Brainscape's Knowledge GenomeTM

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


See full index

Endocrine > Ovulation Disorders > Flashcards

Ovulation Disorders Flashcards

1
Q

what is the normal range of menstrual cycle?

A

28-35 days

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

what is counted as day 1 of the menstrual cycle?

A

first day of bleeding

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

how long does bleeding usually last and how is this expressed>

A

3-8 days

annotated as 7/28 or 5-6/35 etc

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

what does FSH do?

A 
females
- stimulates follicular development
- thickens endometrium
males
- stimulates Sertoli cells
- spermatogenesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what does LH do?

A 
secretd by anterior pituitary
stimulates development of corpus luteum
LH surge triggers ovulation
thickens endometrium
males
- stimulates Leydig cells
- testosterone secretion
-spermatogenesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how do ovulation predictor kits work?

A

detects LH surge (36 hrs before ovulation)

not always reliable in everyone

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

when do estradiol and progesterone peak?

A 
estradiol = peaks before ovulation
progesterone = peaks following ovulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

where is estrogen secreted from?

A

primarily secreted by ovaries (follicles) and adrenal cortex (and placenta in pregnancy)

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

what does oestrogen do?

A

stimulates thickening of the endometrium
responsible for fertile cervical mucous
+ve feedback stimulates gonadotrophin secretion in follicular phase
inhibits secretion of FSH and prolactin in luteal phase via -ve feedback

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

where is progesterone secreted from and what does it do?

A 
secreted from corpus luteum
maintains early pregnancy
inhibits LH secretion
responsible for thick infertile cervical mucous
maintains thickness of endometrium
has thermogenic effect
relaxes smooth muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how can ovulation be assessed in a regular, 28 day cycle?

A

confirm by midluteal (day 21) serum progesterone

ovulation = when >30nmol/L

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

how is ovulation confirmed in irregular cycle?

A

probably anovulatory

needs further hormone testing

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

what are the features of ovulatory disorders?

A

oligomenorrhoea (cycle >35 days)

amenorrhoea (absent menstruation)

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

what are the 3 groups of ovulatory disorders?

A 
1 = hypothalamic pituitary failure
2 = hypothalamic pituitary dysfunction
3 = ovarian failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the features of hypothalamic pituitary failure?

A 
hypogonadotrophic hypogonadism
low FSH/LH
oestrogen deficiency (-ve progesterone challenge test)
normal prolactin
amenorrhoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what can cause hypothalamic pituitary failure?

A 
stress
excessive exercise
anorexia/low BMI
brain/pituitary tumours
head trauma
Kallman's syndrome
drugs (steroids, opiates)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how is group 1 anovulation (hypothalamic pituitary failure) managed?

A

stabilise weight
hormone therapy
- needs US monitoring of response (follicle tracking)

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

what hormone therapy is used in hypothalamic pituitary failure?

A 
pulsatile GnRH
- 90% ovulation rate
- multiple pregnancy rates not really increased
gonadotrophin (FSH and LH) injections
- higher multiple pregnancy rates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the features of hypothalamic pituitary dysfunction?

A 
normal gonadotrophins/excess LH
normal oestrogen levels (progesterone challenge test)
oligo/amenorrhoea
PCOS
- 10-20% have amenorrhoea
- 80-90% have oligomenorrhoea
20
Q

how is PCOS diagnosed?

A

2 out of 3 of

  • oligo/amenorrhoea
  • polycystic ovaries (US appearance)
  • clinical and/or biochemical signs of hyperandrogenism (acne, hirsutism) - free androgen index (testosterone, sex hormone binding globulin)
21
Q

how is PCOS managed?

A 
depends on symptoms
subfertility = ovulation induction
oligo/amenorrhoea = risk of endometrial hyperplasia
hirsuitism
manage obesity
manage acne/alopecia
22
Q

how can PCOS affect glucose metabolism?

A

can cause insulin resistance in 50-80%
normal pancreas so results in hyperinsulinaemia
- insulin acts as co-gonadotrophin to LH leading to elevated LH and altered LH/FSH ratios
- insulin lowers SHBG levels causing increased testosterone and therefore hyperandrogenism

23
Q

pre-treatment for PCOS?

A 
weight loss to optimise results
stop smoking/drinking
folic acid 400mcg/5mg daily
check prescribed drugs
rubella immune
normal semen analysis
patent fallopian tube
24
Q

how can ovulation be induced in PCOS?

A 
clomifene citrate (clomid)
gonadotrophin therapy (daily injections)
laparoscopic ovarian diatherapy
25
Q

what is clomid?

A

estogenic/anti-estrogenic properties

26
Q

what do gonadotrophin injections do?

A

directly stimulate ovaries

27
Q

what is first line for ovulation induction?

A

clomid

28
Q

what can be used if clomid doesn’t cause ovulation?

A

metformin
gonadrtrophin injections
laproscopic ovarian drill
IVF

29
Q

how can metformin affect ovulation?

A

improves insulin resistance causing reduction in androgen production and increase in SHBG
restores menstruation and ovulation
can improve sensitivity to colifene

30
Q

what are the risks of ovulation induction/IVF?

A

ovarian hyperstimulation
multiple pregnancy
small risk of ovarian cancer

31
Q

what causes an increases risk of ovarian hyperstimulation?

A

<35 years old

PCOS

32
Q

why is multiple pregnancy a problem?

A

increased risk of complications

  • hyperemesis
  • anaemia
  • hypertension/pre-eclampsia
  • gestational diabetes
  • postnatal depression/stress
  • mode of delivery/PPH
33
Q

what are the risks to the foetuses in multiple pregnancy?

A 
early and late miscarriage
low birth weight
prematurity
disability
stillbirth/neonatal death
twin-twin transfusion syndrome (MCDA twins only)
34
Q

what is twin-twin transfusion syndrome?

A

where both twins share a placenta in the womb

abnormal blood vessels form meaning blood can travel between both foetuses

35
Q

monochorionic twins?

A

monozygotic twins which share the same placenta

36
Q

what are the main/most common problems in twins?

A

prematurity

low birth weight

37
Q

what are the early problems with prematurity?

A

need for neonatal intensive care and respiratory support

some suffer from respiratory distress syndrome

38
Q

what are the long term complications of prematurity?

A

at least one twin affected with disability in some births (cerebral palsy, vision, congenital heart disease etc)

39
Q

how can ovulation induction/IVF cause ovarian cancer?

A

small risk if used for over 12 months

40
Q

what are the features of prolactinaemia?

A 
amen/galactorrhoea
normal FSH/LH
low oestrogen
raised serum prolactin (>1000)
TFT normal
micro/macro prolactinoma on MRI
41
Q

what are the features of ovarian failure?

A

high gonadrtrophins (FSH>30)
low oestrogen
amenorrhoea
menopause <40 yrs

42
Q

what can cause premature ovarian failure?

A 
genetic (turners, fragile X)
autoimmune ovarian failure
bilateral oophorectomy
pelvic radiotherapy/chemotherapy
family history of early menopause
43
Q

how is premature ovarian failure managed?

A

hormone replacement therapy
egg/embryo donation
cryopreservation of ovary/egg/embryo prior to chemo/radiotherapy

44
Q

what biochemistry tests may be done in a couple attending infertility clinic?

A

mid luteal progesterone
progesterone challenge test
serum FSH, LH, estradiol, prolactin, TSH, serum testosterone (in males) during early follicular phase (day 2-5)

45
Q

how is an ultrasound used in fertility clinic?

A

routine part of infertility consultation
transvaginal
examines pelvic anatomy (uterus, ovaries)
looks for follicular growth/monitors ovulation induction

46
Q

how is hyperprolactinaemia managed?

A

dopamine agonist

  • cabergoline
  • should be stopped when pregnancy occurs
47
Q

what can cause testicular failure/non-obstructive azoospermia?

A 
genetic (klinefelters, Y chromosome deletion)
orchidectomy/undescended testes
testicular trauma/torsion/mumps orchitis
testicular cancer
pelvic radiotherapy,chemotherapy
autoimmune disease

Endocrine (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions