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RePro > Menarche Puberty and Menstrual Disorders > Flashcards

Menarche Puberty and Menstrual Disorders Flashcards

1
Q

The major charactistic of follicular growth and estradiol secretion is explained by what two gonadotropin and two cells

A

Gonadotorpin: LH FSH
cell: theca and grnaulosa

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2
Q

LH stimulates the _ cells to produce androgens

FSH stimulate the _ cells to convert the androgens into estrogen (E1 and E2)

A
  1. Theca cells

2. Granulosa

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3
Q

Does estrogen level reach it’s peak before or after LH?

A

1 day before

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4
Q

Prior to ovulation _ follicle begins to produce increasing amount of progesterone

A

Graafian

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5
Q

what is the cumulus oophorus?

A

The innermost 3-4 layers of multiplying granulosa cells that become cuboidal and adhere to the ovum.

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6
Q

what forms the corona radiata?

A

The innermost layer of the granulosa cells for the cumulus become elongated and connects to the wall.

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7
Q

After ovulation, what makes up and forms the corpus luteum?

A

Luteinzed granulosa cells, theca cells, capillaries and connective tissue

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8
Q

What occurs first, Thelarche or menarche?

A

Thelarche

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9
Q

At what Tanner stage does Thelarche take place?

A

Tanner Stage IV. rare before stage III

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10
Q

If secondary ammorrhea lasts greater than _ days further work up is indicated

A

90 days.

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11
Q

what is mean blood loss per menstraul period?

A

30 cc. most report changing a pad 3-6 times a day

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12
Q

Greater than _ cc is associated with anemia

A

80

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13
Q

What is primary amenorrhea?

A

No menses by age 13 w/o secondary sexual development OR by age 15 with secondary sexual development

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14
Q

what defines secondary amenorrhea?

A

no menses before 6 months

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15
Q

What is polymenorrhea?

A

abnormally frequent menses at intervals

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16
Q

What is menorrhagia (hypermenorrhea)?

A

excessiave and/or porlonged menses

17
Q

what is Metrorrhagia:

A

irregular episodes of uterine bleeding. Menometrorrhagia is heavy and irregular uterine bleeding

18
Q

What is oligomenorrhea

A

menstrual cycles at > 35 days cycles

19
Q

what is dysfunctional uterine bleeding?

A

-Abnormal bleeding NOT due to medications, blood sycrasia, systemic disease, truama, or ganic conditions
- usually caused by aberration in the HPPO axis restulingin anovoluation
Most DUB occurs around the years of menarche

20
Q

What is adenomyosis (AUB-A)

A

Kinda like endometriosis. adenomyosis is when the endometrial lining gets inside of the muscle of the uterus. if you were to palpate it it’ll be boggy large and soggy.

21
Q

90% of these AUB will come with endometrial bleeding (post manopausal bleeding)

A

malignancy and hyperplasia (AUB-M)

22
Q

what disease is a cuase of ovulatory dysfucntion and can cause AUB-O.

A

Polycystic ovarian syndrome

23
Q

during late childhood there is an increase in serum concentration of _ and _ _ which can begin the onset of puberty

A

DHEA
DHEA-S
androstenedione

24
Q

By the late puberty, the positive feedback mechanism of _ on _ release from the anterior pituitary gland is complete and ovulatory cycles are stablished?

A

estradiol on LH

25
Q

The gonatostat’s negative feedback mechanism is matured by _

A

fetal development.

26
Q

Positive feedback mechanism of the gonatostat is comple by _

A

puberty

27
Q

what are the stages of pubertal development?

A
  1. Thelarche
  2. Pubarche/adrenarche
  3. Maximal growth or peak hight velocity
  4. menarche
28
Q

What are the orders of the normal pubertal develoment?

A 
Ages -->stage
9-10 = Thelarche
10-11 = adrenarche 
11-12 = peak height velocity
12-13  = menarche 
14-15 = mature sexual hair and breast
29
Q

which racial group undoes puberty earlier white, african american or hispanic

A

White > African > hispanic

30
Q

what are the tanner stage associated with the breast development?

A

Stage 1: preadolescent: elevation of the papilla only
Stage 2; breast bud stage; elevation of breast and papilla as a small mound with enlargement of the areolar region
Stage 3; Further enlargement of breast and areola w/o separation of their contours
Stage 4; projection of aerola and apilla to form a seocndary mound above the level of the breast
Stage 5; Mature stage; projection of papilla only. resulting from recession of the areola to the general contour of the breast

31
Q

what are the tanner stages associated with pubic hair deveopment?

A

Stage 1; Preadolescent; absence of pubic hair
Stage 2; sparse hair along the labia; hair downy with slgiht pigment
Stage 3; hair spreads sparsely over the junction of the pubes; hair is darker nd coarser
Stge 4: adult-type hair; there is no spread ot the medial surface of the thigh
Stage 5: adult type hair with spread to th emeidal thight assuming an inverted tirangle pattern

32
Q

what are some indication for endometrial biopsy?

A

a. postmenopausal woman sample with any spotting or bleeding and endometraillining >4mm
b. age 45 to menopause with any AUB, including intersmensutal bleeding, menorrhagia
C.

33
Q

what is asherman syndrome?

A

with removal of miscarrage product, causing intrauterine scarring which can shut the uterine and thus prevent mensturation

34
Q

what are some risk factors of GDM?

A
  • maternal obsesity
  • maternal age (over 25)
  • previous delivary of baby larger than 9lbs
  • Hx of unexplained perinatal loss or malformation
  • family hx of diabetes - especially first degree relatives
  • glycosuria at first pre-natal visit
  • metabolic syndrome: 3 or more risk facotrs of atheroscerotic disease and T2DM
  • Polycystic ovarian syndrome (chronic anovulation in the setting of obesity, hyperinsulinemia, T2DM, lipid abnormalities, hirsutism, infertility and ovarin cysts)
  • hypertension
  • glucocorticoid use at tiem of pregnancy
  • ethnic groups with high prevalnce of T2DM (hispanic and south asians mostly)
35
Q

T or F: woman with polycystic ovarian syndrome do not require to be on birth control since they cannot get pregnant.

A

False. They can get prgnant

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