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reproductive system > menstrual disorders > Flashcards

menstrual disorders Flashcards

1
Q

what is secondary amenorrhea

A
  • in a woman who has previously menstruated, absence of menses for 3 months
  • in a women with irregular menses, it is 6 months absence of menses
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2
Q

what is primary amenorrhea with and w/out secondary sex characteristics

A

with: absence menstruation by age 16

w/o: absence menstruation by age 14

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3
Q

common cause of primary amenorrhea

A

pregnancy

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4
Q

women who fail to menstruate in the presence of estrogren stimuation of the endometrium…

A

are at increased risk for endometrial cancer

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5
Q

drug use, stress, big wt change, excessive exercise

A

think secondary amenorrhea

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6
Q

cause of secondary amenorrhea in a woman with nml estrogen

A

asherman syndrome(intrauterine synechiae) or PCOS

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7
Q

first line test for amenorrhea

A

B-hCG, TSH, prolactin

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8
Q

CNS tumor, stress, hyperprolactinemia, hypophysitis, sheenan syndrome, premature ovarian syndrome

A

causes of secondary amenorrhea in a hypoestrogenic women

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9
Q

what test to do determine the presence or absence of sufficient estrogen

A

progesterone challenge test

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10
Q

streak gonads, shield chest, amenorrhea, webbed neck, aortic coartatation, bicuspid aortic valve

A

turner syndrome

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11
Q

increased prolactin means what

A

inhibits the release of GnRH and thus LH and FSH; points to a pituitary pathology

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12
Q

etiology of hypogonadotrophic hypogonadism

A

hypothalmic or pituitary problem

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13
Q

etiology of hypergonadotrophic hypogonadism

A

ovaries have failed to produce estrogen

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14
Q

primary dysmenorrhea

  • caused by what
  • occurs when
A
  • painful menstruation with no pathologic abnormality
  • excess prostaglandin and leukotriene levels
  • occurs within 2 years of menarche
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15
Q

primary dysmenorrhea symptoms

A

painful contractions/cramping in lower abdomen or pelvis radiating to back/thighs, n/v, diarrhea

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16
Q

primary dysmenorrhea tx

A

NSAIDs, heat, combined OCPs, progestin IUD

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17
Q

secondary dysmenorrhea causes; age

A

endometriosis, adenomysis, fibroids, adhesions, IUD, PID;

over 25 yrs of age

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18
Q

when does primary and secondary dysmenorrhea peak

A

primary: late teens and early 20s
secondary: incidence increases with age

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19
Q

secondary dysmenorrhea symptoms

A

similar to primary but also bloating, menorrhagia, dysparenunia

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20
Q

primary and secondary dysmenorrhea related to flow

A

primary: begins or at onset of menses and lasts 1-3 days
secondary: less related to first day of flow

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21
Q

primary dysmenorrhea

  • breast development
  • pubic and axillary hair
A

yes to breast development

no pubic or axillary hair

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22
Q

imperforate hymen

A

a completely sealed hymen will prevent menstrual flow

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23
Q

gonadal agenesis or dysgenesis

A

hypoplastic dysfunctional ovaries

24
Q

turner syndrome

A

45, X

25
Q

androgen insenstivity and tx

A

genetically male child who is phenotypically female

tx: removal of testis due to risk of testicular cancerhow

26
Q

cervical agenesis

A

prevents menstrual flow

27
Q

mullerian agenesis

A

uterus never develops

28
Q

tumor of pituitary or hypothalamus

A

affect LH and FSH production

29
Q

amenorrhea blood work

A

LH, FSH, B hCG, estrogen, prolactin, testosterone

30
Q

amenorrhea imaging

A

pelvic, transvaginal, thyroid

CT/MRI hypothalamus and pituitary

31
Q

how to define secondary amenorrhea in a pt with oligomenorrhea

A

12 month period without menses

32
Q

galactorrhea

A

milk from breast not associated with childbirth; think secondary amenorrhea

33
Q

sheehan syndrome

A

damage to pituitary secondary to ischemia during childbirth, think secondary amenorrhea

34
Q

asherman syndrome

A

intrauterine adhesions

35
Q

main difference with primary and secondary amenorrhea

A

primary has no pathologic findings

36
Q

PMS occurs when during the menstrual cycle

A

begin 1-2 weeks before menses(luteal phase), it ends 1-2 days after the onset of menses

37
Q

PMS and symptom free period

A

monthly symptom free period during follicular phase(frpm day 1 of menses to ovulation)

38
Q

tx for mastalgia

A

bromocriptine

39
Q

menopause

A

cessation of menses for 12 months as as result of follicular depletion
average age 51 years

40
Q

premature menopause

A

cessation of menses before age 40

41
Q

age women stop menstruating

A

between 44 and 55

42
Q

what happens to ovaries during menopause

A

they continue to produce testosterone and androstenedione; estrone is the predominant postmenopausal circulating estrogen

43
Q

diagnostic lab for menopause

A

FSH greater than 30 is diagnostic

44
Q

combine HRT increases what

A

risk for CV disease, breast cancer, and cognitive changes

45
Q

contraindications to HRT

A

undiagnosed vaginal bleeding, acute vascular thrombosis, liver disease, hx of endometrial or breast cancer

46
Q

follicular phase ends with what

A

LH surge and ovulation

47
Q

GnRH is from where? and causes an increase in what 2 things

A

from anterior pituitary; increases FSH and LH

48
Q

FSH role

A

causes follicle growth

49
Q

LH role

A

causes egg to be released and mature, breaks down follicle walls and helps follicle to turn into corpus luteum

50
Q

what happens 24 -36 hrs after LH surge

A

dominant egg is released

51
Q

ovum lives for how long

A

24 hrs

52
Q

describe temperature with ovulation

A

decrease with basal body temp and increase in temp

53
Q

proliferative phase is what cycle days

A

7 to 14

54
Q

days 15-28 is what 2 phases

A

luteal and secretory

55
Q

progestin challenge shows withdrawal bleed

A

(+) anovulation due to noncyclic gonadotropin secretion. think PCOS with inc LH

56
Q

progestin challenge shows NO withdrawal bleed

A

(-) uterine abnormality or estrogen deficiency

reproductive system (11 decks)

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