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CLIN MED II CARA > Paulson Menstral disorders > Flashcards

Paulson Menstral disorders Flashcards

1
Q

In the US average age of puberty is between _________

A

8-13

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2
Q

_________ increase in androgens befoe the onset of puberty

A

adrenarch

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3
Q

____________ is breast development and requires (2 hormones)

A

thelarche, estrogen and progesterone

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4
Q

Menarche requires 5 hormones and ______ (anatomy)

A

GnRh, FSH, LH, progesterone, estrogen, normal outflow tract

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5
Q

pubertal development before 8 age in girls and 9 in boys is called

A

precocious puberty

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6
Q

average age to start menstrating is 12-13, _____ years after breast bud development

A

2.5

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7
Q

Normal cycle is ___________

A

28 days +/- 7 days

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8
Q

primary amenorrheas the abscens of spontaneous mentrastion by age________ with no secondary sex characteristic or ________ with prescesn of secondary sex characteristics

A

13, 15

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9
Q

4 main categories of primary amennorhea

A

ovarian dysfunction, pituitary dysfunction, hypothalamic dysfunction, outflow obstruction

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10
Q

example of ovarian dysfunction

A

turners syndrome. congenital development disorder of the repro system (sex chromosome abnormality)

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11
Q

example of hypothalamic dysfunction

A

GnRH pulse is messed up: Kallmanns (idopathic hypogonadotropic hypogonadism) + anosmia
Anoexia, excercise

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12
Q

Pituitary dysfunction examples

A

Sheehans syndrom (infartion of pitutatry d/t hemmorhage)

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13
Q

Outflow tract obstruction due to _________

A

imperforate hymen

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14
Q

How to work up primary amennohea. 1) sex characteristics Y/N

A

yes-outflow problem
No- check fhs/lh karyotype

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15
Q

Secondary amenorrhea defined:

A

cessation of previsouly present and regular menses for 3 months or irrecular menses for 6 months

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16
Q

M/C reasons for secondary amennhorehea (6)

A

pregnancy, PCOS, OCPS/meds, dibetes, hyper/hypothyroidsm, surgery

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17
Q

workup for secondary amenorrhea

A

1)preg test
2)check tsh/prolactin
3) progesterone challenge test
4) check FSH/LH

Imaging: CT or MR of hypothalamus, pit or pelvis

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18
Q

Progesterone challenge test is done by giving progesterone medication to a woman who doesn’t get periods to try to induce a period .
Med/dose and expected result

A

Provera 5mg BID x 5-7 days
+ withdraw bleed within 2-7 days

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19
Q

A + progesterone challenge test means that there is ________ present but is not __________. If no withdrawal bleeding occurs the patient either has very low ____________ or there is a problem with ___________

A

estrogen, ovulating
estrogen, outflow tract (adhesions)

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20
Q

Mullerian agensis is when the _________- doesnt develop properly

A

uterus

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21
Q

PCOS…consider screenign for ________-

A

metabolic syndrome, losely related to insulin resistance

22
Q

Rotterdam criteria is used to dx ___________. Include criteria

A

PCOS. 2/3 hyperandrogenism, ovulatory dysfunction, polycycstic ovaries

23
Q

Rotterdam criteria:

A

2/3: hyperandrogensim, polycycstic ovaries, issues ovulating

24
Q

Polycycsti ovary is defines as and ovary with _______ or more follicles measuring _____-______ mm , or ______+ml

A

12, 2-9mm
10

25
Q

s/sx of PCOS

A

acne, male hair loss patterns, thick/heavy facial and body hair growth, obestiy, irregular menses, skin tags, acanthosis nigracans

26
Q

Tx for PCOS

A

OCA, metformin (used in cases of hyperglycemia), weight loss,

27
Q

screen for _____ (4)in PCOS

A

lipids, BP, sleep apnea, dpression, DM

28
Q

MEds that cause amenohrrea (4anties on oncol)

A

anti: phycs, depressants, histamines, hypertensives,
opiates

29
Q

female athlete triad

A

amenorrhea, low bone density, eating disorder

30
Q

female athlete triad

A

amenorhhea, osteopenia, eating disorder

31
Q

_______________ are the most frequent pituitary tumor and inhibit GnRH resulting in low __________ and _______ levels

A

prolactinoma, estrogen and gonadotropin

32
Q

primary dysmennhohera is caused by excessive __________ secretion in menstrual fluid with a usual onset within 3-6 months of menarch. peaks late teens, early 20s’

A

E2 prostaglandin

33
Q

Secondary dysmen has a _________ cause

A

pathologic

34
Q

in primary dysmennohreah you may have gneneralized pelvic tenderness, N/V/D, typically _________ (when does it happen)

A

first day of menses

35
Q

In secondary dsymenorrhea pain lasts _____________

A

longer than a menstraul period

36
Q

Secondary is usuallly (age)___________ and timeline

A

older (25+) than primary,
starts prior to menses, worsens and persists

37
Q

causes for secondary dysmen

A

endometriosis, adenomyosis, IUD, cervical stenosis, fibroids, PID

38
Q

__________ is a big risk factor for dysmennorhhea

A

heavy menses

39
Q

TX for dysmennohhea

A

NSAIDS (most effective), tyelnol, heat, OCPs, excercise, TENS

40
Q

NSAIDS for dysmenor

A

IBUPROPHEN (very effective in reducing prostaglandins)

41
Q

Most common cause for AUB

A

PALM COIEN
Polyp
Adenomyosis
Leiomas
Malignancy/hyperplasia

Coag issues
Ovulatory issues
Endometrial
Iatrogenic
Not otherwise classed

42
Q

PALM COIEN

A

Polyps
Adenomyosis
Lieomyoma
Malignancy/hyperplasia

Coag
Ovulation probs
Endometrial
Iatrogenic
Not otherwise speci

43
Q

if a patien is 45+ with AUB, what must you do

A

endometrial biopsy

44
Q

if thre is a palpable mass on PE with somewith AUB, what imagining would you perform

A

transvaginal US

45
Q

TX for AUB

A

IUD (levono-mirena), COC’s, continueous POP’s, TXA (safe when trying to get preggers), hysterectomy and endometrial ablation when done having kids

46
Q

Heavy mentral bleeding in adolescent may be 1st sign of bleeding disorder. In the acute phase you can treat with __________, maintanenc therapy includes ________

A

estrogen, injectibale progestin (depo), levo IUDS (mirena)

47
Q

Acute AUB in repro age people Tx

A

IV estrogen, OCPs (monophasic of ethinl estradiol TIDx 7days)
DEPO +COC
TXA
REFER TO GYN

48
Q

Iv estrogen is contraindicated in

A

breast cancer hx, DVT, liver dz

49
Q

PMS sx occur in which phase

A

luteal

50
Q

PMS can be dxed if they repor sx during the ____ days prior to menses and ends within ______ after onset of menses

A

4, 5

51
Q

PMDD diagnosis

A

5/11 listed sx

52
Q

how to treat PMDD

A

SSRIS
Prozac
Zoloft
Lexapro
Celexa

CLIN MED II CARA (7 decks)

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