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OBGYN > Menstruation and PMS > Flashcards

Menstruation and PMS Flashcards

1
Q

what is the order of pubertal landmarks?

A

thelarche (breast budding), pubarche (axillary and pubic hair growth), and menarch (first menses)

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2
Q

what is the hormone responsible for the onset of thelarche?

A

estradiol

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3
Q

what is the hormone responsibile for the onset of pubarche?

A

adrenal hormones

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4
Q

what is the hormone responsible for menarche?

A

estradiol

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5
Q

a female of 13 years or older without any breast developement is in deficiency of which hormone?

A

estrogen

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6
Q

what is the etiology behind puberty?

A

believed to begin with DISINHIBITION of the pulsatile gonadotropin releasing hormone (GnRH) secretion from the hypothalamus

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7
Q

at what tanner stage of development is the prepubertal child?

A

tanner stage 1

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8
Q

at what tanner stage of development is the developmental child?

A

stages 2-4

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9
Q

at what tanner stage of development is “adulthood” classified?

A

stage 5

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10
Q

what is the definition of precocious puberty?

A

appearance of secondary sex characteristics before 8 years of age

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11
Q

what is the most common etiology behind precocious puberty?

A

unknown

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12
Q

many follicles are stimulated by FSH but which egg is actually released?

A

the follicle that secretes more estrogen than androgen

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13
Q

in terms of the menstrual cycle what is the pathology behind endometrial sloughing?

A

withdrawal of progesterone

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14
Q

which hormone is responsible for endometrial proliferation?

A

estrogen

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15
Q

which hormone causes the oocyte to be released? (ovulation)

A

LH surge

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16
Q

which hormone is responsible for follicle maturation and estrogen secretion?

A

FSH

17
Q

during the luteal phase, what is responsible for secreting progesterone? what is the result?

A

the corpus luteum which causes endometrial maturation and a drop in FSH and LH

18
Q

what is the pathology behind the LH surge?

A

the dominant follicle releases the most estradiol so that its positive feedback causes an LH surge

19
Q

what is the average length of menses?

A

4 to 7 days

20
Q

what is average blood loss during mense?

A

30-50 mL

21
Q

_____ released from the endometrium causes dysmeorrhea

A

prostaglandins

22
Q

ovulation takes place approximately how many hours after LH surge? after LH peak?

A

24-36 hours; 12 hours

23
Q

which phase is more variable in nature - follicular or luteal?

A

follicular (the luteal phase is usually around 11 days due to the length of time the corpus luteum is able to secret progesterone

24
Q

what maintains the corpus lutuem after fertilization?

A

hCG, released by the embryo

25
Q

what is the start of the follicular phase?

A

the first day of the menses

26
Q

at the very beginning of menses (the start of the follicular phase) at what levels are the hormones?

A

they are all very low - and so w/out any negative feedback, GnRH from the hypothalamus causes FSAH release from the pit gland

27
Q

FSH stimulates which cells in the ovary? what is the response?

A

stimulates maturation of granulosa cells; estrogen secretion

28
Q

as the estradiol levels increase during the follicular phase, what is happening with LH and FSH levels?

A

estradiol inhibits FSH and LH due to negative feedback

29
Q

which hormone acts on the theca cells to increase secretion of androgens?

A

LH

30
Q

t or f: androgens are eventually converted to estradiol

A

TRUE

31
Q

t or f: progesterone causes inhibition of FSH and LH

A

TRUE

32
Q

symptoms during which phase of the menstrual cycle is classic for PMS?

A

luteal phase

33
Q

what is the main difference between PMS and PMDD in terms of symptoms?

A

PMS does NOT impair daily activities

34
Q

when do symptoms go away for PMS/PMDD?

A

once menses begins - w/in 4 days (this is also a good way to clinically rule out other causes …IOW if the pt has affective and somatic complaints that go away with menses) - pts are adviced to keep a prospective sx diary for two months

35
Q

t or f: PMDD/PMS can be diagnosed after one cycle

A

FALSE; must be after two prospectively monitor cycles

36
Q

what is the therapy with most evidence for effectiveness for PMS/PMDD?

A

SSRI and ovulation blocking agents

37
Q

t or f: calcium with help to relive PMS/PMDD symptoms

A

TRUE

38
Q

what medication can be given for SEVERE PMS?

A

GnRH agonists

OBGYN (21 decks)

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