14 - Female Reproductive Disorders

Question 1

primary amenorrhea definition

Answer 1

delay of menarche beyond age 16, or beyond 13 in absence of 2ndary sex characteristics

Question 2

functional hypothalamic amenorrhea - pathophys and likely causes

Answer 2

reduced GnRH drive > low / borderline low levels of FSH and LH > anovulation

cause - not a pathologic dz. maybe mediated through leptin, assoc w/ hypercortisolemia

Question 3

Sheehan’s syndrome

Answer 3

pituitary infarct from postpartum hemorrhage

Question 4

Turner’s syndrome - classic findings

Answer 4

primary amenorrhea, short stature, sexual immaturity, webbed neck, short metacarpals, broad chest / widely spaced nipples, droopy eyelids, low hairline, low set ears, short 4th toe, coarctation of aorta

Question 5

Mullerian agenesis

Answer 5

no mullerian structures + renal and bone abnlmalities. genetically female

Question 6

complete androgen insensitivity pts have no mullerian structures as well as what other key exam finding?

Answer 6

decreased body hair

Question 7

Asherman syndrome

Answer 7

intrauterine adhesions that can form an outflow obstruction

usually caused by surgery or curettage

Question 8

hirsutism

Answer 8

excessive androgen dependent hair growth (upper lip, chin, midsternum, upper abdomen, back, buttocks)

Question 9

ddx of hirsutism

Answer 9

r/o malignancy (adrenal or ovarian adenoCA)
cushing’s
non classic adrenal hyperplasia
PCOS
drugs - androgens, anabolic steroids, progestins
hyperprolactinemia
idiopathic