Post-menopausal bleeding is associated with all except:
Ans. is b, i.e. CINRef: Novak 14th/ed, p490; CGDT 10th/ed, p577-578; Jeffcoate 7th/ed, p614Postmenopausal bleeding is defined as bleeding which occurs after 12 months amenorrhea in a middle aged women.Causes of Post-Menopausal Bleeding:* Exogenous estrogen (HRT)* Vaginitis - tubercular, Candida, chlamydia, senile* Endometrial hyperplasia* Cervical cancer* Uterine sarcoma* DUB - ovulatory/anovulatory ulcer/Foreign body* Bleeding from urethra, bladder, rectum which is mistaken for vaginal bleeding.* Endometritis - tubercular, senile pyometra & hematometra* Endometrial/cervical polyp* Endometrial cancer (correct option)* Ovarian cancer (correct option)* Fallopian tube carcinoma* Injuries - direct trauma / DecubitusAs far as Fallopian tube carcinoma is concerned. Most common age group = 50-60 years.Most common symptom: Watery discharge which tracks from the tube through the uterus and vagina (hydrops tubal profluens).It is typically colourless, profuse in amount and escapes continuously or in gushes. The discharge ultimately becomes blood stained from ulceration of growth and female presents as post menopausal bleeding, (correct option).Cervical cancer is a cause of postmenopausal bleeding, but cervical carcinoma in situ which is seen at 25-35 years of age and CIN which is seen in women in their 20's is not a cause of post menopausal bleeding.Remember:"CIN is most commonly detected in women in their 20's, peak incidence of carcinoma in situ is in women aged 25 - 35, while incidence of cervical cancer rises after the age of 40." - Ref: CGDT 10th/ed, p833
Ca cervix
CIN
Ca ovary
Endometrial Ca
Disorders in Menstruation