amenorrhea

Question 1

what is the definition nof amenorrhea ?

Answer 1

absence of menses

Question 2

define primary amenorrhea

Answer 2

non occurrence of menarche by the age of :
14 with no secondary sexual characteristics
16 with secondary sexual characteristics

Question 3

define secondary amenorrhea

Answer 3

absence of menses for 3 consecutive cycles

Question 4

what is the most common cause of false amenorrhea ?

Answer 4

imperforate hymen ( outflow obstruction)

Question 5

what are the effects of imperforate hymen ?

Answer 5

accumulation of blood behind the hymen 
hematocolpos 
hematometra 
hematosalpinx 
pelvic haemorrhage

Question 6

how can we diagnose imperforate hymen ?

Answer 6

Ultrasound

Question 7

what is the treatment of imperforate hymen ?

Answer 7

cruciate incision under anesthesia

Question 8

what are the common causes of true amenorrhea ?

Answer 8

physiologic delay of puberty
psychological trouble
rapid weight loss and exercise

Question 9

what is kallman’s syndrome ?

Answer 9

congenital GnRh receptor deficiency

Question 10

what is the typical presentation of kallman’s syndrome ?

Answer 10

loss of smell

amenorrhea

Question 11

what kind of drugs can cause amenorrhea ?

Answer 11

antipsychotics TCA
Androgenic drugs Danazol
Combined OCPs , post pill amenorrhea
Progestins

Question 12

what type of tumors and infiltrative lesions can cause amenorrhea ?

Answer 12

craniopharyngoma

lymphoma

Question 13

what are the pituitary causes ?

Answer 13

hyperprolactinaemia:
prolactinoma
hypothyroidism
drug induced - dopamine receptor agonists

Question 14

what are the pituitary insufficiency causes ?

Answer 14

sheehan’s synndrome
simmond’s syndrome
pituitary infarction
sheehan eventually causes simmonds

Question 15

what is a congenital pituitary related cause of secondary amenorrhea ?

Answer 15

empty sella syndrome

Question 16

what are the ovarian causes of amenorrhea ?

Answer 16

PCOS 
Premature ovarian failure 
Turner Syndrome ( 45 XO )

Question 17

what is the most common cause of primary amenorrhea ?

Answer 17

turner syndrome

Question 18

what is different about mosaic turner ?

Answer 18

some cells are 45 XO whilst other are 46 XX

Question 19

what are the uterine causes of amenorrhea ?

Answer 19

Androgen insensitivity syndrome
Asherman’s Syndrome
complete or partial mullerian tract agenesis

Question 20

what are the features of individuals that have partial or complete mullerian agenesis ?

Answer 20

46 XX
normal ovaries so she has secondary sexual characteristics
primary amenorrhea and infertility
( externally she looks normal )

Question 21

how can we diagnose a case of complete or partial mullerian agenesis ?

Answer 21

ultrasound
HSG
MRI
karyotyping

Question 22

what are the features of an individual with androgen insensitivity syndrome ?

Answer 22

46 XY
androgen receptors only responsive to E2
external genitalia is female
no pubic hair or axillary hair

Question 23

what operation can be performed for individuals that have androgen insensitivity syndrome ?

Answer 23

Mcindoe operation ( operation to form a vagina to allow for intercourse )

Question 24

what is the main complaint of a patient with Sheehan syndrome ?

Answer 24

complains of no breastfeeding and hypothyroidism