Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Gynaecology > 1: Menstruation: Amenorrhoea and Oligomenorrhoea > Flashcards

1: Menstruation: Amenorrhoea and Oligomenorrhoea Flashcards

1
Q

Define amenorrhoea

A

absence of menstruation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is amenorrhoea classified

A

primary and secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define primary amenorrhoea

A
  • Failure of periods to onset from 14-years if no secondary sexual characteristics
  • Or, 16-years if secondary sexual characteristics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define secondary amenorrhoea

A

Absence of periods for 6-months after menstruation started

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are 4 causes of primary amenorrhoea

A

Turner’s
Congenital adrenal hyperplasia
Congenital malformations of genital tract
Testicular feminisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most common cause of secondary amenorrhoea

A

Pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the causes of secondary amenorrhoea

A
  • Functional disorders
  • Kallman’s
  • Hyperprolactinaemia
  • Thyrotoxicosis
  • PCOS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the role of the hypothalamus in menstruation

A

Release GnRH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What 3 disorders can cause amenorrhoea due to affecting hypothalamus

A

Kallman
Functional
Thyroid disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are 2 functional disorders that can reduce GnRH at the hypothalamus

A

Anorexia

Excessive exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is kallmann syndrome

A

X-linked recessive condition that causes failure of GnRH neurons to migrate to the hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does kallmann syndrome present

A

Anosmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why is kallmann syndrome rare cause of amenorrhoea

A

As it is x-linked recessive and females have two x-linkec chromosomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 3 hypothalamic causes of amenorrhoea

A

Functional
Kallman
Thyrotoxicosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are 4 pituitary causes of amenorrhoea

A
  1. Sheeman’s
  2. Cranial Irradiation
  3. Post-contraception amenorrhoea
  4. Prolactinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Explain how prolactinomas result in amenorrhoea

A

Prolactinomas is a pituitary tumour that results in hyper-secretion of prolactin. Prolactin inhibits GnRH leading to secondary amenorrhoea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the presenting features of prolactinoma

A

Amenorrhoea and galactorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What other pituitary tumours can cause amenorrhoea

A

Pituitary adenoma - due to compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is Sheehan’s syndrome

A

Massive obstetric haemorrhage leads to ischaemic necrosis of the pituitary gland resulting in hormone deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How does Sheehan’s syndrome present

A

Deficiency in several pituitary hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Explain post-contraception amenorrhoea

A

Prolonged used of contraceptives can cause long-term down regulation of the pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the main contraceptive that causes post-contraception amenorrhoea

A

Depo provea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How long can it take periods to return in depo proved

24
Q

What are 3 ovarian causes of amenorrhoea

A
  1. PCOS
  2. Turner’s
  3. Pre-mature ovarian failure
25
How does PCOS classically present
Oligomenorrhoea (Opposed to amenorrhoea)
26
What is the genetics of turner's syndrome
45XO
27
What is turner's syndrome
Genetic condition that causes: - Amenorrhoea - Absence secondary sexual characteristics - Infertility
28
What are common phenotypic presentations of Tuner's Syndrome
- Short stature - Webbed neck - Aortic coarctation - Bicuspid aortic valve (lead to aortic stenosis)
29
What is an 'adrenal' cause of amenorrhoea
Congenital adrenal hyperplasia
30
What is congenital adrenal hyperplasia
Absence of 21-OH
31
What are 4 anatomical causes of amenorrhoea
Imperforate hymen Asherman syndrome Transverse vaginal septum Mayer-Rokitansky-Kuster-Hauser syndrome
32
What is ashermanns syndrome
Instrumentation to the uterus causes damage to basal layer of the uterus, meaning it can no longer respond to oestrogen
33
What procedure is the most common cause of ashermanns syndrome
Surgical management of miscarriage
34
what is an imperforate hymen
No opening in the vagina
35
how does imperforate hymen present clinically
- Asymptomatic before puberty | - At puberty there is primary amenorrhoea and lower abdominal pain
36
how does an imperforate hymen present on examination
Bulging, blue-is tinge to the hymen
37
what is a transverse vaginal septum
Failure re-cannalisation of mullerian duct, cause cervical hypoplasia
38
what is mayer-rokitansy-kust-hauser syndrome
Failure mullerian duct to develop
39
what does agenesis of the mullein duct cause
Absence uterus and upper two-thirds of vagina
40
what is first line secondary amenorrhoea
Pregnancy test
41
what blood tests are ordered in amenorrhoea
TFT FSH, LH Prolactin 17-OH Progesterone
42
why are TFTs ordered
Thyrotoxicosis - as hyperthyroidism can cause amenorrhoea at hypothalamus
43
Why is prolactin ordered
Exclude prolactinoma
44
Why is FSH and LH ordered
Exclude PCOS
45
Why is 17-OH progesterone ordered
CAH
46
When may karyotyping be ordered in amenorrhoea
Exclude Tuner's syndrome as cause primary amenorrhoea
47
Why may an US scan be ordered in amenorrhoea
Exclude anatomical obstructive causes
48
Explain the progesterone challenge
Progesterone is given for 5-10d, or one-off dose. Positive test is shown by bleeding in 2W. Positive test indicates sufficient oestrogen, however individual is not ovulating (such as in PCOS). Negative test indicates insufficient oestrogen to cause proliferation and hence 'no secretion'
49
Explain managing amenorrhoea
Treat underlying cause. Aims include: - Regulate periods - Regulate/Replace hormones - Fertility - Symptom control - Surgery if pituitary cause
50
What may be given to regulate periods
COCP or POP
51
What is the advantage of regulating periods in amenorrhoea
Stops hyper-proliferation of the endometrium which increases risk of endometrial cancer
52
Define oligomenorrhoea
- Less than 9 periods a year | - More than 35 days between periods
53
What is the commonest cause of oligomenorrhoea
PCOS
54
Give 5 causes of oligomenorrhoea
1. PCOS 2. Transient anvoulation (Stress-induced) 3. COCP 4. Perimenopause 5. Hypothyroidism 6. Medications 7. Anorexia
55
Explain management of oligomenorrhoea
Treat underlying cause. May aim to induce regular periods by using COCP
56
What number of periods for PCOS is recommended per year and why
3 periods - to reduce risk of endometrial cancer

Gynaecology (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions