Menstrual Disorders

Question 1

primary amenorrhea

Answer 1

no period by age 15

Question 2

secondary amenorrhea

Answer 2

no period for 6 mo or longer in women previously menstruating

Question 3

turner syndrome

Answer 3

45 XO

Question 4

sx of turner syndrome

Answer 4

short stature
infertility
primary gonadal failure
osteoporosis

Question 5

mayer rokitansky kuster hauser syndrome

Answer 5

“old school” name for the family of the Mullerian agenesis conditions

Question 6

t/f imperforate hymen is more common than mullerian abnormalities

Answer 6

true

Question 7

hematocolpos

Answer 7

imperforate hymen that obstructs menstrual blood from exiting

Question 8

congenital GnRH deficiency associated with anosmia

Answer 8

kallmann syndrome

Question 9

carniopharyngioma

germinoma

Answer 9

tumor of the hypothalamus

Question 10

46 XR karyotype with nonfunctional androgen receptors

Answer 10

androgen insensitivity syndrome

“testicular feminization”

Question 11

labs to order for primary amenorrhea if there is a uterus

Answer 11

BhCG
karyotype if FSH high
Prolactin

Question 12

labs primary amenorrhea w/o uterus

Answer 12

karyotype

serum testosterone

Question 13

most common cause of secondary amenorrhea

Answer 13

pregnancy

Question 14

top 2 most common causes of secondary amenorrhea

after pregnancy r/o

Answer 14

ovarian and hypothalamic issues

Question 15

how does hyperprolactinemia trigger secondary amenorrhea

Answer 15

1. inhibits GnRH from hypothalamus
2. Decrease in LH and FSH production in pituitary
3. Ovaries can’t function normally
4. secondary amenorrhea

Question 16

ovarian cause of secondary amenorrhea

Answer 16

PCOS

Question 17

cause of 20% of all amenorrheas

Answer 17

PCOS

Question 18

depletion of functional oocytes before age 40

Answer 18

primary ovarian insufficiency

cause: genetic, autoimmune, cancer tx

Question 19

present in 60% of teens

Answer 19

primary dysmenorrhea

Question 20

when do dysmenorrhea sx start?

Answer 20

w/ onset of regular ovulatory cycles (1-3yrs post menarche)

Sx start just prior to flow onset and last several days

Question 21

what causes primary dysmenorrhea

Answer 21

excess prostaglandins

= contractions, increased tone, GI tract stimulated

Question 22

tx for dysmenorrhea

Answer 22

NSAIDS
mefenamic acid
start with onset of menses or 1-2 days before

Question 23

NSAIDS are antiprostaglandins how?

Answer 23

prevent arachidonic acid from turning into Prostaglandin E2

Question 24

menorrhagia

Answer 24

menstrual blood loss over 80 ml

Question 25

prolonged menses

Answer 25

over 7 days duration

Question 26

menometrorrhagia

Answer 26

excessive and irregular bleeding DUB

Question 27

dysfunctional uterine bleeding (DUB)

Answer 27

abnormal bleeding not from anatomic abnormality generally anovulatory bleeding

Question 28

Polymenorrhea

Answer 28

cycle length less than 24 days

Question 29

for menorrhagia cc when do a biopsy?

Answer 29

if pt is over 40

or RF for endometrial hyperplasia

Question 30

RF for endometrial hyperplasia

Answer 30

obesity, chronic anovulation

Question 31

pelvic ultrasound or saline infusion sonography is good for r/o..

Answer 31

endometrial thickening, polyps, fibroids

Question 32

hysteroscopy good for

Answer 32

r/o endometrial lesions

Question 33

PMS definition

Answer 33

physical and behavioral sx that recur in the luteal phase of menstrual cycle

Question 34

PMDD

Answer 34

premenstrual dysphoric disorder

severe PMS sx of anger, irritability and internal tension is prominent

Question 35

RF for PMS

Answer 35

less educated
smoker
anxiety disorder
hx of traumatic events

Question 36

average duration of PMS

Answer 36

6 days out of the cycle

Question 37

tx for moderate to severe PMDD

Answer 37

SSRI (fluoxetine, sertraline, etc)

OCP

Question 38

tx refractory PMDD

Answer 38

GnRH agonist (Lupron) 
oophorectomy