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Endocrine > Ovulatory Disorders > Flashcards

Ovulatory Disorders Flashcards

1
Q

what is oligmenorrhea?

A

cycles > 35 days

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2
Q

what is amenorrhea

A

no menstruation

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3
Q

what does GnRH do?

A

stimulate FSH and LH synthesis and release

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4
Q

what does FSH do?

A

follicular development

thickens endometrium

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5
Q

what does LH do?

A

stimulate ovulation
stimulate corpus luteum development
thickens endometrium

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6
Q

when does estradiol peak?

A

before ovulation

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7
Q

when does progesterone peak?

A

after ovulation

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8
Q

what does oestrogen do?

A

thickens endometrium

makes fertile cervical mucus

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9
Q

what does progesterone do?

A

makes infertile thick mucus
maintains endometrium thickness
increases basal body temp
relaxes smooth muscles

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10
Q

how can you confirm regular cycles?

A

midluteal serum progesterone (should be >30nmol/L) take 2 samples

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11
Q

group 1 WHO classification ovulatory disorders

A

hypothalamic pituitary failure

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12
Q

what type of ovulatory disorder is hypogonadotrophic hypogonadism

A

hypothalamic pituitary failure (group 1)

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13
Q

is there oestrogen deficiancy in hypogonadotrophic hypogonadism and low FSH and LH?

A

yes

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14
Q

what can cause hypogonadotrophic hypogonadism?

A 
stress
too much exercise
anorexia
brain/pituitary tumours
head trauma
kallmans syndrome
drugs-steroid, opitaes
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15
Q

how can you manage hypogonadotrophic hypogonadism?

A

stabalise weight

gonadotrophin (FSH and LH) daily injections -needs Ultrasound monitoring

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16
Q

group 2 WHO classification ovulatory disorders

A

Hypothalamic pituitary dysfunction

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17
Q

what type of disorders account for most (85%) of ovulatory disorders?

A

Hypothalamic pituitary dysfunction

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18
Q

what is the main/ most common Hypothalamic pituitary dysfunction?

A

PCOS

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19
Q

is insulin resistance seen in PCOS?

A

YES- in 50-80% of cases

20
Q

what is the first line treatment for ovulation induction in PCOS?

A

clomifene citrate

this can also be taken with metformin to improve insulin resistance

21
Q

second treatment of ovulation induction in PCOS?

A

gonadotrophin injections (daily)

22
Q

last resort treatment for ovulation induction in PCOS?

A

laparoscopic ovarian diatherny

23
Q

risk of ovulation induction

A

multiple pregancy
ovarian hyperstimulation
ovary destruction

24
Q

risk of multiple pregnancy

A 
increase maternal complications
increase miscarriage
increase low birth weight
increase prmaturity
increase disability 
increase still birth

twin twin transfusion syndrome

25
Q

lambda sign on USS

A

dichorionic

26
Q

T sign on USS

A

monochorionic

27
Q

what causes twin twin transfusion syndrome?

A

unbalanced vascular communications within placental bed- recipient gets more stuff so gets bigger, grows better and the donor has growth restriction

28
Q

long term disabilities due to prematurity?

A

cerebral palsy
impaired eye sight
congenital heart disease

struggle with language development

29
Q

medical treatment for hyperprolactinaemia?

A

dopamine agonist

30
Q

group 2 WHO classification ovulatory disorders

A

ovarian failure

31
Q

menopause before 40

A

premature ovarian failure

32
Q

how do you treat premature ovarian failure?

A

hormone replacement

33
Q

in the progesterone challenge test, if you bleed within 5 day course of progesterone what does this mean|?

A

oestrogen levels are normal

34
Q

what is primary amenorrhea?

A

failure of menarche by age 16

35
Q

what is secondary amenorrhea?

A

cessation of periods >6 months in an individual who previously menstruated

36
Q

what can cause functional hypothalamic amenorrhea?

A 
iatrogenic
weight change
stress
exercise
anabolic steroid
systemic illness
infiltrative disorders e.g sarcoidosis
head trauma
recreational drugs
37
Q

what hormones should be checked in someone with oligo/amenorrhea?

A 
LH
FSH
Oestradial
thyroid function tests
prolactin
testosterrone if hairy/acne
38
Q

difference between primary and secondary hypogondism?

A

primary- problem with ovaries, high FSH/LH e.g premature ovarian failure

secondary-problem with hypo/pit. low FSH/LH e.g high prolactin/hypopituitarism

39
Q

what happens in kallmans syndrome?

A

loss of GnRH secretion and ansmia or hyposmia

40
Q

common causes of hyperprolactinemia?

A

prolactinomas
drugs
hypothyroidism
idiopathic

41
Q

what is hirsutism?

A

excess hair, females usually get it

42
Q

short stature
webbed neck
shield chest, wide spaced nipples
XO chromosome

A

turners syndrome

43
Q

difference between primary and secondary male hypogonadism?

A

primary- low testosterone with high LH and FSH

secondary- low testosterone and low LH and FSH
usually pituitary/hypo disease

44
Q

what is the most common cause of male hypogonadism?

A

Klinefelters syndrome

45
Q

reduced testicular volume
gynaecomastia
eunuchoidism

low testosterone, high LH and FSH

A

Klinefleters syndrome

46
Q

health benefits of testosterone therapy?

A 
improved sex function
improved bone health
decrease fat mass
increase muscle strength
small improvement in insulin sensitivity
47
Q

causes of gynaecomastia?

A 
drugs
physiological
hypogonadism
tumours
endocrine disorders
systemic illness
hereditary

Endocrine (29 decks)

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