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women's health > Amenorrhea > Flashcards

Amenorrhea Flashcards

1
Q

Primary amenorrhea definition

A

No menses by the age of 16 and 14 if with normal and no normal secondary sexual characteristics respectively.
No menstruation after 5 years of telarche
No telarche by the age of 13

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2
Q

Secondary amenorrhea definition

A

Absence of menses for 6 months

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3
Q

Premature ovarian failure definition

A

Loss of ovarian function before 40
Elevated FSH and low estradiol
FSH >/= 25-40 IU 4 weeks apart

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4
Q

Metabolic syndrome

A

central obesity
lipid abnormalities
hypertension
elevated glucose levels

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5
Q

Metabolic syndrome specific values for central obesity

A

Male >90
Female >80

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6
Q

Metabolic syndrome specific values for lipid abnormalities

A

HDL <1 in men <1.3 in women
Triglycerides >/= 1.7

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7
Q

Metabolic syndrome specific values for hypertension

A

130/85

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8
Q

Metabolic syndrome specific values for elevated glucose

A

> 5.5

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9
Q

Criteria for PCOS

A

hyperandrogensim
anovulatory cycles
polycystic ovarian morphology

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10
Q

PCOS Pathophysiology

A

Hypothalamus –> GNRH
Pituitary –> FHS LH
Ovary and adrenals –> androgen

Hypothalamus rapid pulses leading to LH>FSH

LH increase leads to increase in progesterone –> androgen

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11
Q

Ferriman Gallwey scoring

A

9 items
0-4 per category
>/= 6 diagnostic of hirsutism

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12
Q

Polycystic ovarian morphology

A

> /=12 follicles with (2-9mm in diameter)
Inceased in the volume of the ovary of > 10mL

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13
Q

Decreased findings in PCOS

A

SHBG and FASH

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14
Q

Rotterdam Phenotype for PCOS A

Hyperandrogenism
Menstrual irregularity
PCOM

A

Hyperandrogenism +
Menstrual irregularity +
PCOM +

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15
Q

Increased findings in PCOS

A

LH
LH:FSH >3
Testosterone, andostrendione, DHEA, DHEA-S
Estrone
AMH >4.7
Prolactin (20-35)

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16
Q

Rotterdam Phenotype for PCOS B

Hyperandrogenism
Menstrual irregularity
PCOM

A

Essential
Hyperandrogenism +
Menstrual irregularity +
PCOM -

17
Q

Rotterdam Phenotype for PCOS C

Hyperandrogenism
Menstrual irregularity
PCOM

A

Ovulatory PCOS
Hyperandrogenism +
Menstrual irregularity -
PCOM +

18
Q

Rotterdam Phenotype for PCOS D

Hyperandrogenism
Menstrual irregularity
PCOM

A

Non hyperandrogenic

Hyperandrogenism -
Menstrual irregularity +
PCOM +

19
Q

First line for hirsutism

A

EP contraceptives
Example: cyproterone and drosperinone

20
Q

Anti androgens

A

Spironolactone
Flutamide
Finasteride
Cyrpoterone acetate

*** must be used with effective contraception because it may cause male undervirilization

21
Q

First line ovulation induction agents

A

Letrozole - less risk for multiple pregnancy
Clomiphine citrate - causes endometrial thinning
Metfromin

22
Q

Second line ovulation induction agents

A

Gonadotropins

23
Q

Side effect of Gonadotropins

A

Ovulation hyperstimulation syndrome

24
Q

Third line ovulation induction

A

IVF
IVM

women's health (13 decks)

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