Amenorrhoea

Question 1

Primary amenorrhoea is defined as not starting menstruation by

Answer 1

13 years when there is no other evidence of puberty
15 years when there are other signs of puberty

Question 2

Normal Puberty starts age … in girls

Answer 2

8-14

Question 3

Normal Puberty starts age … in boys

Answer 3

9-15

Question 4

Hypogonadotropic hypogonadism is caused by

Answer 4

deficiency in LH and FSH

Question 5

Hypergonadotropic hypogonadism is caused by

Answer 5

a lack of response to LH and FSH

Question 6

causes of Hypogonadotropic Hypogonadism

Answer 6

Hypopituitarism
Damage to the hypothalamus or pituitary
Chronic conditions (cystic fibrosis or IBD)
Excessive exercise
Constitutional delay
Endocrine disorders
Kallman syndrome

Question 7

endocrine causes of Hypogonadotropic Hypogonadism

Answer 7

growth hormone deficiency
hypothyroidism
Cushing’s
hyperprolactinaemia

Question 8

in Hypergonadotropic Hypogonadism levels of LH and FSH are

Answer 8

raised

Question 9

Causes of Hypergonadotropic hypogonadism

Answer 9

damage
congenital absence of ovaries
Turner’s syndrome

Question 10

hypogonadotrophic hypogonadism and absent sense of smell

Answer 10

Kallman syndrome

Question 11

Congenital Adrenal Hyperplasia is inherited in what pattern

Answer 11

autosomal recessive

Question 12

Features of Congenital Adrenal Hyperplasia

Answer 12

girls
tall
facial hair
amenorrhoea
deep voice
early puberty

Question 13

Androgen Insensitivity Syndrome results in

Answer 13

female phenotype but absent ovaries / uterus

Question 14

All girls with primary amenorrhoea should be tested for what co-morbidities / causal diseases

Answer 14

CKD, coeliac, Thyroid dysfunction

Question 15

In patients with hypogonadotrophic hypogonadism what can be given to induce ovulation and menstruation

Answer 15

pulsatile GnRH
COCP

Question 16

Define secondary amenorrhoea

Answer 16

no menstruation for more than three months after previous regular menstrual periods

Question 17

most common cause of secondary amenorrhoea

Answer 17

pregnancy

Question 18

Pituitary causes of secondary amenorrhoea

Answer 18

tumours
pituitary failure

Question 19

causes of pituitary failure

Answer 19

trauma
radiotherapy
Sheehan syndrome

Question 20

Treatment of hyperprolactinaemia

Answer 20

dopamine agonists (bromocriptine, cabergoline)

Question 21

High LH, or LH:FSH ratio in context of secondary amenorrhoea is suggestive of

Answer 21

PCOS

Question 22

Raise testosterone in context of secondary amenorrhoea is suggestive of

Answer 22

PCOS
androgen insensitivity
congenital adrenal hyperplasia