Alteration in the Female Reproductive System

Question 1

Complete androgen insensitivity syndrome

Answer 1

characterized by external female genitalia

children with CAIS often have testes within the labia majora, inguinal ring, or abdominal cavity that produce testosterone (and estrogen) in normal-range levels.

Breast development may be normal, but pubic and axillary hair is often sparse and the cervix, uterus, and ovaries are absent. A short vagina that ends without a cervix also may be present.

These individuals are often undiagnosed until puberty when menarche does not occur.

Question 2

partial androgen insensitivity syndrome (PAIS)

Answer 2

ambiguous genitalia and varying genotype

Question 3

Treatment for Complete Androgen Insensitivity Syndrome (CAIS)

Answer 3

Gonadectomy and hormone replacement therapy

Question 4

normal range for the onset of puberty

Answer 4

8 to 13 years

Question 5

Delayed puberty is diagnosed if

Answer 5

there is no breast development by age 13
the absence of a period by age 15 or 16.

Question 6

functional hypogonadotropic hypogonadism

Answer 6

underlying condition or illness (unrelated to gonadal function) responsible for the delayed development of puberty

treated with hormone therapy

Question 7

Precocious puberty

Answer 7

the onset of clinical signs of puberty (breast or pubic hair development) before age 8.

Question 8

Results of precocious puberty

Answer 8

premature development of secondary sex characteristics

premature closure of the epiphysis of long bones, which results in lifelong short stature

often carries profound psychosocial consequences

Question 9

Causes of precocious puberty

Answer 9

alterations in genetic factors,
an increase in obesity,
an increase in protein consumption,
the growing prevalence of molecular compounds known as endocrine disruptors in common household products

Question 10

Central precocious puberty

Answer 10

results from failure of central inhibition of the GnRH pulse generator (the gonadostat), often because of CNS abnormality

Question 11

Partial precocious puberty

Answer 11

partial early development of appropriate secondary sex characteristics alone or in combination
develop breasts and pubic hair early

Question 12

Complete precocious puberty

Answer 12

onset and progression of all pubertal features

Question 13

Primary dysmenorrhea

Answer 13

painful menstruation associated with the release of prostaglandins in ovulatory cycles,

Question 14

secondary dysmenorrhea

Answer 14

related to pelvic pathologic disorders (i.e., ovarian cysts, adenomyosis, endometriosis) that manifest in later reproductive years and may occur any time in the menstrual cycle

Question 15

Causes of primary dysmenorrhea

Answer 15

Elevated levels of prostaglandins (especially PGF2α and PGE2α) cause uterine hypercontractility, decreased blood flow to the uterus, and increased nerve hypersensitivity, resulting in pain.

Question 16

chief symptom of dysmenorrhea

Answer 16

pelvic pain associated with the onset of menses
pain often radiates into the groin and may be accompanied by backache, anorexia, vomiting, diarrhea, syncope, insomnia, and headache

Question 17

dysmenorrhea symptoms are caused by

Answer 17

entry of prostaglandins and prostaglandin metabolites into the systemic circulation

Question 18

treatment of dysmenorrhea

Answer 18

nonsteroidal anti-inflammatory drugs (reduce COX enzyme activity, and thus prostaglandin production)
hormonal contraceptives (stops ovulation and creates an atrophic endometrium, thereby decreasing prostaglandin synthesis and myometrial contractility)

Question 19

Amenorrhea

Answer 19

Lack of menstruation,

Question 20

causes of amenorrhea

Answer 20

pregnancy
chromosomal abnormalities,
hypothalamic dysfunction,
polycystic ovarian syndrome, hyperprolactinemia,
hypothyroidism,
malnutrition
ovarian failure

Question 21

Primary amenorrhea

Answer 21

failure of menarche and the absence of menstruation by age 13 years, without the development of secondary sex characteristics, or by age 15 regardless of the presence of secondary sex characteristics

Question 22

Compartment IV disorders

Answer 22

hypothalamus is unable to synthesize GnRH, so the pituitary fails to secrete LH and FSH. Therefore the ovary does not receive the hormonal signals required to stimulate estrogen production, and ovulation and menstruation do not occur

Question 23

Compartment II disorders

Answer 23

involve the ovary and are often linked with genetic abnormalities
gonadal dysgenesis (Turner syndrome) or androgen insensitivity syndrome (AIS)

Question 24

Compartment III disorders

Answer 24

disorders of the anterior pituitary gland including tumors
interfere with, or interrupt, the secretion of GnRH or FSH and LH
hydrocephalus, craniopharyngiomas, and other space-occupying lesions of the CNS

Question 25

Compartment I disorders

Answer 25

anatomic defects of the outflow tract associated with primary amenorrhea

congenital absence of the vagina and uterus and congenital uterine hypoplasia

Question 26

Turner syndrome

Answer 26

involves the lack of two functional and complete X chromosomes in at least some body tissues
failure of secondary sex characteristic development and amenorrhea, although there are high levels of circulating FSH and LH

Question 27

androgen insensitivity syndrome (AIS)

Answer 27

cells do not have a receptor for testosterone
patient have female external genitalia and female secondary sex characteristics. With the exception of a small vagina, internal female genitalia are absent, accounting for amenorrhea and infertility

Question 28

Typical primary dysmenorrhea sufferers are:

Answer 28

younger than 30
have not given birth
have a history of pelvic inflammatory disease, sexual assault, premenstrual syndrome, or sterilization;
are heavy tobacco or alcohol users
have a family history of dysmenorrhea
have a body mass index (BMI) less than 20

Question 29

Diagnosis of amenorrhea

Answer 29

Absence of sexual characteristics

the appearance of an immature female
structural or physiologic alterations of the reproductive tract

Laboratory studies to document karyotype, abnormal levels of gonadotropins, thyroid and prolactin levels, and ovarian hormones

Question 30

Secondary amenorrhea

Answer 30

absence of regular menses for 3 months or irregular menses for 6 months in women who have previously menstruated

Question 31

Causes of secondary amenorrhea

Answer 31

pregnancy
thyroid disorders (e.g., hypothyroidism), hyperprolactinemia
HPO interruption secondary to excessive exercise,
stress,
weight loss,
polycystic ovary syndrome (PCOS)

Question 32

major manifestations of secondary amenorrhea

Answer 32

absence of menses after previous menstrual periods. Infertility
vasomotor flushes
vaginal atrophy
acne
osteopenia
hirsutism