Paediatric Adolescent Gynae Flashcards
Rudimentary horn management options
menstrual suppression
Laparoscopic resection
Management of rudimentary horn
Pelvic MRI
Renal USS
Baseline renal function tests
Refer to centre that is experience in the management of this condition
Differential Diagnosis Primary amenorrhoea
Hypotrophic hypogonadism - excessive exercise PCOS Hypothyroidism Prolactinoma pregnancy haematocolpos Cushings constituitional delay genetic disorders (turner's, MRKH, CAIS, late onset CAH) androgen secreting tumours premature ovarian failure
CAIS dx
46XY scant pubic hair breast development high testosterone signs of virilisation
CAH dx
46 XX
normal female external genitalia
signs of virilisation
Swyer’s dx/complete gonadal dysgenesis
46XY
no secondary sex characteristics
underdeveloped gonads
Pubertal induction
progy 2 mg nocte, increase every 6 months until w/d bleed
Once w/d bleed then start HRT or COCP longterm
Causes of secondary amenorrhoea
pregnancy hypothalamic dysfunction prolactinoma thyroid cushings androgen secreting tumours medication POF asherman's head injury sheehan's fragile X Turner's mosaicism
Management of Turners
GH - bone health pubertal induction if required ECHO TFTs HbA1c renal assessment hearing/vision psychosocial weight management fertility considerations
Management of central precocious puberty
Refer to paediatric endocrinology GnRH agonists xrays (left hand) for bone age Head MRI Psychosocial support R/V 3/12 for pubertal stuff, yearly for bone USS if think peripheral cause GnRH stimulation test?
Precocious puberty explanation
a condition in which your child’s body is going through puberty too soon. There can be a central or a peripheral cause to this, but often the cause is unknown. This can have effects on her bone health and overall growth height. This condition is treatable however and the aim is to halt the current process and have your child undergo puberty at a normal age
Swyer’s syndrome explanation
a rare disorder characterized by failure of the sex glands to develop. you have the genetic make-up of a boy (XY) but despite this, you have functioning female genitalia with a uterus, vagina, and Fallopian tubes. We will support you whichever gender you most closely associate with.
CAIS explanation
this is a condition in which your body doesn’t recognize and is unable to use androgens. Your genetic makeup is male, but you still go onto to develop female characteristics such as breasts as your body responds to oestrogen.
MRKH explanation
this is an abnormality you were born with in which you do not have a uterus, cervix, or a vagina. Your ovaries are present and function the same as a normal woman by producing eggs and female hormones that keep you healthy
Turner’s syndrome
this is a genetic disorder in which all or part of one of the X chromosomes is absent. This is a highly variable syndrome affecting a woman in different ways
