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Phase 3a Gynae > Amenorrhoea > Flashcards

Amenorrhoea Flashcards

1
Q

what are the 2 types of amenorrhoea?

A

primary 1^
secondary 2^

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1
Q

What is primary amenorrhoea?

A

never had a period

13y/o + no primary sexual characteristics (body/facial hair)

15y/o + no secondary sexual development (androgens responsible for this eg. pubic hair, acne, voice deep, sweat glands)

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2
Q

What are the 2 cases of primary amenorrhoea?

A

Hypergonadotrophic hypogonadism

hypogonadotrophic hypogonadism (hypothalamic)

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3
Q

What happens in hypergonadotrophic amenorrhoea?
what is high/low?

A

High LH/FSH

ovary doesn’t respond to the FSH/LH so -ve feedback causes more to be produced

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4
Q

What causes hypergonadism?

A

Turners + dysgenesis/agenesis (abnormal organ development during embryonic growth and development. As opposed to agenesis, which refers to the complete failure of an organ to develop)

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5
Q

what Is turners?

A

missing sex chromosome 45XO

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6
Q

What happens in hypogonadotrophic amenorrhoea?
what is high/low?

A

low FSH/LH due to hypothalamus not producing hormones to produce FSH/LH

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7
Q

What causes hypogonadism?

A

Kallman’s (delayed puberty + anosmia (partial/full smell loss))

Failure to thrive

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8
Q

What is secondary amenorrhoea?

A

6 or more months of no periods in a prev normally menstruating female

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9
Q

What are the causes of 2^ amenorrhoea?

A

Sheehans - pituitary necrosis after PPH low FSH/LH

Ashermann - uterine adhesions post surgery

Eating disorder, hyperthyroid, PCOS, preg, ectopic, perimenopausal

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10
Q

How would you diagnose amenorrhoea?
what tests would you do?

A

sex bloods - oest, prog, testosterone, FSH, LH, Prolactin, sex hormone binding globulin (SHBG), TFTs (high T4?), IGF-1

HbA1C - PCOS

Hx and Exam (bimanual)

Urine bhCG (Pregnancy)

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11
Q

Tx for:
Hypergonadism?
Hypogonasism?
2^?

A

GnRH Analogue (reduces LH + FSH)

COCP (needs oest + prog)

Tx underlying cause

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12
Q

What are 3 congenital gynae defects?

A

bicornate uterus
transverse vaginal septae
Mullerian agenesis

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13
Q

What is a bicornate uterus?
increases risk of?

A

heart shaped uterus
high risk of miscarriage + IUGR

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14
Q

What is a transverse vaginal septae?
2 types?
increases risk of?

A

perforate (has hole = bleeds period)

imperforate (no hole = no bleed)
(1^ amenorrhoea with 2^ sexual development)

high risk of infertility + endometriosis

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15
Q

what is mullerian genesis?
chromosome?

A

46XX
Internal genetalia not fully formed

16
Q

what causes the bicornate uterus and transvaginal septae to occur?

A

incomplete fusion of the paramesonephric ducts?

Phase 3a Gynae (6 decks)

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