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Y2 Endocrine > Ovulatory Disorders > Flashcards

Ovulatory Disorders Flashcards

1
Q

how long are most menstrual cycles?

A

28-35 days

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2
Q

when does ovulation typically occur?

A

day 14 of the cycle

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3
Q

what are the two phases of the menstrual cycle?

A

follicular phase

luteal phase

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4
Q

which phase of the menstrual cycle can vary in length?

A

follicular phase

luteal phase is ALWAYS 14 days

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5
Q

what is the first day of the menstrual cycle?

A

the first day of menstruation

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6
Q

what is oligomenorrhoea?

A

cycles lasting longer than 42 days

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7
Q

what is amenorrhoea?

A

the complete absence of menstruation

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8
Q

what is primary amenorrhoea?

A

periods never started

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9
Q

what is secondary amenorrhoea?

A

periods started but have stopped

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10
Q

what hormone in the HPO axis does the hypothalamus secrete?

A

GnRH

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11
Q

what does GnRH secretion cause?

A

LH/FSH secretion from the anterior pituitary

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12
Q

what does LH/FSH secretion cause?

A

secretion of progesterone and oestrogen

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13
Q

what do low frequency pulses of GnRH stimulate?

A

FSH release

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14
Q

what do high frequency pulses of GnRH stimulate?

A

LH release

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15
Q

what does FSH do?

A

stimulates follicular development

thickens the endometrium

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16
Q

what do peak levels of LH do?

A

stimulate ovulation

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17
Q

what does LH do?

A

stimulates development of the corpus lute

thickens the endometrium

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18
Q

what is basal body temperature?

A

the bodies temperature in the morning before moving or eating

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19
Q

what can cause the basal body temperature to increase?

A

ovulation

20
Q

what does the LH surge trigger?

A

ovulation

21
Q

when does oestrogen peak?

A

before ovulation

22
Q

when does progesterone peak?

A

following ovulation

23
Q

what produces progesterone?

A

the corpus luteum

24
Q

how is ovulation confirmed?

A

measuring a midluteal serum progesterone - >30 suggests normal

25
Q

when should a midluteal serum progesterone be measured?

A

around day 21

26
Q

what are the three groups of ovulatory disorders?

A

group I
group II
group III

27
Q

what causes group I ovulatory disorders?

A

hypothalamic or pituitary failure

28
Q

what are the clinical features of group I ovulatory disorders?

A

amenorrhoea
low levels of FSH/LH
oestrogen deficiency

29
Q

how is an oestrogen deficiency identified?

A

negative progesterone challenge test

30
Q

what is another name for group I ovulatory disorders?

A

hypogonadotrophic hypogonadism

31
Q

what should be done before initiating treatment for group I ovulatory disorders?

A

stabilise weight
folic acid 400mcg
lifestyle modifications

32
Q

what do management strategies for group I ovulatory disorders require to see if they are working?

A

ultrasound monitoring - known as follicle tracking

33
Q

what are the two possible management strategies for group I ovulatory disorders?

A

pulsatile GnRH

gonadotrophin daily injections

34
Q

how does pulsatile GnRH therapy work?

A

pump worn continuously and a pulse is administered every 90 mins

35
Q

what is there a risk of with gonadotrophin daily injections?

A

multiple pregnancies

36
Q

what is the normal response in a progesterone challenge test?

A

withdrawal bleed in 7-10 days of stopping taking progesterone

suggests normal oestrogen

37
Q

what causes group II ovulatory disorders?

A

hypothalamic pituitary dysfunction

38
Q

what are the clinical features of group II ovulatory disorders?

A

oligomenorrhoea or amenorrhoea
normal gonadotrophin
normal oestrogen

39
Q

what is the main cause of group II ovulatory disorders?

A

PCOS

40
Q

what is the first line management of group II ovulatory disorders?

A

clomiphene citrate

41
Q

what is the diagnostic criteria for PCOS called?

A

Rotterdam diagnostic criteria

42
Q

when is PCOS diagnosed?

A

if patients meet 2/3 criteria

43
Q

what are the criteria on the Rotterdam diagnostic criteria for PCOS?

A

oligomenorrhoea/amenorrhoea
polycystic ovaries on USS
hyperandrogenism

44
Q

what do many patients with PCOS also suffer from?

A

insulin resistance

45
Q

what is another name for group III ovulatory disorders?

A

ovarian failure

46
Q

what are the clinical features of ovarian failure?

A

amenorrhoea
menopause
high gonadotrophin
low oestrogen

47
Q

how is ovarian failure managed?

A

HRT

assisted conception

Y2 Endocrine (33 decks)

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