Ovulatory Disorders Flashcards

1
Q

How long is the normal menstrual cycle?

A

28-35 days

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2
Q

If someone has oligomenorrhoea, how long do menstrual cycles last?

A

Greater than 35 days

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3
Q

What is the difference between primary and secondary amenorrhoea?

A

Primary: never had a period before 16yrs old
Secondary: not had a period for 6mths in a person who has had a period before

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4
Q

What is another name for an ovulatory disorder caused by hypothalamic pituitary failure?

A

Hypogonadotrophic hypogonadism

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5
Q

Which syndrome is associated with hypogonadotrophic hypogonadism?

A

Kallman’s syndrome

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6
Q

Outline management of hypogonadotrophic hypogonadism

A
Pulsatile GnRH
Gonadotrophin injections
Stabilise weight (BMI over 18.5)
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7
Q

What is the most common ovulatory disease caused by hypothalamic pituitary dysfunction?

A

Polycystic ovarian syndrome

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8
Q

What is the criteria for diagnosing polycystic ovarian syndrome?

A

Oligo/amen -orrhoea
Polycystic ovaries on USS (12+ 2-9mm follicles)
Hyperandrogenism

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9
Q

Insulin resistance is commonly seen alongside polycystic ovarian syndrome. True/False?

A

True

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10
Q

Outline management of polycystic ovarian syndrome

A

Ovulation induction
Lifestyle modification
Folic acid 400mcg/5mg if BMI over 30
Check if rubella immunity

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11
Q

By what 3 methods can ovulation be induced in polycystic ovarian syndrome?

A

Clomifene citrate/tamoxifen/letrozole
Gonadotrophin injection
Laparoscopic ovarian diathermy

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12
Q

What type of drugs are clomifene citrate and tamoxifen?

A

Anti-oestrogens (thus help stimulate FSH)

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13
Q

Is metformin useful in ovulation induction? If so, why?

A

Yes

Improves insulin resistance, thus reducing androgen production

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14
Q

What are the main risks of ovulation induction?

A

Ovarian hyperstimulation
Multiple pregnancy
Possible ovarian cancer

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15
Q

What is another name for ovarian failure?

A

Hypergonadotrophic hypogonadism

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16
Q

Oestrogen levels are low in ovarian failure. True/False?

A

True

17
Q

List some causes of premature ovarian failure (menopause before age of 40)

A

Turner syndrome
XX gonadal agenesis
Autoimmunity

18
Q

What is involved in a progesterone challenge test?

A

Should menstrual bleed in response to a 5-day course of progesterone to indicate normal oestrogen levels

19
Q

List clinical features of polycystic ovarian syndrome

A

Hirsutism
Acne/oily skin
Central obesity
Amenorrhoea

20
Q

What are the 2 main anti-oestrogen drugs?

A

Clomifene citrate

Tamoxifen

21
Q

What do aromatase inhibitors do? Give an example of one

A

Letrozole

Inhibit ovarian aromatase enzyme to inhibit oestrogen