Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
49 Cards in this Set
- Front
- Back
|
what is the age range of menarche? And average age?
|
what is the age range of menarche? 9-18 yrs. W/ an average of 13 yrs old
|
|
|
Which are the same and which vary person to person, steroid hormones or peptide hormones?
|
Steroid hormones are the same in all people, but peptide hormones vary from person to person
|
|
|
What effect does dopamine have on the GnRH?
|
Dopamine --| prolactin --| GnRH --> thus blunts ovulation without pulse generation
|
|
|
What effect does CRH have on GnRH?
|
CRH --| GnRH
|
|
|
What effect will reduced cortisol have on GnRH? Does this explain stress and the loss of ovulation?
|
What effect will reduced cortisol have on GnRH? ↓ cortisol -->
CRH (to ↑ ACTH --> cortisol) --| ↓ GnRH… this explains why during stress an increased need for cortisol leads to loss of ovulation |
|
|
What effect will hypothyroid have on GnRH?
|
What effect will hypothyroid have on GnRH? ↓ T3 --> ↑ TRH (to ↑ TSH --> ↑ Thyroid hormone), but ↑ TRH --> Prolactin --| GnRH
|
|
|
What effect do opioids have on ovulation?
|
opioids --| GnRH
|
|
|
match the following definition with the term (oligomenorrhea, polymenorrhea, menorrhagia, metrorrhagia): mentrual inverval less than 21 days
|
match the following definition with the term: polymenorrhea: mentrual inverval less than 21 days
|
|
|
match the following definition with the term (oligomenorrhea, polymenorrhea, menorrhagia, metrorrhagia): irregular interval w/ bleeding between menses
|
match the following definition with the term: metrorrhagia: irregular interval w/ bleeding between menses
|
|
|
match the following definition with the term (oligomenorrhea, polymenorrhea, menorrhagia, metrorrhagia): mentruation greater than 35 days
|
match the following definition with the term: oligomenorrhea: mentruation greater than 35 days
|
|
|
match the following definition with the term (oligomenorrhea, polymenorrhea, menorrhagia, metrorrhagia): normal interval w/ excessive flow
|
match the following definition with the term:menorrhagia: normal interval w/ excessive flow
|
|
|
What's the criteria for primary amenorrhea? (hint: 2 each)
|
What's the criteria for primary amenorrhea? (1) No mensese by age 14 w/o evidence of secondary sexual characteristics… (2) no menses by 16 with secondary sex characteristics
|
|
|
How long before a diagnosis of amenorrhea?
|
How long before a diagnosis of amenorrhea?No menses for 3 cycles or 6 months
|
|
|
What are the 2 causes of ovarian failure?
|
What are the 2 causes of ovarian failure? (1) menopause (median age 51.3)… and (2) POF < 40 yrs old
|
|
|
What type of amenorrhea is seen with anorexics?
|
hypothalamic amenorrhea is seen in anorexics
|
|
|
What is the FSH:LH ratio in hypothalamic amenorrhea?
|
What is the FSH:LH ratio in hypothalamic amenorrhea? high LH with low FSH or normal
|
|
|
What does a high FSH suggest?
|
What does a high FSH suggest? Low E2 --> ↑ FSH --> suggests ovarian failure
|
|
|
What would you expect the estrogen to be in hypothalamic amenorrhea?
|
What would you expect the estrogen to be in hypothalamic amenorrhea? Low
|
|
|
What is hypogonadotropin/ hypogonadims indicate?
|
What is hypogonadotropin/ hypogonadims indicate? Hypothalamic amenorrhea
|
|
|
What is the overall etiology for hypothalamic amenorrhea?
|
What is the overall etiology for hypothalamic amenorrhea? Too few GnRH pulses
|
|
|
What type of menstrual disorder is Kallman's syndrome?
|
What type of menstrual disorder is Kallman's syndrome? Hypothalamic amenorrhea
|
|
|
What is the etiology behind Kallmann's syndrome?
|
What is the etiology behind Kallmann's syndrome? X-linked… --> no GnRH neuronal migration
|
|
|
What is the Rx for hypothalamic amenorrhea?
|
What is the Rx for hypothalamic amenorrhea? (1) provide estrogen and progesterone… (2) GnRH pump (not available) or Exogenous FSH/LH to induce ovulation
|
|
|
Why is Estrogen and progesterone given as Rx for hypothalamic amenorrhea?
|
Why is Estrogen and progesterone given as Rx for hypothalamic amenorrhea? Breast dev, stops epiphyseal growth, ↑ bone density, ↑ uterine size, stimulate endometrium
|
|
|
What is the pulse rate of GnRH?
|
What is the pulse rate of GnRH? 1/ 90 min
|
|
|
What percentage of body fat is need to initiate or to maintain menses?
|
What percentage of body fat is need to initiate or to maintain menses? Initiation = 17%… maintenance = 22%
|
|
|
What is the diagnosis for the following? Low or normal FSH or LH, low Estrogen, normal karyotype, absences of GnRH pulses, eating disorders, Ovaries still work.
|
What is the diagnosis for the following? Low or normal FSH or LH, low Estrogen, normal karyotype, absences of GnRH pulses, eating disorders, Ovaries still work. --> HYPOTHALAMIC AMENORRHEA
|
|
|
What would you expect the levels of FSH, LH, and E to be in a person with hypergonadotropin hypogonadism to be?
|
What would you expect the levels of a person with hypergonadotropin hypogonadism to be? High FSH and High LH, but low Estrogen --> due to ovarian failure
|
|
|
Why is there no ovulation in Turner's syndrome?
|
Why is there no ovulation in Turner's syndrome? No Estrogen spike leading to an LH surge
|
|
|
If a girl is experiencing amenorrhea and has a high FSH, what test could you run?
|
If a girl is experiencing amenorrhea and has a high FSH, what test could you run? Karyotype
|
|
|
What is StAR related to?
|
What is StAR related to? Hypergonadotropin hypogonadism
|
|
|
What is another name for hypergonadotropin hypogonadism?
|
What is another name for hypergonadotropin hypogonadism? Ovarian failure
|
|
|
What do the following etiologies suggest as a diagnosis? Galactosemia, resistant ovaries, surgery, infection, StAR, Sickle cell
|
What do the following etiologies suggest as a diagnosis? Galactosemia, resistant ovaries, surgery, infection, StAR, Sickle cell --> hypergonadotropin hypogonadism
|
|
|
What is the karyotype for Turner's syndrome?
|
45 X --> Turner's syndrome
|
|
|
What are 4 abnormallities associated with Turner's syndrome?
|
What are 4 abnormallities associated with Turner's syndrome? Renal anomolies, hearing loss, autoimmune disorders, CV (bicuspid arotic valve, coarctation of the aorta, aortic aneurisms)
|
|
|
What is the treatment for hypergonadotropin hypogonadism Amenorrhea?
|
What is the treatment for hypergonadotropin hypogonadism Amenorrhea? Estrogen and progesterone (Breast dev, stops epiphyseal growth, ↑ bone density, ↑ uterine size, stimulate endometrium)
|
|
|
If a girl is experiencing amenorrhea, with a ratio of LH:FSH > 3:1 (LH is very elevated), what type of amenorrhea does this suggest?
|
If a girl is experiencing amenorrhea, with a ratio of LH:FSH > 3:1 (LH is very elevated), what type of amenorrhea does this suggest? Hyperandrogenic/anovulation - PCOS… no LH surge… no progesterone
*Note: 3:1 ratio is seen in PCOS... but in hypothalamic amenorrhea LH is markedly higher (not necessarily in a 3:1 ratio) |
|
|
What would you expect the plasma levels of androgens (DHEA and DHEAS, 17 hydroxyprogesterone), LH, FSH, and progesterone to be in Hyperandrogenic/ anovulation - PCOS?
|
In Hyperandrogenic/ anovulation - PCOS you would expect these plasma levels: ↑androgens (DHEA and DHEAS, 17 hydroxyprogesterone) , ↑LH, ↓FSH, and ↓progesterone
|
|
|
In PCOS, given an increase in adipose tissue, what would you expect to happen to the increased androgens?
|
In PCOS: fat converts T--> E
|
|
|
In PCOS, what effect does increased E have on LH and androgens?
|
(Fat T--> E) ↑ E --> ↑LH --> ↑ T --> ↑E…
|
|
|
What effect does the increased E have on FSH?
|
What effect does the increased E have on FSH? Neg FB: ↑E --| FSH(↓)
|
|
|
Where are androgens produced in women? (T, androstenedione, and DHEA)
|
Where are androgens produced in women? T: 50% peripheral conversion… androstenedione: 50% adrenal/ 50% ovarian… and DHEA: 90% adrenal/10% ovarian
|
|
|
In PCOS, what role does increased fat play?
|
In PCOS, what role does increased fat play? ↑Fat cells: ↑ A --> E conversion --> ↑E --> ↑ ovarian LH --> ↑ A (continuing cylcle)
|
|
|
.
|
.
|
|
|
How is it that obesity leads to ↓ SHBP, ↑LH (leading to increased androgens)?
|
How is it that obesity leads to ↓ SHBP, ↑LH (leading to increased androgens)? Obesity --> insulin resistance --> hyperglycemia --> ↑ IGF-1 --> ↑ SHBP… And: Obesity --> insulin resistance --> hyperglycemia --> insulin --> ↑ LH --> (↑ androgens)
|
|
|
What is the general Rx for PCOS?
|
What is the general Rx for PCOS? Estrogen/progesterone: ↓LH/FSH, cylcles endometrium and prevents hyperplasia, prevents cysts, decreases androgens, increases SHBG --> ↓ in free androgens
|
|
|
What is the Rx for ovulation induction in PCOS?
|
What is the Rx for ovulation induction in PCOS? Clomiphene citrate, FSH, Metformin (insulin sensitizers)
|
|
|
What is the Rx for decreasing androgens in PCOS?
|
What is the Rx for decreasing androgens in PCOS? Metformin
|
|
|
What are the 4 key points of PCOS?
|
What are the 4 key points of PCOS? Annovulation, hyperandrogenism, hyperinsulinemia, associated risks (obesity, hypertention, diabetes, endometrial, hyperlasia/cancer)
|
