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2MB Endocrinology > Reproduction Disorders > Flashcards

Reproduction Disorders Flashcards

1
Q

Define oligomenorrhoea

A

Reduced frequency of periods (less than 9/year)

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2
Q

Define primary amenorrhoea

A

Failure of having a period before the age of 16

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3
Q

Define secondary amenorrhoea

A

Cessation of periods for greater than 6mths in someone who has previously had a period

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4
Q

What is the main cause of primary amenorrhoea?

A

Congenital abnormality

Turner’s, Kallman’s

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5
Q

List ovarian causes of secondary amenorrhoea

A

Polycystic ovarian syndrome

Ovarian failure

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6
Q

High prolactin and hypopituitarism can cause amenorrhoea. True/False?

A

True

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7
Q

What triad of symptoms are classic of amenorrhoea/oestrogen deficiency?

A

Flushing
Lack of libido
Dyspareunia (painful sex)

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8
Q

List investigations that all patients with oligo-/amen- orrhoea get

A

LH, FSH, oestradiol levels
Thyroid function tests
Prolactin levels

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9
Q

List additional investigations for oligo-/amen- orrhoea

A

Ovarian USS, endometrial thickness
Testosterone levels if hirsutism
Pituitary function

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10
Q

In primary hypogonadism in females, the problem is arising from where - ovaries or pituitary/hypothalamus?

A

Ovaries

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11
Q

In secondary hypogonadism in females, the problem is arising from where - ovaries or pituitary/hypothalamus?

A

Pituitary/hypothalamus

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12
Q

Describe LH and FSH levels in primary hypogonadism

A

High LH
High FSH
i.e. hypergonadotrophic hypogonadism

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13
Q

Describe LH and FSH levels in secondary hypogonadism

A

Low LH
Low FSH
i.e. hypogonadotrophic hypogonadism

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14
Q

Give an example of a condition where primary hypogonadism occurs

A

Premature ovarian failure

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15
Q

What happens in premature ovarian failure?

A

Loss of ovarian function causes amenorrhoea, low oestrogen and elevated gonadotrophins

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16
Q

What is idiopathic hypogonadotrophic hypogonadism?

A

Absent/delayed sexual development assoc. with low levels of gonadotrophins in the absence of anatomical/functional defect in the H-P-gonadal axis

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17
Q

Which syndrome is like idiopathic hypogonadotrophic hypogonadism but includes anosmia (inability to smell)?

A

Kalmann’s syndrome

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18
Q

What is the major defect/identified cause of idiopathic hypogonadotrophic hypogonadism?

A

Mutated GnRH receptor (thus inability to sense GnRH from hypothalamus)

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19
Q

What is the function of kisspeptin?

A

Regulates GnRH secretion and thus puberty

Regulates fertility

20
Q

What is Kallman’s syndrome?

A

Genetic disorder of loss of GnRH secretion characterised by anosmia and hyposmia

21
Q

Males are more affected by Kallman’s syndrome. True/False?

A

True

4:1

22
Q

What causes hirsutism?

A

Excess androgen at the hair follicle

23
Q

What is the most common cause of hirsutism?

A

Polycystic ovarian syndrome

24
Q

Which chromosome is missing in Turner syndrome?

A

X

so women only have one X

25
Q

List clinical features of Turner syndrome

A 
Short stature
Failure/delayed puberty
Coarctation of aorta
Poor breast formation
Infertility
26
Q

Define primary hypogonadism in males in terms of testosterone and LH/FSH levels

A

Low testosterone

High FHS/LH

27
Q

Define secondary hypogonadism in males in terms of testosterone and LH/FSH levels

A

Low testosterone

Low FSH/LH

28
Q

What is the most common congenital form of primary hypogonadism?

A

Klinefelter’s syndrome (XXY)

29
Q

List clinical features of Klinefelter’s syndrome

A

Reduced testicular volume
Gynaecomastia
Eunuchoidism

30
Q

Infertility risk increases with chlamydia infections. True/False?

A

True

31
Q

List some male factors contributing to infertility

A

Decreased quality sperm
Increased testicular cancer
Cryptoorchidism- testicles do not descend
Hypospadias- opening of the urethra not at tip of penis

32
Q

Define infertility

A

Failure to achieve pregnancy after 12 months of regular unprotected sex in a couple who have never had a child

33
Q

What is the difference between primary + secondary infertility?

A

Primary: never conceived
Secondary: unsuccessful pregnancy

34
Q

List factors increasing the chance of conception

A 
Women less than 30yrs
Less than 3yrs trying to conceive
Intercourse during 6days before ovulation
Women BMI 20-30
Non-smokers
Low caffeine intake
35
Q

What are the main causes of female infertility?

A 
Ovulation failure (50%)
Tubal damage (25%)
Endometriosis (10%)
Misc. (15%)
36
Q

List hypothalamic causes of anovulatory infertility

A

Anorexia, bulimia

Excessive exercise

37
Q

List pituitary causes of anovulatory infertility

A

Hyperprolactinaemia
Sheehan syndrome
Tumours

38
Q

What is a hydrosalpinx?

A

Fallopian tube dilation by fluid (due to blockage)

39
Q

What is endometriosis?

A

Condition where endometrial tissue grows outside of the womb/uterus

40
Q

What is the characteristic sign of endometriosis on USS?

A

Chocolate cysts on ovary

41
Q

What is the most common cause of male infertility?

A

Varicocele

42
Q

What is a varicocele?

A

“varicose veins” of the testis

43
Q

List endocrine disorders that can cause male infertility

A 
Hypogonadotrophic hypogonadism (Kallman's)
Testicular failure
Klinefelter's syndrome (XXY)
Hyperprolactinaemia
Acromegaly
Cushing's
44
Q

List investigations for causes of infertility in females

A 
Endocervical swab (chlamydia)
Cervical smear
Pelvic USS
Bloods (rubella)
Mid-luteal progesterone
Hormone levels (PRL, FSH, LH)
Hysterosalpingiogram (tubal patency)
45
Q

List causes of WHO group I ovulatory disorders

A 
(hypothalamic causes)
Hypogonadotrophic hypogonadism
Kallman's syndrome
Anorexia, bulimia
Excessive exercise
46
Q

List causes of WHO group II ovulatory disorders

A

(pituitary dysfunction)
Normogonadotrophic hypogonadism
Polycystic ovarian syndrome

47
Q

List causes of WHO group III ovulatory disorders

A

Hypergonadotrophic hypogonadism

Ovarian failure

2MB Endocrinology (21 decks)

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