Reproduction

Question 1

hypogonadotropic hypogonadism

Answer 1

ETI

• severe stress
• excessive weight loss
• eating disorders
• chronic illnesses

PATHOPHYS

• decreased GnRH pulses
• decreased LH and FSH
• low estrogen
• lack of ovulation

CLINICAL

• oligomenorrhea/amenorrhea
• infertility
• normal physical exam
• low BMI

TREAT
-manage underlying cause

Question 2

Absolute contraindications to combined hormonal contraceptives

Answer 2

• migraine with aura
• more than 15 cigs a dat PLUS age over 35
• hypertension over 160/35
• heart disease
• DM with end organ damage
• history of thromboembolic disease
• anti phospholipid Ab syndrome
• history of stroke
• breast cancer
• cirrhosis and liver cancer
• major surgery with prolonged immobilization
• use less than 3 weeks post partum