycystic ovary syndrome. | journal=Clin Epidemiol | year= 2013 | volume= 6 | issue= | pages= 1-13 | pmid=24379699 | doi=10.2147/CLEP.S37559 | pmc=3872139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24379699 }}</ref>
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| |Risk factors include:
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| *Type 1 diabetes
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| *Type 2 diabetes
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| *Obesity
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| *Hereditary facotors
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| |PCOS may initially be suspected upon physical examination, commonly presenting with [[hirsutism]] and [[weight gain]]. Confirmation requires [[FSH]]/[[LH]] level abnormalities as well as multiple [[ovarian cysts]] seen on [[ultrasonography]].
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| |}
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| ===Other Causes===
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| *Endometrioma
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| *Hyperprolactinemia
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| *Hypo- or [[Hyperthyroidism]]
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| *Hypothalamic lesion
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| *Medications (e.g., [[Norepinephrine]])
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| *Nonuterine bleeding
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| *:*Rectal
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| *:*Urinary
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| *:*Vaginal
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| *:*Cervical
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| *Other malignancy
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| *Pelvic infection
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| *[[Polycystic Ovarian Syndrome]] ([[Stein Leventhal Syndrome]])
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| *Systemic disease
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| *[[Anorexia Nervosa]]
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| *Immature hypothalamic-pituitary-ovarian axis
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| *Intense exercise
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| *Nutritional status (Very low calorie diets)
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| *Peri-menopause
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| *Psychologic stress <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref>
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| ==References==
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| {{reflist|2}}{{WH}} {{WS}}
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| __NOTOC__
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| {{Dysfunctional uterine bleeding}}
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| <br />
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| ==References==
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| {{reflist|2}}
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| {{WH}}
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| {{WS}}
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| [[Category:Needs content]]
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| [[Category:Disease]]
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| [[Category:Gynecology]]
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