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8 Cards in this Set
- Front
- Back
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primary and secondary amenorrhea:
Pathologic except for when? Anatomic abnormalities that can cause amenorrhea? hypothalamic causes? |
primary - not occurred by 16 y/o
secondary - previous had them, but not in the past 3 months prepuberty, during pregnancy, early lactation, post menopause cervical stenosis, imperforate hymen anorexia nervosa, acute weight loss, chronic malnutrition, tumors |
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Pituitary causes?
Other causes? Accompanying S/S? |
hyperprolactinemia, adenoma, hypopituitarism (Sheehan's syndrome, trauma)
ovarian failure, CAH, PCOS, Cushing's, thyroid dysfunction hirsutism, obesity, galactorrhea |
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What is galactorrhea?
Most common cause? Explain how primary hypothryoid can cause it. |
lactation in men or non-breast feeding women
prolactinomas - high prolactin levels increased TRH --> increased TSH, prolactin |
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3 subsets of galactorrhea?
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Chiari-Frommel - persistent G/A post pregnancy
Ahumada-Del Castillo syndrome - G/A not associated w/ pregnancy Forbes Albright syndrome - G/A caused by chromophobe tumor of pituitary |
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Definition of polyuria, causes:
Normal urine output is: Definition of oliguria, anuria: S/S of DI: |
>3 L/24 hrs.; uncontrolled DM, decreased vasopressin, decreased tubular response to ADH from hypercalcemia or hypokalemia
700-2000 cc/day oliguria - <450 cc/day; anuria - <100 cc/day polyuria, polydipsia, dilute urine (spec grav < 1.005 or urine osmol <300), nocturia |
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How to figure anion gap:
Serum osmolality: Difference between central and nephrogenic DI: |
Na+ - (Cl- + HCO3-)
2x Na+ + Glucose/18 + BUN/2.8 central - vasopressin sensitive - usually due to trauma, infection, tumor nephrogenic - vasopressin resistant - acquired tubular diseases (MM, pyelo, SCD, high Ca++, low K+) |
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Drugs that can cause polyuria:
How to start a H20 deprivation test: |
lithium, diphenylhydantoin, amphotericin
pt is NPO get urine/serum osmolality, lytes, weight hourly urine, spec grav, osmolality give 5-10 units ADH SQ/IV hour later check urine again |
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Explain normal, CDI, and NDI response to water deprivation, vasopressin:
How long do you continue the test for? |
normal - urine osmolality exceeds serum
CDI - urine osmolality increases >50% NDI - minimal or no response to ADH orthostatic hypotension, postural tachycardia, 5% or more BW is lost. urine concentration doesn't increase >0.001 |
