ppt Flashcards
PCOS A disorder characterized by? 3
also associated with what?
Hyperandrogenism - Hirsutism stiff and dark body hair
Ovulatory Dysfunction - Anovulation
Polycystic Ovarian Morphologic Features
- 50% of patients have associated insulin resistance and hyperinsulinemia
PCOS dx?
PCOS is a diagnosis of exclusion
Virilization
associated with what?
is a condition in which women develop male-pattern hair growth and other masculine physical traits. Women with virilization often have an imbalance in sex hormones, such as estrogen and male sex hormones, or androgens, like testosterone. An overproduction of androgens can cause virilization
- associated with Ovarian or Adrenal Tumor
diagnostic for endometriosis
tx? first line
cure?
Gold Standard: direct visualization at laparoscopy and histological study
“viewed as a chronic disease that requires a lifelong management plan with the goal of maximizing the use of medical treatment and avoiding repeated surgical procedures” - Chronic Progressive and Relapsing
Medical therapy is non specific and focused on relieving pain - First Line
Oral contraceptives that combine estrogen and progesterone
No cure
Laparoscopy not required to initiate TX
most common cause of secondary dysmenorrhea.?
cause of dysmenorrhea
Endometriosis
Dysmenorrhea is primarily caused by the action of uterine prostaglandins, particularly PGF2α - contract, vasoconstric
Amenorrhea define
primary
is an absence of menstruation
menarche by the age of 15
in females who have had appropriate growth and
secondary sexual development otherwise.
If breast development (thelarche) has not occurred by
age 13, primary amenorrhea should be considered.
If thelarche has occurred but no menses not initiated
after 2 years, consider primary amenorrhea.
Secondary
In females who have had regular menstrual cycles, a
period of ＞ 3 months of no menstrual cycle.
In females who have had irregular menstrual cycles, a
period of ＞ 6 months of no menstrual cycle.
Normal physiology during perimenopausal period,
pregnancy, and lactation.
most common cause of primary amenorrhea,? 3
what happens?
genetics:
1 Gonadal dysgenesis: is caused by chromosomal abnormalities ○ these disorders result in premature depletion of all ovarian oocytes and follicles.
2 Turner syndrome: Amenorrhea occurs because the oocytes and follicles undergo apoptosis.
3 Müllerian agenesis: congenital absence of vagina with variable uterine development.
Asherman syndrome
Intrauterine adhesions: the only uterine cause of secondary amenorrhea.
○ results from acquired scarring of the endometrial lining
causes of primary amenorrhea
Primary
- Congential causes
- CNS disorders (hypothalamic disorders, HPG
axis dysfunction)
- Pituitary disorders (tumours, congenital or
acquired CNS defects such as hydrocephalus
and lesions)
- Genetic ovarian disorders (e.g. Turner syndrome)
- Defects of outflow tract
- Congenital absence of vagina or uterus
- Uterine hypoplasia
2ndary Eating disorders: Anorexia nervosa - Malnourishment (especially decreased fat intake) - Weight loss >10% - Systemic illness: DM, PCOS, thyroid, celiac - Excessive exercise - Increased levels of stress (emotional and medical) - MI, burns, infection The female athlete triad: - Amenorrhea - Eating disorder - osteopenia/porosis
when dx amenorrhea, r/o preggers then consider other causes? 4
consider the separate areas that conduct the menstrual cycle: hypothalamus, pituitary, ovaries, and uterus.
diff btwn benign vs malignant
Benign masses tend to be solid or cystic,
malignant masses are generally solid.
1 most frequently diagnosed cancer in canada
s/s
Breast Cancer
● Thickening ● Asymmetry ● Fixed to the skin or chest wall ● Peau d’orange ● Nipple retraction ● Nipple discharge (bloody, unilateral, spontaneous)
Fibrocystic Changes
An overgrowth of fibrous breast tissue. Not truly a
pathologic disease but rather a variation of normal that
occurs in 50% of women clinically, and 90% of women
histologically
fat necrosis
A benign mass that occurs after trauma
Generally associated with bruising
Usually appears after injections, blunt trauma, surgery, or
radiation
Difficult to distinguish from malignant mass
