Which of the following lists the PALM causes of abnormal uterine bleeding (AUB)?

• A. Polyp, Adenomyosis, Leiomyoma (fibroids), Malignancy and Hyperplasia.
• B. Coagulopathy, Ovulatory dysfunction, Endometrial abnormalities, Not yet classified.
• C. Infections, Endometriosis, Ovarian cysts, Cervical polyps.
• D. Hormonal imbalance, Uterine cancer, Thyroid disease, Diabetes

Answer: (A)

PALM-COEIN is a framework used to classify abnormal uterine bleeding by dividing causes into structural and non-structural categories. The structural group, known as PALM, includes four specific uterine-related problems: Polyp, Adenomyosis, Leiomyoma (fibroids), and Malignancy or Hyperplasia. These are physical or anatomic factors that can alter the lining or cavity of the uterus and lead to abnormal bleeding.

The list that fits PALM is the one that includes Polyp, Adenomyosis, Leiomyoma, Malignancy and Hyperplasia because it enumerates those exact structural factors.

The other options describe non-structural causes or conditions not grouped under PALM. For example, COEIN covers non-structural issues like coagulopathy, ovulatory dysfunction, endometrial abnormalities not caused by a structural lesion, and conditions not yet classified. Some items in the other choices refer to infections, endometriosis, ovarian cysts, or systemic diseases, which are not part of the PALM structural category.