GYN- Mentrual Cycle

Question 1

what is thelarche?

Answer 1

breast development

Question 2

what is pubarche?

Answer 2

growth of pubic/axillary hair

Question 3

what is menarche?

Answer 3

onset of menses

Question 4

hoow soon after thelarche is menarche?

Answer 4

~ 2.5 yrs

Question 5

What is the age/timing of puberty?

Answer 5

"Always Go (to) The Pub, Men"
7 yo: adrenarch
8: gonadarche
9--
10: thelarche 
11: pubarche/Peak growth
12: menarche

Question 6

what are the tanner stages

Answer 6

1: kid
2: buds
3: elevation
4: areolar mound (big nipples)
5: adult

Question 7

what endo things can cuase infertility

Answer 7

hypothyroidism (inc TRH/TSH inc PRL which dec GnRH)
hyper PRL (dec GnRH)

Question 8

what is Kallman syndrome

Answer 8

congenital dec GnRH

Question 9

at what point in menstrual cycle is E at peak?

Answer 9

end of follicualr phase/right before LH surge

smaller inc in middle of proliferative phase

Question 10

what hormone is relatively constant during menstual cycle?

Answer 10

FSH, small bump with inc E

Question 11

What do theca cells respond to/make/do?

Answer 11

stimulated by LH to make androgens (inc desmolase activity to convert cholesterol to androgens)

Question 12

What do granulose calls respond to/make/do?

Answer 12

stimulatef by FSH to inc activity of aromatase which converts androgens to estrogens

Question 13

when is woman in menopause

Answer 13

no menses > 12 mos

Question 14

avg age for onset of menopause

Answer 14

51

Question 15

how to diagnose menopause

Answer 15

elevated FSH

Question 16

how to treat menopause + why treat?

Answer 16

lowest dose HRT (E and P) for only 6-12 mos

prevents osteoporosis, relif of smx

Question 17

risks and CI to HRT

Answer 17

risks: inc endometrial hyperplasia/cancer

CI: clotting disorders, liver dz, pregnancy, E dept neoplasm (breast and endometrial cancer), undiagnosed vaginal bleedign (endometial ca needs to be r/o)