Adolescent Gynae Flashcards
Percentage of acquired and congenital bleeding disorders in adolescents
10-15%
Cyclical progesterone in menorrhagia
Must be given for 21 days
Can make periods heavier
Rokitansky syndrome aetiology
Congenital absence of the vagina
Associated with other congenital abnormalities of the urinary tract
Rokitansky syndrome presentation
Primary amenorrhoea Blind ending vagina Normal pubertal development Normal hormones Karyotype 46XX
Causes of ambiguous genitalia
Congenital adrenal hyperplasia
Partial androgen insensitivity
Disorders of testosterone biiosynthesis
Gonadal dysgenesis
CAh pathogens is
21-hydroxylase deficiency, leading to a decrease in cortisol, which in turn causes an increase in ACTH secretion
Treatment of CAH
Fludrocortisone lifelong
CAH ambiguous genitalia
Labial fusion
Clitoromegaly
Confluence of the vagina and distal urethra
Androgen insensitivity
Defect in the androgen receptor gene
X-linked recessive disorder
Have testes and normal testosterone; no mullerian structures present
Management:psychological support and treatments for vaginal hypoplasia
Disorders of sexual development definition
Congenital conditions in which development of chromosomal, gonadal, or anatomical sex is atypical
Complete androgen insensitivity syndrome definition
Genetically male
Unable to respond to androgens, and therefore have female external sex characteristics but do not have a uterus
May have male internal sex organs
CAIS at risk of what Comorbidities
Germ cell tumour
Osteoporosis
Incidence of CAIS
2-5 per 100000
CAIS inheritance pattern
Defect on AR gene
X-linked recessive pattern
Signs of CAIS
Primary amenorrhoea
Diminished or absent terminal hair
1/3 have absent axillary hair
Palpable testes
