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Gynaecology > Amenorrhoea > Flashcards

Amenorrhoea Flashcards

1
Q

What is amenorhhoea?

A

Absence of periods

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2
Q

What is primary amenorrhoea?

A

Failure to commence periods

  • by 13 with no other signs of puberty
  • by 15 with other signs of puberty
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3
Q

What are the causes of primary amenorrhoea?

A

Hypogonadism
CAH
Androgen insensitivity syndrome
Structural pathology

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4
Q

What are the types of hypogonadism?

A

Hypogonadotropic

Hypergonadotropic

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5
Q

What is hypogonadotropic hypogonadism?

A

Lack of LH + FSH

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6
Q

What can cause hypogonadotropic hypogonadism?

A 
Hypopituitarism 
Damage to hypothalamus/pituitary 
Chronic conditions
Excessive exercise/dieting 
Endocrine disorders
Kallman syndrome
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7
Q

What is Kallman syndrome?

A

X-linked recessive condition

Primary amenorrhoea + anosmia

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8
Q

What is hypergonadotropic hypogonadism?

A

Lack of response to LH + FSH

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9
Q

What can cause hypergonadotropic hypogonadism?

A

Damage to gonads
Congenital absence of ovaries
Turner’s syndrome

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10
Q

What is CAH?

A

Congenital adrenal hyperplasia

Autosomal recessive

Congenital deficiency of 21-hydroxyase

  • overproduction of cortisol + aldosterone
  • underproduction of androgens

Features

  • tall
  • facial hair
  • primary amenorrhoea
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11
Q

What is androgen insensitivity syndrome?

A

Tissues unable to respond to androgen

Female phenotype but male abdominal organs

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12
Q

What structural problems can cause primary amenorrhoea?

A

Imperforate hymen
Transverse vaginal septum
FGM

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13
Q

How is primary amenorrhoea investigated?

A

Pregnancy test

Bloods

  • FBC
  • TFTs
  • Prolactin
  • FSH
  • LH
  • Progesterone
  • Testosterone
  • 17 hydroxyprogesterone (if CAH suspected)

Karyotyping

Pelvic USS

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14
Q

How is primary amenorrhoea managed?

A

Treat underlying cause

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15
Q

What is secondary amenorrhoea?

A

No periods for >3 months if previously regular

No periods for >6 months if previously irregular

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16
Q

What can cause secondary amenorrhoea?

A 
Pregnancy 
Menopause/premature ovarian failure 
Hormonal contraception 
Hypothalamus/pituitary pathology 
PCOS
17
Q

How is secondary amenorrhoea investigated?

A

B-HCG
LH + FSH
Prolactin
TFTs

18
Q

How is secondary amenorrhoea managed?

A

Treat underlying cause

Gynaecology (32 decks)

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