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Zak, Endo/Repro 2 > Puberty, Development, and Menstrual Disorders > Flashcards

Puberty, Development, and Menstrual Disorders Flashcards

1
Q

What occurs to the endometrium during the menstrual phase

A

Sloughing of the functionalis and compression of the basalis layers

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2
Q

What occurs to the endometrium during the proliferative/estrogenic phase

A

Increased length of spiral arteries and numerous mitoses

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3
Q

What occurs to the endometrium during the secretory/progestational phase

A

Glands become tortuous and lumens dilate
Mitoses are rare
Spiral arteries convolute

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4
Q

What is the normal menstrual flow

A

30cc

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5
Q

What is considered a high enough flow to be concerned about anemia

A

80cc

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6
Q

What are the stages of normal pubertal development

A 
TAG Me
Thelarche
Adrenarche/Pubarche
Maximal growth
Menarche
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7
Q

What are the Tanner stages for breast development

A 
1 = pap elevation
2 = pap + breast elevation
3 = enlargement of breast + areola
4 = projection of areola + pap
5 = recession of areola, projection of pap only
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8
Q

What are the Tanner stages of pubic hair development

A 
1 = no hair
2 = sparse hair on labia
3 = hair over junction of pubes
4 = no spread to medial thigh
5 = spread to medial thigh
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9
Q

What are the subgroups of precocious puberty and how are they different

A 
Heterosexual = 2˚ sex oppo expected
Isosexual = 2˚ sex same as expected
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10
Q

What is Pseudoisosexual Precocity

A

Increased E levels cause 2˚ sex w/out activation of HPO axis

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11
Q

What syndromes are associated with Pseudoisosexual Precocity

A

McCune-Albright

Peutz-Jegher

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12
Q

Sx’s = cystic bone defects, cafe au lait spots, adrenal hypercortisolism d/t somatic mutation

A

McCune-Albright syndrome

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13
Q

Sx’s = GI polyposis, mucocutaneous pigmentation d/t E secreting sex cord tumor

A

Peutz-Jegher syndrome

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14
Q

What are the 4 definitions of delayed puberty

A 
1 = no 2˚ sex by 13 yo
2 = no thelarche by 14 yo
3 = no menarche by 15 yo
4 = no menses by 5 years after thelarche
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15
Q

If a pt has Turner syndrome, which type of delayed puberty do they have and what are their relative FSH/LH levels

A

Hypergonadotropic Hypogonadism

High FSH/LH

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16
Q

If a pt has Kallman syndrome, which type of delayed puberty do they have and what are their relative FSH/LH levels

A

Hypogonadotropic Hypogonadism

Low FSH/LH

17
Q

What is the definition of primary amenorrhea

A

No menses or 2˚ sex by 13 yo
OR
No menses by 15 yo with 2˚ sex

18
Q

Sx’s = external female genitalia, male T levels, sparse pubic hair, testes in ab wall, no uterus, small areolas/nipples

A

Androgen Insensitivity Syndrome (AIS)

19
Q

What is the karyotype for AIS

A

46XY

20
Q

Sx’s = obstruction of vaginal canal, female T levels, normal breast development

A

Mullerian dysgenesis/agenesis

21
Q

What is the karyotype for Mullerian dysgenesis/agenesis

A

46XX

22
Q

What is Meyer-Rokitansky-Kuster-Hauser syndrome

A

Failure of distal mullerian ducts to fuse and form upper genital tract (no uterus, vaginal dimple)

23
Q

Sx’s = monthly dysmenorrhea with no vaginal bleeding, midline cystic mass, vaginal bulge

A

Imperforate hymen

24
Q

Sx’s = monthly dysmenorrhea with no vaginal bleeding, midline cystic mass

A

Transverse vaginal septum

25
Q

What is the definition of 2˚ amenorrhea

A

Pt with prior menses has no menses for ≥ 6 months

26
Q

What are the common dysfunction associated with 2˚ amenorrhea

A

Hypothyroidism
Abnormal PRL
Microadenoma

27
Q

What is the Tx for a Microadenoma

A

Bromocriptine

28
Q

If a pt has 2˚ amenorrhea and normal TSH/PRL, what is the next step

A

Progesterone Challenge Test (bleeding = +)

29
Q

If a pt with 2˚ amenorrhea has a + PCT, what gonadal dysfunction do they have and what is the most common cause of this dysfunction

A

Normogonadotropic Hypogonadism

PCOS

30
Q

If a pt with 2˚ amenorrhea has a - PCT, what are the possible abnormalities and what is the next step

A

Inadequate estrogenization
Outflow tract abnormality
E/P Challenge test

31
Q

If a pt with 2˚ amenorrhea and a - PCT has a - E/P challenge test, what is the issue

A

Outflow tract obstruction

32
Q

If a pt with 2˚ amenorrhea and a - PCT has a + E/P challenge test, what is the issue

A

Abnormality in HPO axis or ovaries

33
Q

What does PALM-COEIN classify and stand for

A 
DUB
Polyp
Adenomyosis
Leiomyoma
Malignancy
Coagulopathy
Ovulatory dysfunction
Endometrial (infection)
Iatrogenic
Not specified
34
Q

What is the maximal thickness a postmenopausal endometrial lining should be

A

4mm

35
Q

What is the Tx for massive DUB

A

Hospitalization and transfusions

36
Q

What is the Tx for moderate DUB

A

OCP’S or Mirena

Zak, Endo/Repro 2 (33 decks)

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