Menarche/Puberty/Menstrual Disorders Flashcards

1
Q

How does the hypothalamus and pituitary effect menstruation?

A

GnRH from hypothalamus stimulates anterior pituitary to release FSH and LH which stimulates estrogen and protegesterone release from ovarian follicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

LH stimulates theca cells to produce what?

FSH stimulates granulosa cells to convert androgens into what?

A

androgens (androsenedione and testosterone)

estrogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the average age of menarche?

A

12.43 years old

occuts 2-3 years after thelarche at tanner stage IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Primary amenorrhea defined

A

absense of menarche by age 13 without secondary sexual development

Or

absence of menarche by age 15 with secondary sexual developement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Within the first year of menstrual cycles, what is the typical cycle length?

A

21-45 days

by third year after menarche, most menstural cycles are 21-35 days long

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a normal menstrual cycle in a young female?

A

median age 12.43

32.2 days in first GYN year

menstural cycle interval 21-45 days

flow length is 7 days or less

flow rate is 3-6 pads/tampons per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is secondary amenorrhea?

A

absence of menstriation for 6 months

if greater than 90 days at time of presentation, get pregnancy test

may be associated with other conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Excessive menstrual flow is quantified by?

A

changing pads/tampons every 1-2 hours, esp if longer than 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is polymenorrhea?

A

abnormally frequent menses at intervals at <21 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is menorrhagia?

A

excessive and or prolonged menses (>80ml and >7 days) occuring at regular intervals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is metrorrhagia?

A

irregular episodes of uterine bleeding (not nec. heavy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is menometrorrhagia?

A

heavy and irregular uterine bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is intermenstrual bleeding?

A

scant bleeding at ovulation for 1-2 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is oligomenorrhea

A

too few periods

menstrual cycles at >35 day cycles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are structural causes for abnormal uterine bleeding?

A

PALM

polyp

adenomyosis

leimyoma

malignancy and hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are nonstructural causes of abnormal uterine bleeding?

A

COEIN

coagulopathy

ovulatory dysfunction

endometrial

iatrogenic

not classified

17
Q

What is the most common neoplasm of the uterus?

A

Fibroids

18
Q

what are coagulopathic causes of AUB?

A

present with heavy flow, assx with von willebrand disease

19
Q

what can cause ovulatory dysfunction related AUB?

A

PCOS

20
Q

what can be an endometrial cause of AUB?

A

infection

21
Q

What can be a cause of an iatrogenic AUB?

A

IUD, IUS (mirena), exogenous hormones (Prometrium)

22
Q

What are the average ages of the following in white populations

Thelarche

Adrenarche

Menarche

A
  1. 3yrs
  2. 5yrs
  3. 5 yrs

earlier in african american and hispanic populations

23
Q

Tanner Staging Breast Development

A
  1. preadolescent elevation of papilla only
  2. breast bud stage with elevation of breast and papilla and enlargement of areolar region
  3. further enlargement of breast and areola without separation of contours
  4. projection of areola and papilla to form secondary mound above the level of the breast
  5. mature stage, projection of papilla only, recession of areola to general contour of breast
24
Q

Tanner Staging of Hair Growth

A
  1. preadolescent absence of pubic hair
  2. Sparse hair along labia, slight pigment
  3. hair spreads sparsly over junciton of pubes, darker
  4. adult type hair without spread to medial thigh
  5. adult type hair with spread to medial thigh and inverted triangle shape
25
Q

What are treatment options for AUB?

A

Depends on cause: If polyp or fibroid can remove those, or do a hysterectomy. Can try ablation to remove endometrium, Mirena or continous OCP to avoid cycling/bleeding, or tranexamic acid, or scheduled NSAIDs, or Provera/daily progesterone.

If nonstructural, can treat underlying condition.