menstruation n tingz Flashcards

1
Q

which is the most important hormone in follicular development?

A

anti-Mullerian hormone (AMH)

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2
Q

where is AMH secreted from?

A

small ovarian follicles

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3
Q

what does AMH cause?

A

reduction in oestrogen

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4
Q

starting with the release of AMH, describe the first half of ovulation.

A

1) AMH released
2) oestrogen drops
3) this drop triggers GnRH release
4) GnRH triggers FSH + LH release

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5
Q

where is GnRH released from?

A

hypothalamus

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6
Q

where do FSH and LH get released?

A

anterior pituitary

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7
Q

starting from the follicle getting bigger, describe the second half of ovulation.

A

1) follicle grows
2) AMH goes down
3) oestrogen goes back UP
4) GnRH goes down
5) FSH + LH go down
6) dominant follicle is large enough to survive and support itself
7) releases its own oestrogen
6) causes LH + FSH surge
7) egg released (ovulation)

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8
Q

what happens to the released egg at the end of ovulation?

A

it will be swept away by fimbrae

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9
Q

what happens to the follicle after the egg has been released?

A
  • becomes corpus luteum

- releases oestrogen + progesterone

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10
Q

which hormones does the corpus luteum release and why?

A

oestrogen and progesterone, to maintain endometrium for potential embryo

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11
Q

what happens in the event the egg is not fertilised?

A
  • corpus luteum dies
  • oestrogen + progesterone levels fall
  • lining sheds (menstruation)
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12
Q

how long is the luteal phase?

A

14 days, FIXED

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13
Q

what happens if the embryo does implant in the endometrium?

A
  • trophoblast tissue starts producing hCG

- CL carries on releasing oestrogen + progesterone

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14
Q

when does the placenta replace the corpus luteum in hormone release?

A

8-10 weeks gestation

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15
Q

key feature in hypothalamic hypogonadism?

A

amenorrhoea

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16
Q

which conditions could cause hypothalamic hypogonadism?

A
  • anorexia nervosa
  • strict dieting
  • athlete
  • stress
  • idiopathic
17
Q

pathophysiology of Kallmann’s syndrome?

A

GnRH-secreting neurones don’t develop

18
Q

management of Kallmann’s syndrome?

A

give exogenous GnRH

19
Q

how does hyperprolactinaemia impact menstruation?

A
  • excessive prolactin inhibits GnRH release
  • stops ovulation
  • amenorrhoea
20
Q

signs of hyperprolactinaemia?

A
  • oligo/amenorrhoea
  • galactorrhoea
  • headache
  • bitemporal hemianopia (if pit adenoma)
21
Q

investigations for hyperprolactinaemia?

A
  • CT head

- serum prolactin

22
Q

management of hyperprolactinaemia?

A
  • bromocriptine
  • cabergoline
  • they’re DA agonists, DA inhibits prolactin release
  • surgery
23
Q

main cause of pelvic inflammatory disease?

A
  • chlamydia

- adhesions form

24
Q

management of tubal adhesions?

A
  • laparoscopic adhesiolysis

- salpingostomy

25
Q

what % of infertility is caused by pelvic inflammatory disease?

A

25%

26
Q

define amenorrhoea

A
  • primary = no onset of menstruation by age 16

- secondary = cessation of menstruation for >6 months

27
Q

definition of menopause

A
  • diagnosed retrospecitvely
  • 12 months of anemorrhoea
  • FSH >30 U/L