JOKO WIBOWO S (012116424)

1.

Why she had mens over 15 days and a lot of blood out of the birth canal?
Etiology:
Organic
Functional (ovulatory & anovulatory), and Psychological complications of contraception

Etiologyirregular menstrual cycleprolonged bleeding & outside the menstrual cyclemenometrorhagia

Manuaba,chandradinata.dkk. 2004. Gawat-darurat Obstetriginekologi & Obstetri-ginekologi sosial untuk profesi bidan. Jakarta: EGC.

Patofisiologi gangguan perdarahan metropatia hemorrhagika menurut Prawirohardjo (2005)

2. Why she had menstrual cycle twice in a month ?

irregular somtimes

Etiology:
Organic

Functional (ovulatory

& anovulatory), and Psychological complications of contraception

Etiologyirregular menstrual cycle

3. Why is the abdominal pain was found to interfere with the activity? Autonomic nervous:
lumbar and sacral segments Visecerosensibel fibers by plexus uterovaginalis Etiologymass, an increase in estrogen, inflammationincrease in uterine sizepain
Manuaba,chandradinata.dkk. 2004. Gawat-darurat Obstetri-ginekologi & Obstetri-ginekologi sosial untuk profesi bidan. Jakarta: EGC.

4.

Why is the foul-smelling discharge was found between the two menstrual cycles?
myoma uterichanges in the blood supply for growthsecondary changes or degenerativedeficit circulationnecrosis in center of the tumorinfectionsepticfoulsmelling discharge.

Prawirohardjo, Sarwono. 2010. ILMU KEBIDANAN. Jakarta: PT Bina Pustaka.

5.

Why she had anemia and whats to do with the state of the obese patient's illness?
Anemia:
As a result of the bleeding patient may complain of anemia due to blood deficiency, dizziness, tired, and easy-going infection.

Obese:
Obese=hypercholesterolemiacholesterol is a steroid hormone-forming materialLDL cholesterol is a carrier molecule in the theca cells to be used as raw material for the androgenincreased levels of estrogen & LHRestraints on FSH secretion causes disruption of follicular proliferationirregular menstrual cycledisfunctional bleeding. (Kakisina, 2008), (Wasita, 2007).

6.

Whats interpretation gyn. exam available anteflexi uterine position and size of an adult fist?

7.

What is the relationship between the mother dying patient complaints with ca cervix?

8.

Why is the USG and histopathological examination is required for the patient?

9.

What is the relationship between never conceived and her illness?

10. DD?
Menometrorhagia Disfunctional Uterine Bleeding Myoma Uteri

MENOMETRORAGIA

Definition: Menometrorhagia is hipermenorhea menstrual bleeding or menorrhagia is more than the normal / longer than normal (more than 8 days). (Prawirohardjo, 2005).

Etiology: 1. Organic: a. Cervical polyps uterine b. Erosio portionis uteri c. Ulcers portio d. Abortion, ectopic pregnancy e. Ovarian tumors

Functional: Bleeding from the uterus that has nothing to do with organic causes, called dysfunctional bleeding. Dysfunctional Bleeding can occur at any age between menarche and menopause. But this disorder is more common during the early period and the end of ovarian function can. Two-thirds of women of women hospitalized for bleeding dysfunctional over 40 years old, and 3% under 20 years. Actually, in practice found also in puberty dysfunctional bleeding, but because of this condition is usually selflimiting, rarely needed treatment in the hospital. Signs and Symptoms: 1. ovulatory bleeding 2. anovulatory bleeding
2.

Clinical manifestations: 1. Irregular menstrual cycles, 2. Not long menstrual periods (amenorrhea) 3. Also, it will often have spots 4. Painful 5. Tense in the breast 6. Quick emotions Pathophysiology: Broadly speaking, the above condition can occur in cycles of ovulation (egg expenditure / ovum from the ovary), without ovulation or other circumstances, for example in premenopausal women (persistent follicle). Approximately 90% difunctional uterine bleeding (uterine bleeding) occurs without ovulation (anovulation) and 10% occurred in the ovulation cycle. In the ovulation cycle. Uterine bleeding that can occur in conjunction with the mid-menstrual and menstrual period. This bleeding occurs due to low levels of the hormone estrogen, while progesterone remains formed.

In cycles without ovulation (anovulation), Uterine bleeding that often occurs in the pre-menopause and reproductive period. This is because ovulation does not occur, so that the excessive estrogen levels while low progesterone. As a result of the uterine lining (endometrium) experienced excessive thickening (hyperplasia) without being followed by buffer (rich in blood vessels and glands) are adequate. Well, this condition causes uterine bleeding due to uterine wall is fragile. On the other hand, the bleeding did not occur simultaneously. Surface of the wall of the uterus in a new section recovered was followed in other surface bleeding. Be prolonged uterine bleeding. Manuaba,chandradinata.dkk. 2004. Gawat-darurat Obstetri-ginekologi & Obstetri-ginekologi sosial untuk profesi bidan. Jakarta: EGC.

DISFUNCTIONAL UTERINE BLEEDING In the uterus and ovaries at the same time can occur
menometrorhargia bleeding disorder called follicles that occurs because of the persistence of ovulation and corpus luteum formation. As a result, there was hyperplasia of the endometrium due to excessive estrogen stimulation and continuously. Dysfunctional bleeding can be found along with various types of endometrial atrophic endometrium ie, hyperplastic, proferatif, and secretory. With the kind of non-secretory endometrium with endometrial secretion is important because the type of premises can thus be distinguished from the avulatoir anovulatoar bleeding. In the ovulatory dysfunctional bleeding disorders ascribed to neuromuscular factors or hematologic mechanism is not understood was some bleeding anovolatoir usually considered to stem from endocrine disorders. (Sarwono Prawirohardjo,2003: 225)

MYOMA UTERI

Definition:

Physiology of fluxus

Pathology : oligomenore, amenore, menoragie

Hormonal and organ

Bleeding in TM 1 and 3

Trauma & infection

The mechanism of neoplasma in biomolecular

Initiation Is a process that involves a genetic mutation that became permanent in the cell's DNA . Triggered by the initiator ( material which is capable of causing gene mutations )initiated cells . Cells was similar to that of normal cells . 2. Promotion It is a stage when mutant cells proliferate. Caused because the clones are unstable and undergo initiation , forced to proliferate and undergo additional mutations and eventually develop into malignant tumaor ( neoplasm ). Initiated cells triggered by the promoter (continuous / repetitive)transformed cells . Changes in genetic information, DNA synthesis, replication increasessitu lesions. Hormones are often the promoters that stimulate cell growth ganas. Ex: Estrogen can stimulate the growth of breast and ovarian cancer . 3. Progression It is stage when mutant cell clones acquire one or more characteristics of malignant neoplasms with a growing tumor, the cells became more heterogeneous as a result of additional mutations to the gene. 4. Changes in protooncogene into an oncogene oncoprotein Changes in the phenotype : clinical terdpt lump ( tumor ) . Changes in chromosome karyotip example. Some subklon can show a more aggressive behavior of malignant or better able to evade the immune system.
1.

Represent endometriosis, adenomyosis, endometrial Ca (Risk factor & Clinical manifestations)

Endometriosis
Risk factor:
Clinical manifestations: 1. Scar tissue in the oviduct and ovary: a sense of discomfort in the bottom quadrantinfertility. 2. Rectal wallpain during defecation. 3. Serous uterine and bladder: dysuria and dyspareunia. 4. Intrapanggul bleeding and adhesions periuterusheavy Dismenorhea

Adenomyosis
Risk factor: 1. Usia 40 tahun Clinical manifestations: 1. Menorrhagia 2. Disminore

Endometrial Ca
Risk factor: 1. Age 55-60 years 2. Obesity 3. Diabetes 4. Hypertension 5. Infertility Clinical manifestations: