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ENRP > Primary Amenorrhea tree > Flashcards

Primary Amenorrhea tree Flashcards

1
Q

What is the first thing to assess with primary amenorrhea?

A

Is there secondary sex characteristics present?

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2
Q

If there are NO secondary sex characteristics present, what should you do?

A

Measure FSH and LH

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3
Q

If there are no secondary sex characteristics present and you measure FSH and LH, what are the levels that correspond to Hypogonadotropic Hypodonadism?

A

FSH + LH < 10

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4
Q

FSH + LH < 10

A

Hypogonadotropic Hypogonadism

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5
Q

What are the levels of FSH/LH that can define Hypogonadotropic Hypogonadism?

A

FSH + LH < 10

FSH and LH < 5

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6
Q

If there are no secondary sex characteristics present and you measure FSH and LH, what are the levels that correspond to Hypergonadotropic Hypogonadism?

A

FSH > 30

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7
Q

FSH > 30

A

Hypergonadotropic Hypogonadism

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8
Q

What are the levels of FSH/LH that can define Hypergonadotropic Hypogonadism?

A

FSH > 30

FSH > 20 and LH > 40

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9
Q

With Hypergonadotropic Hypogonadism, what diagnostic test is performed next?

A

Karyotyping

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10
Q

What are the 2 possible conditions that can cause Hypergonadotropic Hypogonadism and their corresponding karyotype?

A 
46XX = premature ovarian failure
45XO = Turner's syndrome
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11
Q

What are the signs of Turner’s Syndrome?

A

45XO

- neck webbing, short stature, primary amenorrhea

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12
Q

If there are secondary sex characteristics present, what should you do?

A

Get an ultrasound of the uterus

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13
Q

With secondary sex characteristics, you get an ultrasound of the uterus. If it is absent or abnormal, what test is done next?

A

Karyotype

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14
Q

Absent or abnormal uterus with a 46XY karyotype is likely what condition?

A

Androgen Insensitivity Syndrome

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15
Q

What are the signs of Androgen Insensitivity Syndrome?

A

46XY
= Male range testosterone and female genitalia externally
– absent/abnormal uterus

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16
Q

If the uterus is normal following the ultrasound, what should you check for next?

A

Outflow obstruction

17
Q

If there is NOT an outflow obstruction, what is an item on your differential/

A

Secondary Amenorrhea

18
Q

If there is an outflow obstruction of the uterus, what are 2 conditions that could be causing the primary amenorrhea/

A
  • Imperforate Hymen

- Transverse Vaginal Septum

19
Q

If there is an outflow obstruction of the uterus, what are 2 possible conditions that could be causing the primary amenorrhea?

A
  • Imperforate hymen

- Transverse septum

20
Q

What is primary amenorrhea and what is the first thing to assess?

A

No menses by 13 without secondary characteristics or no menses by 15 with secondary characteristics
– Assess if there are secondary sex characteristics present

ENRP (45 decks)

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