4/17 Flashcards
Most common cause precocious puberty males
CAH
Folicular phase
begins 1st day of menses
FSH stimulated ovarion follicle which in turn secretes estradiol
What does estradiol do
induces endometrial proliferation, further increasing FSH and LH
What causes ovulation in Luteal phase
LH surge
Progesterone effect on FSH and LH
decreases
what does hCG do
Maintains corpus lutteur and progesterone secretion
Amenorrhea first test
B-hcg
first question primary amenorrhea
is there secondary sex traits?
Secondary sex traits primary amenorrhea final tests
US and genetic analysis to determine anatomy and kayitypes
No secondary sex traits primary amenorrhea next test
FSH LH
No secondary sex traits primary amenorrhea low FSH and LH next test and results.
check prolactin to see if it’s Prolactinoma or HPA dysfunction(GnRH, etc.)
No secondary sex traits primary amenorrhea high FSH and LH dx
Gonadal Agenesis or ovarian failure
Secondary Amenorrhea first test
thyroid
2nd amenorrhea normal thyroid next test
prolactin
2nd amenorrhea normal thyroid, normal prolactin next test
progestin challenge
2nd amenorrhea normal thyroid, normal prolactin, - progesterone challenge, next step
Estrogen-progesterone challenge
2nd amenorrhea normal thyroid, normal prolactin, - progesterone challenge, - Estrogen-progesterone challenge dx
Ashermans
2nd amenorrhea normal thyroid, normal prolactin, - progesterone challenge, +Estrogen-progesterone challenge next test
FSH, LH
2nd amenorrhea normal thyroid, normal prolactin, - progesterone challenge, +Estrogen-progesterone challenge, High FSH and LH dx
Ovarian failure
2nd amenorrhea normal thyroid, normal prolactin, - progesterone challenge, +Estrogen-progesterone challenge, Low FSH and LH dx
HPA dysfuntion
2nd amenorrhea normal thyroid, normal prolactin, + progesterone challenge, next step
Is there hirsutism
2nd amenorrhea normal thyroid, normal prolactin, + progesterone challenge, Hirsutism dx
PCOS, Adrenal tumor, Cushing’s syndrome