Amenorrhea + Menorrhagia

Question 1

Most common cause of amenorrhea

Answer 1

Pregnancy

Question 2

Hypothalamic Amenorrhea

• Eti
• LabDx

Answer 2

• Eti: Exercise, Chronic stress, anorexia, post hormonal suppression
• LabDx: FSH + Estrogen are both low

Question 3

Pituitary Amenorrhea

• Eti
• LabDx

Answer 3

• Eti: Prolactinoma, Primary hypothyroidism

- LabDx: Insufficient FSH/LH; normal-high GnRH levels;

Question 4

Ovarian failure

• Eti
• LabDx

Answer 4

• Eti: Menopause, premature failure (under 40), Mosaic gonadal dysgenesisl resistant overy syndrome
• LabDx: Gonadotropins elevated; estradiol low

Question 5

Anovulatory Amenorhea

• Eti
• LabDx

Answer 5

• Eti: Normal estrogen + endometrium; HPO not synchronous; PCOS is common
• LabDx: Exogenous progestin -> withdrawal bleeding

Question 6

(+) Progestin challenge with no remarkable Hx/exam/(-) preg test

Answer 6

Chronic Anovulation

Question 7

Progestin challenge negative, pregnancy test negative, FSH elevated.

Answer 7

Menopause

Karyotype if under 30 YO

If Y chromosome present -> Gonadectomy

Question 8

Whyat condition is A/S PRL elevation

Answer 8

Hypothyroidism

Question 9

Hyperprolactinemia Eti

Answer 9

• Adenoima
• Dopamine antagonists
• primary hypothyroidism

Question 10

Prolactinemia Tx

Answer 10

• Dopamine agonists (Bromocriptone/Cabergoline)

- transpinoidal surgery

Question 11

AUB Eti nonpregnant female

Answer 11

PALM-COEIN
Polyp
Adenomyosis
Leiomyoma
Malignancy

Coagulopathy
Ovulatory dysfxn
Endometrial causes
IAtrogenic
Not Yet Classified