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Obstetric And Gynecology > AMENORRHEA > Flashcards

AMENORRHEA Flashcards

1
Q

Define amenorrhoea.

A

Absence or abnormal cessation of menstruation.

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2
Q

Fill in the blank: Amenorrhoea is classified as ______ or ______ based on its occurrence relative to menarche.

A

Primary; secondary.

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3
Q

What are the two main etiological categories of amenorrhoea?

A

Physiological; pathological.

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4
Q

Define primary amenorrhoea.

A

Failure of menstruation by age 16 (with secondary sexual characteristics) or 14 (without them).

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5
Q

Fill in the blank: Primary amenorrhoea is diagnosed if there is no menstruation by age ______ with secondary sexual characteristics or age ______ without them.

A

16; 14.

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6
Q

Define secondary amenorrhoea.

A

Cessation of menstruation for at least six months or three previous cycles in a woman with established menstruation.

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7
Q

What is oligomenorrhoea, and how is it different from amenorrhoea?

A

Infrequent menstruation with intervals exceeding 35 days but less than six months.

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8
Q

Fill in the blank: Amenorrhoea has a prevalence of ______ to ______% among women of reproductive age.

A

5%; 20%.

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9
Q

What is the prevalence of primary amenorrhoea compared to secondary amenorrhoea?

A

Primary <1%, secondary more common.

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10
Q

Name two physiological causes of primary amenorrhoea.

A

Prepubertal stage, delayed puberty.

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11
Q

Fill in the blank: ______ and ______ are physiological causes of secondary amenorrhoea.

A

Pregnancy; lactation.

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12
Q

Name two chromosomal causes of primary amenorrhoea.

A

Turner syndrome, Androgen Insensitivity Syndrome (AIS).

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13
Q

Fill in the blank: Turner syndrome is associated with a ______ karyotype.

A

45 XO.

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14
Q

What are some outflow tract abnormalities causing primary amenorrhoea?

A

Mullerian agenesis, transverse vaginal septum, imperforate hymen.

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15
Q

List three systemic conditions that can cause secondary amenorrhoea.

A

Tuberculosis, HIV, severe anemia.

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16
Q

Fill in the blank: Drugs like ______ and ______ can cause secondary amenorrhoea.

A

Antipsychotics; antihypertensives.

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17
Q

What is the significance of differentiating between primary and secondary amenorrhoea?

A

It determines the cause and guides management.

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18
Q

What key feature is assessed in the evaluation of primary amenorrhoea?

A

Presence or absence of secondary sexual characteristics and uterus.

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19
Q

Name one cause of primary amenorrhoea where the uterus is absent.

A

Mullerian agenesis, AIS.

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20
Q

Fill in the blank: Androgen Insensitivity Syndrome (AIS) is associated with a ______ karyotype.

A

46 XY.

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21
Q

What are the typical physical features of AIS?

A

Female phenotype, absent axillary/pubic hair, normal breast development.

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22
Q

Fill in the blank: The incidence of malignancy in AIS gonads is ______%.

A

0.22

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23
Q

What is Mullerian Agenesis, and what are its key features?

A

Congenital absence of uterus, cervix, upper vagina.

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24
Q

Fill in the blank: Turner syndrome causes streak gonads due to the absence of ______ genes.

A

Ovarian determinant.

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25
Q

List three clinical features of Turner syndrome.

A

Short stature, webbed neck, wide spaced nipples.

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26
Q

Fill in the blank: Gonadal dysgenesis can result from mutations in the ______ gene.

A

SRY.

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27
Q

What are the features of Kallman syndrome?

A

Anosmia, midline defects, hypogonadotropic hypogonadism.

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28
Q

Fill in the blank: Elevated prolactin levels suppress ______ secretion from the hypothalamus.

A

GnRH.

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29
Q

What investigations are performed for primary amenorrhoea?

A

FSH, LH, E2, karyotype, testosterone, pelvic ultrasound.

30
Q

Fill in the blank: Pelvic ultrasound is essential to assess the presence of ______ and ______ in primary amenorrhoea.

A

Uterus; ovaries.

31
Q

What is the significance of karyotype analysis in primary amenorrhoea?

A

To identify chromosomal abnormalities.

32
Q

Name one adrenal gland disorder associated with secondary amenorrhoea.

A

Cushing syndrome.

33
Q

Fill in the blank: Progestogen challenge tests help evaluate ______ abnormalities in secondary amenorrhoea.

A

Endometrial.

34
Q

What factors are assessed in the physical examination for secondary amenorrhoea?

A

Secondary sexual characteristics, pelvic masses, hirsutism.

35
Q

Fill in the blank: The ______ test is used to confirm pregnancy in secondary amenorrhoea.

A

Serum 尾-hCG.

36
Q

What imaging studies are used to evaluate secondary amenorrhoea?

A

MRI, CT, cone radiograph of the sella turcica.

37
Q

List two treatment options for prolactinomas.

A

Bromocriptine, cabergoline.

38
Q

Fill in the blank: Vaginoplasty is a surgical treatment for ______ abnormalities.

A

Outflow tract.

39
Q

What is the first step in evaluating a patient with amenorrhoea?

A

Comprehensive history, physical exam, investigations.

40
Q

Fill in the blank: Amenorrhoea is a ______ and not a disease.

A

Symptom.

41
Q

What history details are essential for evaluating secondary amenorrhoea?

A

Menstrual history, family history, systemic illnesses, surgeries.

42
Q

Fill in the blank: ______ syndrome presents with anosmia and hypogonadotropic hypogonadism.

A

Kallman.

43
Q

How is uterine presence confirmed during pelvic examination?

A

By pelvic examination or ultrasound.

44
Q

Fill in the blank: ______ imaging is used to evaluate the sella turcica in secondary amenorrhoea.

A

Cone radiograph or MRI.

45
Q

What hormones are evaluated in the investigation of secondary amenorrhoea?

A

FSH, LH, PRL, TSH, E2, androgens.

46
Q

Fill in the blank: A serum prolactin level above ______ ng/mL requires further imaging studies.

A

100 ng/mL.

47
Q

What is Asherman syndrome, and how does it affect menstruation?

A

Uterine scarring that leads to menstrual irregularities.

48
Q

Fill in the blank: Sheehan syndrome is caused by postpartum ______.

A

Hypopituitarism.

49
Q

How does stress contribute to secondary amenorrhoea?

A

It disrupts hypothalamic-pituitary-ovarian function.

50
Q

Fill in the blank: Hypothyroidism is associated with ______ TSH levels.

A

Elevated.

51
Q

What is the role of lifestyle modification in managing secondary amenorrhoea?

A

Helps address underlying causes like low body weight.

52
Q

Fill in the blank: Elevated ______ levels can be indicative of polycystic ovarian syndrome (PCOS).

A

Androgens.

53
Q

How is constitutional delay diagnosed in primary amenorrhoea?

A

History, delayed pubertal signs.

54
Q

Fill in the blank: The absence of ______ and ______ development indicates hypogonadism.

A

Breast; pubic hair.

55
Q

What are the physical examination findings in Mullerian agenesis?

A

Normal breasts, absent uterus, vaginal dimple.

56
Q

Fill in the blank: Elevated FSH levels in a patient with primary amenorrhoea suggest ______ failure.

A

Ovarian.

57
Q

What imaging is recommended for suspected adrenal disorders in secondary amenorrhoea?

A

CT or MRI of the abdomen.

58
Q

Fill in the blank: In Kallman syndrome, GnRH neurons fail to migrate from the ______ placode.

A

Olfactory.

59
Q

What are the common presenting features of Swyer syndrome?

A

Lack of secondary sexual characteristics, streak gonads, normal uterus.

60
Q

Fill in the blank: Streak gonads in Swyer syndrome increase the risk of ______ tumors.

A

Germ cell.

61
Q

What role does thyroid dysfunction play in amenorrhoea?

A

Can disrupt the hypothalamic-pituitary-ovarian axis.

62
Q

Fill in the blank: Adrenal hyperplasia can present with ______ androgen levels.

A

Elevated.

63
Q

How is anorexia related to secondary amenorrhoea?

A

Caloric deficit suppresses the hypothalamic axis.

64
Q

Fill in the blank: Elevated ______ levels suppress ovulation in hyperprolactinemia.

A

Prolactin.

65
Q

What is the purpose of endometrial biopsy in secondary amenorrhoea evaluation?

A

To assess endometrial function and exclude endometriosis.

66
Q

Fill in the blank: ______ and ______ are common symptoms of PCOS-associated amenorrhoea.

A

Acne; hirsutism.

67
Q

What are the indications for surgical management of primary amenorrhoea?

A

Correcting structural anomalies like imperforate hymen.

68
Q

Fill in the blank: Secondary amenorrhoea in athletes is often caused by ______ energy availability.

A

Low.

69
Q

What laboratory tests are used to diagnose androgen insensitivity syndrome?

A

Karyotype, testosterone levels.

70
Q

Fill in the blank: Primary treatment for prolactinomas includes ______ or ______ medication.

A

Bromocriptine; cabergoline.

Obstetric And Gynecology (26 decks)

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