Reproductive Disorders: Female Flashcards

1
Q

High FSH and LH with low estrogen indicates ___________.

A

primary ovarian insufficiency (such as Turner’s)

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2
Q

__________ often gets disrupted in women due to exercise, stress, or malnutrition.

A

GnRH

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3
Q

What gonadotroph levels are typical in the early follicular phase?

A

Equal LH and FSH

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4
Q

In the luteal phase, ___________ stimulates the lowering of FSH in relation to LH.

A

progesterone

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5
Q

Inhibin A is important in the __________ phase and inhibin B is important in the __________ phase.

A

luteal; follicular

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6
Q

How does prolactin affect the HPG axis?

A

It shuts off GnRH, thereby eliminating LH and FSH.

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7
Q

What is premature ovarian insufficiency?

A

A form of hypergonadotropic hypogonadism caused by early menopause or any other disorder that damages the ovaries (such as radiation or an autoimmune infiltrative process)

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8
Q

____________ percent of PCOS patients are overweight, but all are ____________.

A

Only 60; insulin resistant

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9
Q

PCOS presents with a ratio of ________ LH:FSH.

A

2.5 or greater

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10
Q

Why does PCOS raise risk of endometrial cancer?

A

Because there is elevated estrogen without opposing progesterone

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11
Q

New data suggests that ____________ can improve ovulation and suppress androgen levels in women with PCOS.

A

metformin

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12
Q

How can you distinguish ovarian or adrenal tumors that make androgens from PCOS?

A

Speed of onset and change from baseline

That is, those with PCOS will have symptoms starting before puberty while those with ovarian tumors will develop hyperandrogenism out of the blue.

Also, tumors usually make T greater than 200 or DHEA greater than 800.

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13
Q

________________ presents like PCOS but without elevated LH.

A

Obesity-induced anovulation

This can be treated with weight reduction.

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14
Q

How does clomiphene citrate (Clomid) work?

A

In patients with an intact HPG axis, Clomid stimulates a rise in FSH that induces ovulation.

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15
Q

If patients fail Clomid therapy (for fertility), _____________ can be used.

A

LH and FSH

Though there is an increased risk of multiple gestations.

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16
Q

Remember that ___________ can also stimulate prolactin release from the anterior pituitary.

A

TRH (so primary hypothyroidism can cause prolactin elevations and subsequent inhibition of GnRH)

17
Q

What is the average age of menopause?

A

51 (in the U.S.)

18
Q

How is androgenism treated in women with PCOS?

A

Spironolactone

19
Q

Which PCOS drug should be discontinued prior to pregnancy?

A

Spironolactone (because it can have anti-androgenic effects on the fetus)