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32 Cards in this Set
- Front
- Back
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What is the definition of amenorrhea?
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1. No period by age 14, absence of growth or development of 2nd sexual characteristics
2. No period by age 16 regardless of the presence of normal growth & development or appearance of 2nd sexual characteristics 3. No period for at least 3 cycles or no periods for 6 months |
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What is the 4-compartment classification of amenorrhea?
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- Outflow tract
- Ovary - Anterior pituitary - Hypothalamus |
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What is oligomenorrhea?
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Menstrual interval >35 days
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What is polymenorrhea?
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Menstrual interval <25 days
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What is Menorrhagis?
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Normal menstrual intervals with extra flow & duration
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What is Metrorrhagia?
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Irregular menstrual intervals with extra flow & duration
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What are the WHO classification of amenorrhea?
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Group 1: Low FSH, LH, Estradiol
Group 2: Normal FSH, LH, Estradiol Group 3: High FSH, LH; Low Estradiol |
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What are the cause of hypogonadal hypergonadotropic amenorrhea? (7)
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- Srugery
- Chemotherapy - Radiotherapy - Autoimmune - Idiopathic - FMR1 premutation - Resistant ovary syndrome |
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What is Swyer syndrome?
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Non-functioning SRY gene
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What are the cause of hypogonadal hypogonadotropic amenorrhea with abnormal MRI? (4)
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- Prolactinoma
- Craniopharyngioma - CNS lesions - Sheehan's syndrome |
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What are the cause of hypogonadal hypogonadotropic amenorrhea with normal MRI? (9)
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- Anorexia
- Stress - Strenuous exercise - Primary hypothyroidism - Hyperprolactinemia - Physiological delay - Kallmann syndrome - Idiophic (IHH) - FSH β mutation |
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What causes eugonadal chronic anovulatory amenorrhea?
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PCOS
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What causes eugonadal out flow tract abnormality amenorrhea?
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1. Congenital
- Imperforated hymen - Transverse vaginal septum - Mullerian agenesis 2. Genetic - Androgen resistance 3. Acquired - Asherman's syndrome |
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What is the definition of natural menopause
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- Permanent loss of ovarian follicular activity
- 12 consecutive months of amenorrhea |
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What is induced menopause?
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Cessation of menstruation due to surgical removal of the ovaries OR therapeutic ablation
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What is the prevalence of vasomotor symptoms in menopause?
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- 75-80% of women
- 6 months to 2 years |
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What is the management of vasomotor symptoms?
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- Lifestyle (Cool rooms, regular exercise, stop smoking)
- Non-Rx (Vitamin E) - Rx (SSRI, Gabapentin, Clonidine) |
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What are the urogenital concerns for menopause?
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- Urinary incontinence
- Urinary tract infection - Vaginal atrophy - Pelvic prolapse |
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Why do women in menopause get more urinary tract infections? (4)
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- Mucosa is thinner
- Glycogen production declines - Decreasing levels of lactobacilli - Reduced lactic acid production |
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Why do women in menopause get urinary incontinence? (2)
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- Reduction in mean urethral closure pressure
- Thinning of bladder mucosa and increased irritation |
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Why are women during menopause are more at risk to depression?
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Estrogen has positive effect on serotonin activity
- Up-regulation of 5HT1 receptors - Decreased MOA activity |
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Why do you have increased cardiovascular risk with menopause? (3)
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- Less favorable lipid profiles
- Increased insulin resistance - Increased likelihood of thrombosis |
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What is hormone replacement therapy approved for?
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- Moderate to severe vasomotor symptoms associated with menopause
- Moderate to severe symptoms of vulvar and vaginal atrophy associated with menopause - Prevention of postmenopausal osteoprosis |
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What are the 4 types of bleeding?
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- Estrogen withdraw bleeding (Mid cycle estrogen drop)
- Estrogen breakthrough bleeding (Too much estrogen and lining falls off) - Progesterone withdraw bleeding (Bleeding after stopping progesterone) - Progesteron breakthrough bleeding (Bleeding due to thin lining) |
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What is the differential for anovulatory bleeding? (6)
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= DUB
= Structural - Pregnancy - Uterine cancer - Polyps/Fibroids - Cervical Polyps - Adenomyosis |
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What causes dysfunctional uterine bleeding? (4)
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- PCOS
- Hypothalamic Hypogonadism - Perimenopausal patients - Adolescents |
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When do you not biopsy?
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- When uterine lining is <5mm
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Generally what are the menopause symptoms? (11)
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- Vasomotor symptoms
- Urogenital Concerns - Mood - Sexual Concerns - Cardiovascular Risk - Bones - Weight gain - Skin changes - Eye changes - Aches & Pains - Sleep Disturbances |
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What are the abortion techniques in early pregnancy?
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- Surgical: Suction Aspiration
- Medication |
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What are the abortion techniques in late pregnancy?
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- Surgical: Dilation and Evacuation
- Medication |
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What are the pre-abortion care?
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1. Offer to explore supports & decision
2. Establish gestational age 3. Review next steps 4. Discuss/prove contraception |
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What are the pro-abortion care?
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1. Listen
2. Pelvic exam 3. Contraception 4. Arrange follow up |
