LE 1 Flashcards
Due to a hypoxic event caused by hemorrhage DURING pregnancy…
Sheehan’s syndrome.
Single contour of breast and areola.
Adult hair in thickness and texture; midline distribution.
B5
PH4
TRUE OR FALSE:
Blind girls have menarche earlier.
TRUE
TRUE OR FALSE:
Peak heigh velocity is earlier in girls than in boys.
TRUE
Increase in gonadal estrogen.
Gonadarche
Irregular, prolonged, excessive menses
Menometrorrhagia
Regular, prolonged, excessive menses
Menorrhagia
How many days of no menses to consider amenorrhea?
90 days
17 years old never had menses. Breasts and pubic hair are B1PH1. Initial diagnosis?
Primary Amenorrhea
XX Karyotype
Mullerian agenesis/anomalies
XY Karyotype
Androgen insensitivity (Testicular feminization)
Formation of intrauterine adhesions secondary to uterine manipulation.
Ashermann’s Syndrome
Most common cause of primary amenorrhea
Gonadal dysgenesis
Turner’s syndrome
45X
Uterus present
Breast development absent
Elevated progesterone levels
17 a hydroxylase deficiency
46XX
Most common non-prolactin secreting tumor of the pituitary
Chromophobe adenoma
Compartment IV is disoders of ____________?
Hypothalamus
Use of OCPs inhibit ovulaion by acting both at these two sites.
Hypothalamus & Pituitary
Increase in dopamine will ___________ LH/FSH levels
Decrease (due to inhibition of GnRH release)
Diagnostic marker for patients with anorexia nervosa
Serum T3 levels
Most common female endocrine disorder
PCOS
Rotterdam Criteria
- Oligo-ovulation/Anovulation
- Ultrasound findings of polycystic ovaries
- Hyperandrogenism
Hypothalamic pituitary dysfunction has Estradiol levels of
> 40 pg/nl
Normal menstruation:
Interval
Amount
Duration
21-35 days
35 ml
4-7 days
An oocyte arrested at prophase
Enveloped by a single layer of spindle-shaped pregranulosa cells, surrounde by a basement membrane
Primordial follicle
The variable phase of menstruation.
Follicular
Completed by day 5 of the follicular cycle
Secretion of dominant follicle
It causes detachment of oocyte to the cumulus from the granulosa cells
Plasmin
How many hours does an oocyte wait for fertilization?
48-72 hrs
Dominant steroid in the luteal phase
Progesterone
Hypothalamic GnRH neurons are concentrated mostly in the:
Arcuate nucleus
Two things that control the menstrual cycle:
- Frequency of pulses
2. Amplitude of pulses
Difference of gonadotropins with TSH
Beta subunit
Act on theca cells to induce steroidogenesis
LH
FSH acts on these cells
Granulosa
Stimulates thecal androgen production
Inhibin
Causes enlargement of labia majora and minora, uterus, increased fundal to cervical ratio
Cornification of vagina
Growth of ductal system of breasts
Estrogen
Decreases tubal mobility
Thickening of cervical mucus
Stabilizes endometrium
Progesterone
Layer of the endometrium that desquamates at the time of menses
Stratum functionale
1st endocrinologic sign of menopause
Decreased levels of inhibin
Menstrual cycle is controlled by the…
HPO axis
Interval between menstruation and ovulation.
12-16 days
Desquamation of the endometrium mainly occurs in the….
Uterine fundus
Occurs because of estrogen-progesterone withdrawal
Menstrual bleeding
2 mechanisms for hemostasis after menstruation
Hemostatic plug formation
Vasoconstriction
Reported to occur in 10% of ovulatory women
Ovulatory DUB
Reduced levls of PGF2 alpha
Normal levels of PGE
Anovolutary DUB
Predominant cause of DUB among postmenarcheal and perimenopausal years
Anovulatory DUB
FIGO classification
Anatomic causes
PALM
L in PALM
Leiomyoma
N in COIEN
Not yet classified
C in COEIN
Coagulopathy
What is PALM and COEIN
Polyp
Adenomyosis
Leiomyoma
Malignancy
Coagulopathy Ovulatory dysfunction Endometrial Iatrogenic Not yet classified
Most objective diagnostic modality
Transvaginal Ultrasound
To confirm presence of submucous myomas and polyps
Saline infusion sonography
Evaluate endometrial cavity
Hysteroscopy
Blind procedure performed under anesthesia
D&C
Management for AUB
Stop bleeding
Not for acute control of bleeding
GnRH agonists
Androgenic steriod, rarely used
Danazol
MOA is photovaporization with Nd-YAG laser
Endometrial ablation
