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23 Cards in this Set

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  • Back
common cause of amenorrhea
retined corpus luteum maintainence from an ovulatory cycle
Dysfunct uterine bleeding is commonly related to what
HPO axis dysfunction
DUB most commonly affects what age groups
adolescents and perimenopausals
workup for perimenopausal pt with DUB
consider endometrial bx, sonohysterogram (inject saline to view endometrial cavity
Tx for DUB
high dose estrogen or progestin will help control profuse menstrual bleeding; DNC will give you a path dx and stop the bleeding; progestin containing IUD will tx perimenopausal pt; endometrial ablation
Best test to determine menopause
high FSH
Most common cause of bleeding in postmenopausal pt
hormones (possibly from supplements)
primary amennorheais suggested by:
Menstrual Cycle absent by age 13 in absence of NL growth and sexual development or by age 15 with NL growth and sex dev
most common cause of secondary amennorhea
pregnancy!
clinical def. of secondary amennorhea
Absence of 3 menstrual cycles or a period of 6 mo in a previously NL menstruating female
catagories of causes of amennorhea
HYPOTHALAMIC DEFECTS
are most common
GNRH TRANSPORT
GNRH PULSE
defects in pulse production – d/t stress, severe physical activity, elevations in PRL
FUNCTIONAL
No pathologic processes that you can identify
CONGENITAL
• Rare, x-linked
PITUITARY DEFECTS
Most common cause of ovarian dysfunction
ovarian dysgenesis
sex chromosome abnormalities result in what?
STREAK GONADS-FOLLICLE DEPLETION & absence of estradiol
HYPOGONADOTROPIC HYPOGONADISM WILL HAVE WHAT RELATIVE HORMONE LEVELS 
DECREASED FSH, LH, & ESTROGEN
at what level would you expect to find circulating gonadotropins in primary ovarian failure?
high
phenotypic female with y chromosome
early turners or vanishing testes syndrome
meopause before what age is considered premature ovarian failure?
40
what would the circulating hormoones in this type of pt look like?
INCREASE IN FSH & LH, BUT MARKED DECREASE IN ESTRADIOL
Ovarian resistance or salvage syndrome results from what?
Elevated FSH, LH, NL primordial cells in ovary, but receptor defect that does not allow cells to develop
Dx of polycystic ovarian disease
2 of the following:
-Oligo ovulation
-Clinical or biochemical signs of elevated androgens
-See polycystic ovaries on US
Tx of polycystic ovarian
Metformin, Avandia)- both induce ovulation
- also could give OCP
Dx and workup in pt with hyperprolactin, galactorrhea
• Serum TSH to r/o hyporthyroid b/c TRH stim PRL
• Look at medical and drug hx to make sure not on 5HT increasing med b/c it also increases PRL
Tx of pt with galactorrhea and macroadenoma
ovulation induction:
Bromocriptine
Surgery to remove macroadenoma
Most common ovulatory inducing agent = clomiphene citrate