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27 Cards in this Set
- Front
- Back
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Pt who does not menstruate is at higher risk of _ with subsequent development of _
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endometrial hyperplasia,
endometrial cancer* |
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Primary amenorrhea is seen in what type of patients?
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Young woman with secondary sexual characteristics that has not menstruated by age 16
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_ is when a woman who has previously menstruated has no menses for greater than 6 months.
Less than 6 months is called _ |
Secondary amenorrhea
Suppressed menstruation |
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_: Greater than 35 consistent days between cycles
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Oligomenorrhea*
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_:Less than 21 days between cycles
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Hypermenorrhea*
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Menometrorrhagia:
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Dysfunctional Uterine Bleeding (DUB). •
Cycles are overlapping, body is confused and does not know when to initiate and finish a cycl |
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5 things that should be addressed when a patient has a menstrual problem:
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Hx, PE, Blood tests, Radiology, Pathology
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Disorders in menstruation are usually attritubable to _
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Hypothalmic pituitary ovarian axis
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Gonadotropin Releasing Hormone (GnRH) released by _,
It stimulates _ |
hypothalamus
LH and FSH release from pituitary |
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FSH is released from the _, and induces _
LH is released by _, and induces _ |
anterior pituitary
granulosa cells to produce estradiol anterior pituitary theca cells, induces ovulation |
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If patient has irregular intervals with their menstuation, which half of the cycle is usually the culprit?
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1st half, the proliferative phase; because there is a fixed lifespan to the luteal phase that has to do with the ovulation event and the formation of the corpus luteum.
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How long does the luteal phase last?
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11 days,
has to do with the lifespan of the corpus luteum (it 'dies off' --> withdrawal of progesterone --> menstruation) |
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What hormone is responsible for an increase in BBT?
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(basal body temperature)
PROGESTERONE, causes an increase in BBT by .6 to 1 degree |
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What is the mc reason for secondary amenorrhea?
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Pregnancy!
Always run a pregnancy test! |
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What tests should you run for amenorrhea?
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FSH, LH, TSH, Prolactin, DHEA -S
Progesterone helpful NOT Estrogen!! |
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What are some etiologies of amenorrhea, (other than prgnancy)
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Excessive Weight loss,
Obesity chemotherapy agens, Pituitary adenoma (prolactin secreting tumor) Psychogenic (anorexia nervosa) |
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You should diagnose premature ovarian failure by measuring _
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FSH levels (NOT estrogen),
this is aka premature menopause, which can occur as early as 40 yo. |
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How do you treat anovulatory cycles?
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transition into secretory endometrium by giving luteal phase progestin.
(this is a continuous build up of proliferative endometrium) |
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What is asherman's syndrome?
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scarring of the uterine cavity (thick fibrous bands)
This is the most frequent anatomical cause of secondary amenorrhea? |
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Hyp(o/er) thyroidism can result in skipped menses
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hypOthyroidism
treat with synthetic T4 |
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Elevated/Decreased serum prolactin levels results in amenorrhea
What is an important test to run? |
ELEVATED,
also results in galactorrhea even though patient delivered a long time ago. MRI imaging of sella turcica -- MAKE sure you DON"T miss a pituitary adenoma!! |
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32 yo female complains of amenorrhea. Pregnancy test is negative. She delivered her son 10 months ago, and stopped breast feeding at 8 weeks. Also states she has leaked breast milk recently. What is the dx?
How do you treat this? |
Hyperprolactinemia
Bronocriptine, a dopamine agonist |
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19 yo female complains of amenorrhea. She denies any previous or current sexual activity. PE shows oily skin, with hair growth on stomach and upperlip, with acne. What diagnostic test should be run to confirm the diagnosis of PCOS?
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LH:FSH ratio of > 3:1
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What other conditions are associated with Polycystic ovarian syndrome?
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Type II diabetes (comorbid finding up to 30%)
These patients are more prone to endometrial hyperplasia--> endometrial carcinoma |
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The progesterone challenge determines if the patient _
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has an adequate endometrium
has an outflow tract obstruction (these pts have complaints of bloating, and feel cranky) |
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What PCOS treatment is given to patients who are trying to become pregnant?
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Clomiphene Citrate
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All oral contraceptives have _.
Failure of contraceptives is mostly due to _ problems |
Ethinyl Estradiol
Compliance |
