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ObGyn > Puberty and Menopause > Flashcards

Puberty and Menopause Flashcards

1
Q

State 2 physiological events in puberty and what influences it

A

Gonadarche- HPO axis
Adrenarche- Adrenal glands

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2
Q

Describe what happens during gonadarche x4

A

Release of GnRH by hypothalamus> ant pituitary gland> FSH and LH release > gametogenesis and steroidogenesis in gonads

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3
Q

State the function of estradiol in puberty x2

A

Breast development
Skeletal growth

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4
Q

Which hormone causes cessation of linear growth and how

A

Estradiol by fusion of growth plates

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5
Q

Which part of the adrenal glands produces DHEA

A

Zona reticularis

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6
Q

Purpose of adrenarche x2

A

Induce pubic and axillary hair growth
Apocrine sweat gland maturation

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7
Q

What is the sequence of pubertal maturation x5

A

Growth spurt
Thelarche
Pubarche
Peak growth velocity
Menarche

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8
Q

Hormones that influence growth spurt x4

A

Estradiol
Progesterone
Growth hormone
Insulin like growth factor

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9
Q

What is thelarche and what hormone causes it

A

Appearance of breast tissues
Due to estradiol

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10
Q

Hormones responsible for pubarche x2

A

DHEA- dehydroepindrosterone
Androsterone

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11
Q

Two parts of the secondary mound of the breast

A

Areola and papilla

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12
Q

Why is menarche an anovulatory cycle

A

There is HPO immaturity, the small amounts of FSH and LH produced are not sufficient for follicle development but can influence endometrial cycle

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13
Q

Factors influencing puberty x3

A

Genetics
Social environment
General health and nutrition

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14
Q

What is classified as delayed or interrupted pregnancy x3

A
  1. Failure to develop secondary sex characteristics by age 13
  2. No menarche by age of 15
  3. Not attained menarche 5+ years since onset of puberty
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15
Q

Causes of delayed or interrupted puberty x3

A

Anatomical abnormalities
Hypergonadotropic hypogonadism
Hypogonadotropic hypogonadism

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16
Q

What causes the high levels of FSH in hypergonadotropic hypogonadism

A

Lack of suppression of ant pituitary gland by negative feedback from ovaries

17
Q

What is asynchronous puberty and its cause

A

Puberty that deviates from the normal pattern of puberty
Androgen insensitivity syndrome

18
Q

What is androgen insensitivity syndrome

A

X linked recessive disease with absence of androgen receptors > failure of normal masculinization

19
Q

Classification of precocious puberty x3

A

Central
Peripheral
Benign or non progressive pubertal variants

20
Q

What is benign pubertal variants and what causes it

A

Isolated thelarche or pubarche
Caused by early activation of hypothalamic pituitary adrenal axis

21
Q

Causes of precocious puberty x5

A

Ovarian cyst
Ovarian tumor
CNS lesions
Genetics
Exogenous sex androgens

22
Q

Management of precocious puberty

A

GnRH agonists eg leuprolide, triptorelin

23
Q

Define climacteric period

A

When a woman passes from reproductive to non reproductive stage.
From peri,meno, to post lasting 5 to 10 years

24
Q

What causes high FSH/LH in menopause x4

A

Depletion of oocytes > decreased estrogen and inhibin b > decreased negative feedback on pituitary > increase in FHS

25
Q

Diagnostic criteria of menopause x4

A

Cessation of menses for 12 months
Appearance of menopausal symptoms
Low serum estradiol
High serum FSH & LH

26
Q

Management of menopause x3

A

Non hormonal- lifestyle modification
Tibolone- reduces bone resorption
Selective estrogen receptors modulators - treats osteoporosis

27
Q

Contraindications of hormonal therapy in menopause x5

A

CHD
Active liver disease
Previous thromboembolic event
Active endometrial cancer
Hx of breast cancer

28
Q

3 types of estrogen and when they are produced

A

E1 estron- produced by aromatisation i peripheral fat
E2 estradiol- produced in ovary
E3 estriol produced during pregnancy

29
Q

MOA of tibolone in post menopausal women x3

A

Reduces osteoclastic activity and prevents bone resorption
Also reduces vasomotor symptoms eg hot flushes

30
Q

Contraindications for hormonal therapy in post menopausal women x5

A

Hx of
CHD
Breast cancer
Endometrial Ca
Thromboembolic event
Acute liver disease

ObGyn (34 decks)

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