Pathophysiology Flashcards
Pregnancy»_space; Secondary amenorrhea
hCG production by placenta stimulates corpus luteum to secrete progesterone during first trimester
Hyperprolactinemia»_space; Secondary amenorrhea
Prolactin negatively feeds back on GnRH release
Hypothyroidism»_space; Hyperprolactinemia
TRH normally stimulates prolactin release
TRH is high in hypothyroidism due to negative feedback from low T3/T4
PCOS»_space; Secondary amenorrhea
No dominant follicle selection, low estrogen production, no LH surge, no ovulation
PCOS»_space; Hyperandrogenism
- Increased baseline insulin resistance
- Excess insulin binds to theca cells, stimulating increased androgen production
- Androgens inhibit sex hormone binding globulin production in liver
- Increased serum free testosterone
Hyperinsulinema/Obesity»_space; Secondary amenorrhea
[Theory]
Excess insulin stimulates theca cells to produce excess androgens, converted to estrogen –> together inhibit HPG axis
Why is pregnancy a thromboembolic state?
Fulfills Virchow’s triad:
- hypercoagulability (estrogen increases synthesis of coagulation factors)
- venous stasis (progesterone-mediated vasodilation)
- endothelial damage
Why is pregnancy a diabetogenic state?
Human placental lactogen increases insulin resistance
Why are DVT’s most common in left calf?
Right iliac artery compresses left branch of vena cava
Most concerning consequence of neonatal hyperbilirubinemia?
Kernicterus (irreversible neurological damage)
Cushing’s»_space; short stature?
Increased cortisol stunts growth (evolutionarily, chronic stress - body is not concerned about growing)
Asherman Syndrome»_space; Secondary amenorrhea
Loss of basalis (regenerative layer of endometrium) from scarring, commonly due to overaggressive D&C
