OG Flashcards
Which Phase causes follicle /egg maturation
Follicular (phase 1) - FSH
Which hormone cause sudden LH surge and what would happens
Estrogen causes sudden LH surge and ovulation happens
After ovulation = rupturing of follicle, what is phase now. And what is the ruptured follicle transformed and its function
Secretory phase
Corpus luteum, it would secret progesterone for maintaining endometrial lining and secretion
Estrogen is produced by ____
Provides (positive/negative) feedback on ___.
granulosa cells of follicle
Positive feedback on LH –> LH surge to cause ovulation
Inhibins is produced by ___.
Provides (positive/negative) feedback on ____.
Inhibin B levels rise during ___, highest during ___. Increase again during ___.
Inhibin A levels decrease during ___.
granulosa cells of follicle
Negative feedback for FSH
* luteal-follicular transition
* highest during mid follicular phase
* LH peak
late luteal phase
Ovulatory dysfunctional uterine bleeding caused by ___.
ovulation with prolonged progesterone secretion d/t low estrogen –> blood loss from endometrial vessel dilation and prostaglandins –> metrorrhagia
Tx of acute severe uterine bleed
High dose IV estrogens
D&C if IV estrogen fails
Tx of anovulatory dysfunctional uterine bleeding
OCPs
Medroxyprogesterone acetate
Leuprolide
Tx of ovulatory dysfunctional uterine bleeding
OCPs
Medroxyprogesterone acetate
Leuprolide
NSAIDs*
MC/most important diagnostic for DUB
Endometrial bx
Primary amenorrhea = failure of onset of menarche by ___.
15 y/o
High FSH in setting of primary amenorrhea suggests problem with ___
ovaries. FSH screaming at unresponsive ovaries
Low FSH in setting of primary amenorrhea suggests problem with ___
H-P axis problem. Ovaries don’t know what to do without FSH.
Breasts that are present, with absent uterus, 46, XX suggests ____
Mullerian agenesis = congenital absence of vagina, uterine agenesis
Breasts that are present, with absent uterus, 46, XY suggests ____
Androgen insensitivity = female phenotype d/t testosterone resistance
what is Kallmann’s Syndrome ?
Hallmark symptom:
Hypogonadotropic hypogonadism –> pituitary secretion of FSH and LH VERY low
Anosmia (lack of smell)
short stature, webbed neck, edema, low hairline, low ears, widely set nipples , Dx
Tx
Turner Syndrome (45, XO)
Tx: estrogen
Most common form of secondary amenorrhea
Induces a hypothalamic state in which reduced secretion of 1__–> low __2 –> no stimulation of _3___ –> __4__ is not produced by follicles
Stress related
1 GnRH
2 LH and FSH
3 ovulation
4 estrogen
Progesterone challenge test used for ____
Result interpretation:
determining ovarian disorders in secondary amenorrhea
If withdrawal bleeding = ovarian cause –> anovulatory. Estrogen present to build up the endometrial lining.
If no bleeding = Hypoestrogenic (Hypothalamus-Pituitary failure OR uterine disorder)
Hypothalamus dysfunction causing amenorrhea occurs when ____
Causes:
Tx:
disruption of pulsatile GnRH –> low FSH and/or LH from pituitary
Causes: Anorexia, weight loss, exercise**
Stress, nutritional deficiency, systemic disease
Tx:
Clomiphene = estrogen agonist/antagonist actions to stimulate gonadotropin release and ovulation
Menotropin = gonadotropin secretion
Ovarian disorders causing amenorrhea will show (high/low) FSH, (high/low) LH, (high/low) (Estradiol/Prolactin).
High FSH and LH
Low Estradiol
Pituitary disorders causing amenorrhea will show (high/low) FSH, (high/low) LH, (high/low) (Estradiol/Prolactin).
Tx:
Low FSH and LH
High Prolactin
Tx:
OCP
Bromocriptine (Dopamine agonists to inhibit prolactin)
Asherman’s Syndrome =
Dx:
Tx:
Acquired endometrial scarring (overaggressive D and C)
“A”dhesions + “A”menorrhea
Pelvic US showing absence of normal uterine stripe
Tx: Estrogen
Primary dysmenorrhea is caused by ___
High prostaglandins = painful uterine muscular wall
