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GI/GU Exam > Menarche, Puberty, Menstrual Disorders > Flashcards

Menarche, Puberty, Menstrual Disorders Flashcards

1
Q

What does the follicular phase begin and end with?

A
  • onset of menstruation and ends with preovulatory LH surge
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2
Q

What does the luteal phase begin and end with?

A
  • onset of preovulatory LH surge and ends with first day of menses
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3
Q

What happens with the corpus luteum regresses, regarding FSH?

A

Decreasing levels of estrogen and progesterone initiate increase in FSH by negative feedback, stimulating follicle growth and estradiol secretion

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4
Q

What is GnRH synthesized by, specifically?

A

The arcuate nucleus

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5
Q

What does estradiol do in regards to GnRH?

A

Enhances release of GnRH and induces midcycle LH surge

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6
Q

How much progesterone does the ovary secrete during follicle development? Prior to ovulation? When does it peak?

A
  • very little
  • lots more
  • reaches max 5-7 days after ovulation then returns to baseline
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7
Q

What are the two zones of the endometrium?

A
  • the functionalis

- the basalis

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8
Q

What happens in the functionalis? What does it contain?

A
  • this is the part that undergoes cyclic changes during menstrual cycle and is sloughed off during menstruation
  • contains spiral arteries
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9
Q

What happens in the basalis? What does it contain?

A
  • this layer remains unchanged during menstrual cycle, contains stem cells for renewal of functionalis layer
  • contains basal arteries
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10
Q

What happens during the menstrual phase? (5)

A
  • disruption and disintegration of endometrial glands and stroma
  • leukocyte infiltration
  • red blood cell extravasation
  • sloughing of functionalis layer
  • compression of basalis layer
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11
Q

When does menarche occur with regards to Thelarche and Tanner stages?

A
  • 2-3 years after Thelarche

- at tanner stage IV, usually

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12
Q

What is primary amenorrhea?

A

Absence of menarche by age 13 without secondary sexual development OR by the age of 15 with secondary sexual development

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13
Q

What is secondary amenorrhea?

A

absence of menstruation for six months or longer

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14
Q

What are the 4 categories for causes of menstrual irregularity?

A
  • pregnancy
  • endocrine causes
  • acquired conditions
  • tumors
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15
Q

What is dysfunctional uterine bleeding (DUB)? (5)

A

Abnormal uterine bleeding that can’t be attributed to:

  • medications
  • blood dyscrasias
  • systemic disease
  • trauma
  • organic conditions
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16
Q

What is D.U.B. usually caused by?

A

Aberrations in the H-P-O axis resulting in anovulation

17
Q

What is polymenorrhea?

A

Abnormally frequent menses at intervals of less than 21 days

18
Q

What is menorrhagia? What specific qualifiers does it have?

A
  • Excessive and/or prolonged menses occurring at regular intervals
  • greater than 80ml of blood and greater than 7 days
19
Q

What is metrorrhagia?

A

Irregular episodes of uterine bleeding

20
Q

What is menometrorrhagia?

A

Heavy and irregular uterine bleeding

21
Q

What is intermenstrual bleeding?

A

Scant bleeding at ovulation for 1 or 2 days

22
Q

What is oligomenorrhea?

A

Menstrual cycles at greater than 35 day cycles

23
Q

What are the structural causes of AUB?

A

PALM

  • Polyp
  • Adenomyosis
  • Leiomyoma
  • Malignancy and Hyperplasia
24
Q

What are the Nonstructural causes of AUB?

A

COEIN

  • Coagulopathy
  • Ovulatory dysfunction
  • Endometrial
  • Iatrogenic
  • Not yet classified
25
Q

What is adenomyosis? How deep specifically?

A
  • Extension of the endometrial glands and stroma into the uterine musculature
  • greater than 2.5 mm below basalis layer

It’s basically endometriosis of the myometrium

26
Q

What are leiomyomas?

A

benign smooth muscle tumors

27
Q

What are leiomyomas also called?

A

fibroids

28
Q

What are risk factors for leiomyomas? (4)

A
  • increasing age during reproductive years
  • african american women have increased risk
  • nulliparity
  • family history
29
Q

What is the pathogenesis of leiomyomas? (what is it caused by)

A

Estrogen stimulates the proliferation of smooth muscle tissue
(so typically they don’t grow before menarche or after menopause)

30
Q

What are symptoms of leiomyomas? (4)

A

Typically asymptomatic, but:

  • pelvic or lower back pain
  • frequency of urination
  • prolonged or heavy bleeding
  • increased incidence of infertility
31
Q

What is endometrial hyperplasia? What is it usually caused by?

A
  • Overabundant growth of the endometrial lining

- unopposed estrogen

32
Q

What can cause endometrial hyperplasia? (4)

A
  • PCOS
  • obesity
  • exogenous estrogens
  • tamoxifen (estrogen receptor antagonist)
33
Q

Why is endometrial hyperplasia significant?

A

It is a precursor to endometrial cancer

34
Q

What is the average duration of puberty?

A

4-5 years

35
Q

What is the order of the stages of normal pubertal development in females?

A
  • thelarche
  • pubarche/adrenarche
  • maximal growth/peak height
  • menarche
36
Q

What hormone does thelarche require?

A

estrogen

37
Q

What happens in each Tanner stage of breast development?

A
  • Stage 1 = papilla only elevated
  • Stage 2 = ‘breast bud’ stage, elevation of breast and papilla, enlargement of areola
  • Stage 3 = further enlargement of breast and areola
  • Stage 4 = areola and papilla form secondary mound over breast
  • Stage 5 = only papilla projects now
38
Q

What happens in each Tanner stage of pubic hair development?

A
  • Stage 1 = preadolescent, no pubic hair
  • Stage 2 = sparse, downy hair w/little pigment
  • Stage 3 = hair spreads, becomes darker and coarser
  • Stage 4 = adult-type hair that hasn’t spread to medial surface of thighs
  • Stage 5 = adult-type hair spread to medial thighs

GI/GU Exam (21 decks)

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