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My2 endocrinology > female ovulatory disorders and infertility > Flashcards

female ovulatory disorders and infertility Flashcards

1
Q

what signifies ovarian failure

A

high LH and FSH, low oestrogen, amenorrhea

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2
Q

what defines infertility

A

absence of pregnancy after trying for 12 months in a couple who have never conceived

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3
Q

what is primary vs secondary infertility

A

primary = never conceived, secondary = miscarried

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4
Q

what is the most common form of primary (hypergonadotrophic) hypogonadism

A

premature ovarian failure

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5
Q

what is premature ovarian failure

A

menopause before 40

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6
Q

what can cause premature ovarian failure

A

idiopathic, genetic (turners, fragile X), chemo, radio

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7
Q

what are symptoms of premature ovarian failure

A

hot flushes, night sweats, atrophic vaginitis, decreased periods, vaginal dryness, headaches

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8
Q

how do you diagnose premature ovarian failure

A

high FSH/ LH + low oestrogen, progesterone challenge test, USS for follicular growth

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9
Q

how do you treat premature ovarian failure

A

HRT and egg/ embryo donation

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10
Q

what is secondary hypogonadism

A

problem from pituitary/ hypothalamus

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11
Q

name some common secondary hypogonadism causes in woman

A

PCOS (most common), anorexia, overeating

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12
Q

what are symptoms of PCOS

A

obesity, hirsutism (androgens), acne (testosterone), oligomenorrhoea/ amenorrhea, diabetes

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13
Q

what hormone abnormalities are found in PCOS

A

high androgens, high LH< impaired glucose tolerance (T2DM)

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14
Q

how do you diagnose PCOS

A

need 2/3: chronic anovulation, polycystic ovaries on scans, hyperandrogegism (testosterone)

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15
Q

what treatment can be given to manage PCOS (6)

A

weight loss, stop smoking/ alcohol, folic acid, rubella vaccine, metformin (if needed)

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16
Q

what is given to induce ovulation in ovulation disorders

A

clomiphene citrate/ LH+FSH daily injections/ laparoscopic ovarian diathermy

17
Q

what are risks associated with ovulation induction

A

hyperstimulation, multiple pregnancy (hyperemesis, hypertension, miscarriage, twin transfusion syndrome)

18
Q

what is twin transfusion syndrome

A

unbalanced communications with twins and placenta: recipient twin has poyhydramnios and pressure on heart. donor twin doesn’t have enough blood for growth

19
Q

how do you treat twin transfusion syndrome surgically

A

laser division of placenta, amnioreduction, septosomy

20
Q

where is the problem with PCOS

A

pituitary

21
Q

what are symptoms of hyperprolactinaemia

A

amenorrhea, galactorrhea, vaginal dryness, visual field disruption

22
Q

how do you diagnose hyperprolactinaemia

A

normal FSH/ LH, low oestrogen, raised prolactin, MRI of head

23
Q

how do you treat hyperprolactinaemia

A

dopamine agonist eg cabergoline (Stop in pregnancy)

24
Q

what can cause hypogonadotrophic (secondary) hypogonadism that affects the hypothalamus

A

stress, anorexia, over-exercise, tumours, Kallman’s, drugs

25
Q

what happens to hormone balance in secondary hypogonadism

A

low FSH LH and oestrogen

26
Q

what can cause infertility in women (3)

A

ovulatory disorders (premature ovarian failure/ PCOS), tubal disease and

27
Q

what is tubal disease

A

damaged/ blocked fallopian tubes

28
Q

what infective causes can cause tubal disease (3)

A

pelvic inflam (chlamydia, gonorrhoea)/ transperitoneal spread (appendicitis)/ after procedures (coil)

29
Q

what non-infective causes can cause tubal disease

A

endometriosis, surgical sterilisation, polyps, congenital

30
Q

what is hydropsaplinx from pelvic inflamm disease

A

fallopian tube becomes blocked and filled with fluid

31
Q

what are symptoms of hydropsaplinx from pelvic inflamm disease

A

abdo/ pelvic pain, febrile, vaginal discharge, infertility, ectopic pregnancy

32
Q

what is endometriosis

A

endometrial tissue grows on other tissue eg fallopian tubes/ ovaries and swells when preparing for pregnancy

33
Q

what are symptoms of endometriosis

A

dysmenorrhoea (v painful periods), mennorhagia, painful daefacation, chronic pain

34
Q

what are fibroids

A

noncancerous growths in/ around uterus

35
Q

what can cause fibroids

A

increased oestrogen

36
Q

who typically gets fibroids

A

black woman 30-50 and overweight

37
Q

what are symptoms of fibroids

A

heavy/ painful periods, lower abdo pain, increased urination, pain on sex, constipation

38
Q

how do you treat fibroids

A

mini pill, progesterone only stuff, GnRG analogues

My2 endocrinology (19 decks)

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