random u-wise 2 Flashcards
what is the clomiphene challenge test? when is it used?
5-9 days of clomiphene citrate + checking FSH on day 3 / day 10
eval ovarian reserve
what is the E / FSH levels in exercise-induced hypothalamic amenorrhea?
low FSH, low E
what is TRH’s effect on prolactin?
TRH stimulates prolactin, so super hypothyroid –> elevated prolactin
how might post-menopausal women continue to have estrogen?
peripheral fat cell’s aromatization of circulating androgens
what happens to lipid profile in postmenopausal females with hormone replacement?
dec. LDL, incr. HDL
why do women stop taking hormone therapy?
vaginal bleeding / spotting, most common in first 6 mo
In order to remain in zero calcium balance, postmenopausal women require a total of how much calcium per day?
1200 mg of elemental Ca2+
when should bone mineral density scans (BMD) be done & how often should they be repeated?
when beginning SERMs / every 2 yrs thereafter
women > 65 yo
When does premature ovarian failure occur?
< 35 yo
How do leiomyosarcomas appear on histology?
> 10 mitotic figures / HPF
How do fibroids appear on histology?
well-circumscribed, non-encapsulated myometrium
when might you do endometrial biopsy with irregular bleeding?
> 40 - r/o endometrial carcinoma
what are management options for adenomyosis?
endometrial ablation, insertion of levonorgestrel-containing IUD, progesterone IUD, hysterectomy
GnRH 1st choice for medical therapy, but often recurs after d/c meds
what is histo findings of endometriosis?
blue-black powder burn lesions macroscopically
endometrial glands/stroma with hemosiderin-laden macrophages
what is medical management of endometrial polyps?
progestin
at what size is observation not recommened for endometrial polyps?
if > 1.5 cm
what is most common clotting disorder? how does it present
vWF most common
heavy bleeding in young women
what does estrogen do to the endometrium?
rapid endometrial growth
conversion of proliferative to secretory endometrium
regeneration of the functional layer
what process does progestin mimic?
involution of the corpus luteum –> sloughing of the endometrium
progestins mechanism of action?
converts proliferative to secretory endometrium
Danazol sfx
worsen hirsuitism / acne
treatment for hirsuitism?
spironolactone
2nd line - Lupron/Depo-provera
Hyperthecosis + treatment prognosis?
more severe form of PCOS
more difficult to treat w/ OCPs
more difficult to achieve successful ovulation induction
estrogen + hair changes?
- synchrony of hair growth - grow + shed in the same phase - significant post-
partum hair loss
premenstrual syndrome correlated w/ a def. in vita
A, E, B6
Risk factors for PMS:
FHx, vita B6, calcium, mg deficiency.
PMDD risk factors
Previous anxiety, depression, mental health problem
Compound presentation:
extremity prolapses alongside the fetal presenting part
Differential for vulvar whitening:
vulvar intraepithelial neoplasia + vulvar cancer
Donovanosis def + treatment
painless, ulcerated lesions with beefy-red granulation tissue + clean, sharp edges
Treatment: TMP-SFX / Doxycycline
how does clomiphene work?
estrogen-receptor antagonist in the hypothalamus –> induces lots of FSH –> stimulates follicular dev’t –> ovulation
