Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 2 OBGYN > Normal menstrual cycle > Flashcards

Normal menstrual cycle Flashcards

1
Q

average duration of normal adult reproductive cycle

A

28 days

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

what are the three distinct ovarian phases

A
  • follicular phase: onset of menses and ends at LH surge
  • ovulation: occurs within 30-36 hours of LH surge
  • luteal phase: begins on day of LH surge and ends with onset of menses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how long do the follicular and luteal phases last in a normal menstruating woman?

A

follicular phase - 14 days

luteal phase - 14 days

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

in irregular cycles, how are the follicular and luteal phases affected?

A

duration of luteal phase remains fairly constant; duration of follicular phase can vary

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

what is the normal volume of menstrual blood volume?

A

30 mL (1 ounce)

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

what is an abnormal amount of menstrual blood volume?

A

greater than 80 mL

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

what organ serves as the pulse generator of the reproductive cycle?

A

hypothalamus

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

what does the corpus luteum secrete upon ovulation?

A

progesterone

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

where are the primordial germ cells? where do they go from there, and what do they do?

A

endoderm of yolk sac

migrate to genital ridge by 5-6 weeks gestation, then wildly multiply

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

what is the first visible sign of follicle recruitment?

A

an increase in size and change in granulosa cell shape

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

follicular phase - preantal - what happens?

A
  • oocyte enlarges and is surrounded by single layer of granulosa cells and a membrane - zona pellucida
  • FSH binds to FSH receptors on granulosa cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what does the preantral follicle do in response to FSH?

A

aromatize androgens to estrogens

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

which cells produce estrogen? which receptors do they have?

A

granulosa cells

FSH

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

which cells produce androgens? which receptors do they have?

A

theca cells

LH

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

what are the criteria for folllicle progression in terms of hormone levels?

A
  • elevated FSH

- low LH

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

the success of a follicle depends on what factors?

A

ability to convert an androgen microenvironment to an estrogen one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ovarian steroidogenesis is always dependent upon which hormone?

A

LH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

events of follicular phase - antral

what must the granulosa cell acquire in order to respond to ovulation?

A
  • increase in follicular fluid

- granulosa cells must acquire LH receptors to respond to ovulation

19
Q

which hormone rises during the antral part of the follicular phase? what is the purpose of this?

A

LH

stimulates androgen production in theca cells

20
Q

what occurs during the preovulatory follicle phase?

A
  • granulosa cells enlarge and acquire lipids
  • oocyte resumes meiosis (has been arrested in prophase of meiosis I)
  • LH promotes luteinization of granulosa which results in progesterone production
21
Q

what is the time frame from LH surge to menses?

A

14 days, consistently

22
Q

what hormone prevents luteal regression? what is its role?

A

HCG

maintains steroidogenesis of corpus luteum until 9-10th week of gestation

23
Q

what are the three endometrial phases in an ovulatory cycle?

A
  • menstrual endometrium and proliferative phase
  • ovulation
  • secretory phase
24
Q

what is responsible for cessation of menstruation?

A

rising estrogen levels in early follicular phase - induce endometrial healing

25
Q

loss of estrogen and progesterone in the absence of fertilization / implantation initiates what 3 endometrial events?

A
  • vasomotor reactions
  • tissue loss
  • menstruation
26
Q

70% of blood loss during menstruation occurs when?

A

first 2 days

27
Q

definition: menorrhagia

A

prolonged (over 7d) or excesive (over 80 mL) uterine bleeding at regular intervals

28
Q

hypomenorrhea

A

cycle length of 2 days or less or also can be a reduction in flow

29
Q

metorrhagia

A

bleeding at irregular but frequent intervals or variable amount

30
Q

menometorrhagia

A

frequent bleeding that is excessive and irregular in amount and duration

31
Q

what is the most common cause of amenorrhea?

A

pregnancy

32
Q

what are causes of HP amenorrhea?

A
  • functional
  • drug induced
  • neoplastic
  • psychogenic
  • other
33
Q

what is the definitive way to diagnose HP dysfunction for amenorrhea?

A

measure FSH, LH, and prolactin serum levels

FSH and LH will be low
prolactin may be normal

34
Q

what is asherman syndrome?

A
  • scarring of uterine cavity

- most frequent anatomic cause of secondary amenorrhea

35
Q

how is amenorrhea diagnosed and treated? how is it performed and what are the results?

A

progesterone challenge test - assesses if pt has adequate estrogen, competent endometrium, and an adequate genital outflow tract

  • induces a progesterone withdrawal bleed within one week of completing 10-14 day course of oral progesterone
  • if bleeding occurs - pt is anovulatory
  • if no bleeding - hypoestrogenic or anatomic
36
Q

how is hyperprolactinemia treated?

A

bromocriptine or cabergoline

37
Q

what is done if a patient with amenorrhea desires to get pregnant?

A

ovulation can be induced with clomiphene citrate, human menopausal gonadotropins, pulsatile GnRH, or aromatase inhibitors

38
Q

what describes abnormal uterine bleeding - luteal phase defect? what happens to the menstrual cycle?

A
  • ovulation occurs bu the corpus luteum doesnt secrete adequate quantities of progesterone to support the endometrium and is not adequate to support a pregnancy if one occurs
  • menstrual cycle is shortened with menstruation occurring earlier than expected
39
Q

how can abnormal uterine bleeding lead to endometrial cancer?

A

chronic unopposed estrogen stimulation of the endometrium which can lead to increased proliferation followed by hyperplasia and ultimately endometrial cancer

40
Q

what is necessary to diagnose endometrial cancer?

A

biopsy

41
Q

what is the goal of treatment for AUB? what drugs can be used?

A

ensure regular shedding of endometrium

  • progestin 10-14d: mimics the physiologic withdrawal of progesterone
  • combination oral contraception: suppresses the endometrium and also establishes a regular withdrawal cycle
42
Q

what is done for acute heavy abnormal bleeding? if that fails?

A
  • high dose estrogen and/or progesterone for acute management
  • followed by preventative management with itnermittent progestin treatment or oral contraceptives

if not responsive to medical management - surgical treatment with D&C (dilation and curretage), endometrial ablation, hysterectomy

43
Q

what is dilation and curretage? when is it used?

A
  • biopsy and exploration

- used for older patients who are at higher risk of having endometrial hyperplasia

44
Q

what does endometrial ablation do? what is a contraindication?

A

changes architecture by ablating / cauterizing vessels

contraindicated in women who wish to maintain reproductive status

Year 2 OBGYN (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions