Brainscape's Knowledge GenomeTM

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


See full index

Pathophysiology > OBGYN: Puberty, MS, Amenorrhea, Dysmenorrhea > Flashcards

OBGYN: Puberty, MS, Amenorrhea, Dysmenorrhea Flashcards

1
Q

define puberty

  • series of what two events

- what develops?

A
  • series of neuroendocrine + physiological events

- results in develop of secondary sex characteristics, menarche and ovulation

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

puberty

-onset is determined by? (5)

A
  1. genetic factors
  2. geographical location
  3. nutritional status
  4. excessive exercise
  5. psychological factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what happens 1 yr before puberty

A
  • nocturnal pulses of gonadotropin secretion—FSH and LH
  • incr resp in the pituitary to GnRH

results in stimualtion of gonadal maturation with ESTRADIOL and TESTOSTERONE secretion

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

age of onset of puberty

  • girls + anatomically whats starting?
  • boys + anatomically whats starting
A

girls: 8-9–thelarche (breast enlargement)
boys: 11— enlargement of testes and thining of scrotal skin

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

define thelarche

A

breast enlargement

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

what causes development of breasts, maturation of repro organs and deposition of fat in female hips

A

estradiol

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

list the repro organs in girls

A

vagina
uterus
ovaries

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

3 things that estradiol does to female body during puberty

A
  1. breast maturation
  2. develop of repro organs—vagina, uterus, ovaries
  3. deposition of fat in female hips
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what causes rapid skeletal growth of testes, scrotum and penis

A
  1. incr in prod of growth factors

2. estrogen

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

when is male puberty complete

A

first ejaculation that contains mature sperm

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

when is female puberty is complete

A

time of first ovulatory menstrual period

—can take up to 1-2 years after menarche

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how do we describe the stages of puberty

A

tanner stages

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

no sexual hair (both), flat appearing chest with raised nipple (girl)
-age + stage?

A

stage 1

pre-pubertal

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

pubic hair appears (both), testicular enlargement, breast bud forms
-age + stage?

A

stage 2

8-11.5 YO

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

coarsening of pubic hair (both), -penis size/length incrs,

  • breast enlarge, mound forms
  • age + stage?
A

stage 3

11.5-13 YO

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

coarse hair across pubis—sparing thigh (both),

  • penis width/glans incr,
  • breast enlarges, raised areola, mound on mound
  • age + stage?
A

stage 4

13-15YO

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

coarse hair across pubis and medial thigh (both)

  • penis and testies enlarge to adult size
  • adult breast contour, areola flattens
  • age + stage?
A

stage 5

usually >15 YO

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

define precocious puberty

A

too early

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

both delayed and precocious puberty involve?

A

-inappropriate onset of sex hormone production by gonads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

define delayed puberty in girls and boys

A
  • girl hasnt developed breast buds by age 13

- boys havnt had enlargement of the testes by 14.5 yrs old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

in about 95% of delayed puberty cases— what is cause

-tx? when to do it?

A

normal physiologic event

  • **everything is happen normally but SLOWLY
  • *tx rarely needed—>causing psychosocial problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

% of cases that delayed puberty is normal physiologic event

A

95

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

% of delayed puberty cases caused by genetic mutations, disruption of HPG axis or outcomes of systemic dz

A

5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

causes of the 5% of delayed puberty cases (3)

A
  1. genetic mutations
  2. disruption of HPG axis
  3. by outcomes of systemic dz
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

two main general causes of delayed puberty causes

-exs for each one

A

HypERgonadotropic HyPOgonadism–>increased FSH and LH

  1. ***Gonadal dysgenesis turner syndrome
  2. ***Klinefelter syndrome (47, XXY)
  3. Bilateral gonadal failure from traumatic, infectious or autoimmune causes

HyPOgonadotropic HyPOgonadism—>decr LH and FSH

  1. Kallmann syndrome (GnRH deficiency)
  2. pituitary adenomas
  3. drug use
  4. anorexia/extreme exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

MCC for delayed puberty in the 5% of cases that is not physilogic normal

A
  1. Turner syndrome–Gonadal dysgenesis

2. Klinefelter syndrome—47 or XXY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is Kallmann syndrome

A

GnRH deficiency causing Hypogonadatropic Hypogonadism delayed puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

define precocious puberty–girls and boys

A
  • sexual maturation occuring b4 age 6 in black girls or 7 in white girls
  • b4 age 9 in boys
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

causes of precocious puberty (3)

A
  • obesity
  • endocrine disruptions in common household products–pesticides, plasticizers and pharmaceuticals
  • lethal central nervous system tumors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

complete precocious puberty

  • define
  • what is the axis?
  • cause in 10% of cases?
A
  • premature development of appropriate characteristics
  • hypothalamic-pituitary-ovarian axis functioning normally BUT prematurely

10% cases–lethal CNS tumor is cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

partial precocious puberty

  • define
  • can develop to?
  • cause?
A

partial development of appropriate secondary sex characteristics

can progress to complete precocious puberty

cause: estrogen secreting neoplasms or may be variant of normal pubertal development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

mixed precocious puberty

  • define
  • cause
A
  • partial development of some secondary sex characteristics of the OPPOSITE gender
  • commonly caused by adrenal hyperplasia or androgen-secreting tumors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

MC congenital mullerian anomalies–>which class is MC

A

Biconuate uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

follicular phase also called

A

menses + proliferative phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Luteal phase also called

A

Secretory phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Seccretory phase?

A

luteal phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

proliferative and menses phase?

A

Follicular phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

days 0-14

A

follicular phase/proliferative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

days 14-28

A

secretory phase/luteal phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

surge in what hormone causes ovulation

A

LH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

hormone predominating the luteal phase

A

progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

hormone predominating follicular phase

A

estradiol + FSH

43
Q

what is phase 1 of reproductive cycle

A

Menstruation and Follicular phase

44
Q

LMP really means?

A

first day of menstrual bleeding=day ONE of the menstrual cycle

45
Q

day one of menstrual cycle?

A

first day of menstrual bleeding

46
Q

The average cycle is how long?

A

21-35 days

avg=28

47
Q

average menses lasts ?

A

3-7 days

48
Q

average volume of blood loss during menses

A

30-50 mL

49
Q

If a woman is not using hormonal birth control, you can assume that ??

A

women are ovulating (releasing an egg) each time they have a period

50
Q

having a period means?

A

you are fertile

51
Q

two days before start of menses, what hormone increases

-what does this hormone cause

A

FSH

  • causes maturation of a group of ovarian follicles (oocytes/eggs)
  • dominant follicle emerges
52
Q

what marks the beginning of follicular phase

A

menses starting—-DAY 1 of cycle!!!

**egg/follcile is starting to mature and getting ready for ovulation

53
Q

during follicular phase, what hormone does the oocyte/follicle start to secrete?? what happens due to this hormone being secreted

A

it starts to secrete estradiol–>provides (-) feedback to PG to stop producing FSH (+) feedback to start incr LH

54
Q

which hormones are at its lowest during follicular phase

A

estradiol
LH
Progesterone

55
Q

what hormone is highest at the start of the menstrual cycle

A

FSH

56
Q

what is phase 2 of the reproductive cycle

A

ovulation

57
Q

Ovulation

-by day 11-13 of normal cycle, what happens

A

LH surge— triggers ovulation

58
Q

what triggers ovulation and what day of cycle

A

days 11-13= LH SURGE

59
Q

after LH surge, what happens during ovulation

A

Oocyte is expelled from follicle

60
Q

where does the expelled oocyte travel to next

A

fallopian tubes–>uterus–>awaiting fertilization

61
Q

after expulsion of the oocyte, what does the empty follicle turn into?

A

corpus luteum

62
Q

define ovulation

A

mature egg or oocyte released from follicle in the ovary

63
Q

what is the follicle

A

protective sac around the egg giving the maturing egg nutrients and protection

64
Q

what is left behind after ovulation

A

follicle– turns into corpus luteum

65
Q

follicular phase is dominated by?

A

estradiol

66
Q

luteal phase is dominated by?

A

progesterone

67
Q

after ovulation, how long does it take to produce progesterone

A

24 hours after ovulation

***rises rapidly thereafter

68
Q

when is the peak of progesterone

**maintained for how long?

A

3-4 days after ovulation

**maintained approx for 11 days

69
Q

what happens to progesterone levels if fertilization and implantation do not occur

A

progesterone production diminishes rapidly

70
Q

what is making the progesterone

A

corpus luteum

71
Q

“prime” time to get pregnant

A

2-4 days after ovulation—oocyte is now in uterus waiting for fertilization

72
Q
  1. surge in LH=?
  2. day 1 of menstrual cycle, the highest hormone=?
  3. what happens after egg is released?
A
  1. ovulation
  2. FSH
  3. corpus luteum makes progesterone—the egg that would be fertilized and implanted needs progesterone to IMPLANT
73
Q

why does a fertilized egg need progesterone

A

to implant into endometrium and sustain the pregnancy into early first trimester

74
Q

life span of corpus luteum

A

13-14 days unless pregnancy occurs

75
Q

if oocyte becomes fertilized and implants within endometrium— early pregnancy begins secreting?

A

Human Chorionic Gonadotripin (hCG)

76
Q

what does hCG do early on in pregnancy

A

sustain the life span of corpus luteum for another 6-7 weeks—-so progesterone continues to be produced

77
Q

progesterone produces ____ feedback to PG to ____ levels of what hormone(s)

A

progesterone provides negative feedback on PG–>both FSH and LH levels are suppressed

78
Q

what happens when corpus luteum gets HCG hormone

A

it sustains the life of the corpus luteum for another 6-7 weeks so more progesterone can be secreted to sustain early pregnancy

79
Q

what happens when progesterone levels fall due to egg not being fertilized?

A

FSH begins to rise—- preparing woman for another reproductive cycle

80
Q

what inhibits FSH and LH

A

Progesterone

81
Q

what hormones are highest at days
7
14
21

A

7= FSH

14=LH

21=progesterone

82
Q

ammenhorrhea define

A

absence of menstruation

83
Q

primary amenhorrhea define

A

menarche has not occured by age 13-15

84
Q

causes of primary amenorrhea (3)

A
  1. anatomical defects—absence of vagina and uterus
  2. genetic disorders–Turner syndrome
  3. problems with AP—tumors or problems with CNS that affect hypothalamic defects—prevents release of GnRH–which means no signaling of AP to release FSH and LH
85
Q

how to diagnose primary amenorrhea

A

labs–abnormal levels of gonadotropins or ovarian hormones or precense of genetic conditions

diagnositc imaging–US and MRI`

86
Q

tx for primary amenhorrhea

A

correction of underlying disorders and implementation of HRT

surgery only to correct structural abnormalities

87
Q

number one cause of secondary amenohorrhea

A

pregnancy

88
Q

define secondary amenorrhea

A

absense of menstration for a time equivalent to three or more cycles in women who have previously menstruated

89
Q

how many cycles missed to call it secondary amenorrhea

A

THREE+

90
Q

causes of secondary amenorrhea (7)

A
  1. PREGNANCY *****
  2. hypothryoidism
  3. hyperprolactinemia
  4. excessive exercise
  5. stress
  6. weight loss
  7. PCOS
91
Q

define dysmenhorrhea

A

painful menstruation

92
Q

s/s of dysmenorrhea

A
  • pelvic pain associated with onset of menses
  • backache
  • anorexia
  • vom/dia
  • syncope
  • HA
93
Q

what is causing HA with dysmenorrhea

A

prostaglandins enter the systemic circulation

94
Q

define primary dysmenhorrea and what causes it pathophys wise

A

-painful menstruation caused by release of prostaglandins in NORMAL OVULATORY CYCLE

95
Q

prostaglandin is a vasodilator or contrisor

A

vasoconstrictor–constricts endometrial BVs a

96
Q

prostaglandin is myometrial inhibitor or stimulant

A

stimulant—increases myometrial contractions

97
Q

pathophysiology to the pain caused in dysmehorrhea

A

prostaglandin is released into systemic circulation–>excess prostaglandin increases myometrial contractions, constricts endometrial BVs and enhances nerve hypersensitivity——–results in PAIN

98
Q

primary dysmenorrhea always correlates to?

A

menses

**ovulatory cycle is releasing the prostaglandins causing the pain **

99
Q

secondary dysmenorrhea

  • define
  • manifests when?
  • occurs when?
A

pathologic pelvic conditions

–manifests later in reproductive years and can occur ANY TIME during the menstrual cycle

100
Q

causes of secondary dysmenhorrhea–including the MC (8)

A
  1. endometriosis—MC
  2. PID
  3. adhesions
  4. Uterine fibroids
  5. polyps
  6. tumors
    7 cysts
  7. IUDs
101
Q

secondary dysmenorrhea has no correlation to?

A

period

wherehas primary always correlates to period

102
Q

tx for primary and secondary dysmenorrhea

A
  1. NSAIDS—– reduce COX enzyme activity–>reducing prostaglandins
  2. hormonal contraception—stops ovulation and creates atrophic endometrium—-decring prostaglandin synthesis and myometrial contractility
103
Q

what hormone is responsible for

  1. ovulation
  2. menses
A
  1. LH

2. FSH

Pathophysiology (13 decks)

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