184- anovulation Flashcards

1
Q

FSH: what cells does it stimulate? Stimulates production of what else?

A

proliferation of granulosa cells

aromatase and estradiol, granulosa cell FSH/LH receptors, activin and inhibin

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2
Q

primary vs secondary amenorrhea

A

primary: no menses by 16, no breasts by 14
secondary: no menses for 6 months

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3
Q

things to rule out when someone presents with secondary amenorrhea? what are disease/disfunction causes?

A

pregnancy, breast feeding, OCP, IUDs, progestin pill

hypogonadotropic hypogonadism, hyperprolactinemia, PCOS, POF, Asherman’s

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4
Q

Hypogonadotropic hypogonadism: most common cuases? LH/FSH levels? Estogen levels? Other findings?

A

weight loss, exercise, stress

Low, low. Thin endometrial stripe

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5
Q

Hyperprolactinemia: what drugs cause it? what else?

A

prolactinomas and antipsychotics: phenothiazines, haloperidol, risperidone. Clozapine is only transient

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6
Q

Criteria for PCOS

A

anovulation, androgen excess, polycystic ovaries (multiple large follicles)

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7
Q

Treatment of PCOS

A

Weight loss is first (5% wt loss leads to regular menses). OCPs for anovulation and hirsutism. Possible metformin for insulin resistance.

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8
Q

Premature ovarian failure: define? What chromosomal abnormalities can cause it? What other autoimmune syndromes present with it? Are POF ppl at risk of anything else?

A

menopause before 40 or two FSH levels >40 one month apart

15% of Fragile X (FMR1) premutations have POF. 45XO is at risk for CV issues

Hypothyroidism

Osteoporosis

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9
Q

Asherman’s syndrome

A

adhesions from abortions or other procedures

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10
Q

most common causes of primary amenorrhea

A

gonadal dysgenesis (often from abnormal karyotype), hypogonadotropic hypogonadism, anatomic (imperforate hymen, MRKH absence of vagina)

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11
Q

ovulation induction in PCOS: what meds can you use?

A

aromatase inhibitors: anastrozole, letrozole

Gonadotropin injections

Clomiphene citrate

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