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Endocrinology > Reproductive Tutorials > Flashcards

Reproductive Tutorials Flashcards

1
Q

what are the key features of PCOS

A

Acne (especially back), high BMI, hirsutism, irregular painful or no periods - hyperandrogenism

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2
Q

what FSH is suggestive if PCOS

A

if high twice 6 weeks apart

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3
Q

is tubal disease anovulatory

A

no as egg released it just cant get through - if fertilised will case ectopic pregnancy

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4
Q

what are the pituitary causes of anovulation

A

prolactinoma, pituitary tumour/ mass

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5
Q

what are the key features of anorexia

A

low BMI, hair loss, increased lanugo, low pulse and BP (hypothyroid), anaemia (vit deficiency), halitosis (ketones), low mood, food restriction, excessive exercise

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6
Q

why does anorexia develop amenorrhoea

A

Hypothalamus- lack of gonadotrophin releasing hormone, loss of GnRH pulsatile release= low FSH and LH = hypothalamic hypogonadotropic failure. Low oestradiol, low BMI

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7
Q

what are other complications of anorexia

A

hypothalamic disorder, bone loss, GH resistance, stunted growth, hypercortisolaemia, renal failure, hepatic failure, starvation ketoacidosis, muscle wasting, pancreatic failure, death

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8
Q

what are the main features of menopause

A

Hot flushes, night sweats, atrophic vaginitis, irritable, irregular periods, amenorrhoea

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9
Q

what would hormone tests show in premature ovarian failure

A

High FSH, high LF, low oestradiol

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10
Q

what does anti mullerian hormone show

A

egg reserve

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11
Q

what are the long term complications of ovarian failure

A

osteoporosis, vaginal prolapse

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12
Q

what is at risk in obese patient with high oestrogen levels

A

endometrial cancer - importance to release calcium

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13
Q

what should a gynaecological history should include

A

menstrual history: age of menarche, last period, regularity and length of cycle, dysmenorrhoea/ menorrhagia, discharge
cervical smear history
sexual history (inc contraception, frequency, libido, dyspareunia, STIs)
previous gynae treatment or surgery
obstetric history: previous pregnancies, year, gestation, outcome, antenatal/intrapartu,/postnatal problems, previous miscarriages, previous terminations

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14
Q

how are oestrogens produced

A

androgens converted into it by granulosa cells via the enzyme aromatase

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15
Q

what is oestradiol

A

the most potent form of oestrogen produced by the ovaries

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16
Q

what happens to hormones in the follicular phase

A

GnRH increases causes the ant pit to release more FSH and LH

LH causes the theca cells to prosuce androgens

FSH stimulates the granulosa to convert the androgens to oestrogen

in this phase oestrogen will rise casugn FSH to be inhibited

17
Q

how does FSH affect follicles

A

stimulates them to mature

18
Q

when is there a surge in LH

A

between day 12 and 14, triggers ovulation

19
Q

what triggers the formation of the corpus luteum

A

LH

20
Q

what does progesterone do to the endometrium

A

induces a secretory effect, prepares it for egg implantation

21
Q

what happens to the endometrium during the luteal phase

A

thickens

22
Q

when is the luteal phase

A

after ovulation (day 15-28)

23
Q

what are the other roles of progesterone

A

increases basal body temp
increases thickness of cervical mucous
glandular development of the breasts

24
Q

what will high levels of progesterone inhibit

A

FSH and LH production

25
Q

what happens to hormones as the endometrium is shed

A

levels of FSH and LH increase as no longer inhibited by progesterone - allows cycle to begin again

26
Q

what does corpus luteum secrete

A

progesterone

27
Q

how does insulin drive an increase in androgens

A

drives the thecal cells of the follicle to produce more androgens

28
Q

is PCS usually bilateral or unilateral

A

bilateral

29
Q

how can hyperandrogenism be managed

A

oral contraceptive pill (decreases free testosterone and increases SHBG)

can be combined with anti-androgen: cyrpterone acetate

30
Q

why does low weight cause amenorrhoea

A

as hypothalamic-pituitary axis is disturbed, levels of GnRH fall

31
Q

why is full blood count done in anorexia

A

as bone marrow components may be compromised

32
Q

how can chronic dehydration affect U&Es

A

hypokalaemia and hyponatraemia

33
Q

what is trousseaus signs

A

in hypocalcaemia

inflating BP cuff causes the fingers to flex and draw together

34
Q

what ECG signs show hypokalaemia

A

small or inverted T waves

35
Q

what are tented T waves a sign of

A

hyperkalaemia

Endocrinology (46 decks)

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