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RDS Test 1 > B8-008 CBCL Female Infertility > Flashcards

B8-008 CBCL Female Infertility Flashcards

1
Q

female infertility is defined as unprotected intercourse for […] under the age of 35 and […] over the age of 35

A

12 months
6 months

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2
Q

lack of menses by 15 years of age

A

primary amenorrhea

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3
Q

secondary amenorrhea is the absence of menses for […] in females with a prior regular cycle OR
absence of menses for […] in females with prior irregular cycles

A

3 months
6 months

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4
Q

characterized by follicular and endometrial growth/proliferation

A

follicular phase

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5
Q

characterized by the LH surge

A

midcycle

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6
Q

characterized by corpus luteum

A

luteal phase

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7
Q

controls the release of both FSH and LH

A

GnRH

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8
Q

high frequency, high amplitude GnRH favors […] release

A

LH

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9
Q

low frequency, low amplitude GnRH favors […] release

A

FSH

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10
Q

[…] increases GnRH pulse frequency

A

estrogen

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11
Q

[…] decreases GnRH pulse frequency

A

progesterone

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12
Q

low FSH
low LH
low E2

A

hypothalamic amenorrhea (WHO 1)

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13
Q

causes of WHO 1 amenorrhea (hypothalamic amenorrhea)

A

systemic illness
marathon runner
famine

(overall bad conditions to have a baby)

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14
Q

normal FSH
normal LH
normal E2

A

WHO 2 amenorrhea
(normogonadotropic state)

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15
Q

PCOS is an example of WHO […] amenorrhea

A

2

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16
Q

elevated FSH
elevated LH
low E2

A

WHO 3 amenorrhea (primary ovarian insufficiency)

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17
Q

most commonly related to stress and low energy states

A

WHO 1 (hypothalamic amenorrhea)

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18
Q

must be ruled out before considering a diagnosis of hypothalamic amenorrhea

A

pathology affecting the brain (tumors/scars) via MRI

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19
Q

risk factors for hypothalamic amenorrhea [3]

A

excess exercise
stress
nutritional deficiency (hypoleptinemia)

20
Q

criteria for diagnosis of PCOS (Rotterdam criteria)

A

> 12 antral follicles on US
hyperandrogenism
irregular menses

2 or more

21
Q

chromosomal causes primary ovarian insufficiency [4]

A

turner’s syndrome (short stature)
galactosemia (seen on newborn screen)
fragile X (CGG repeats 80-100)
perrault syndrome (deafness)

22
Q

treatment for WHO 1 amenorrhea

A

decrease stress, increase energy intake

gonadotropins

23
Q

treatment for WHO 2 amenorrhea

A

decrease energy intake
letrozole

clomid, gonadotropins, ovarian drilling

24
Q

treatment for WHO 3 amenorrhea

A

donor oocytes

25
Q

WHO 1 women need less than […] of exercise per week

A

3

26
Q

WHO 2 women should aim for […]% weight loss to induce ovulation

A

10

27
Q

steroidogenic cells present in the ovarian follicles [2]

A

granulosa cells
thecal cells

(separted by basement membrane)

28
Q

the LH surge requires […] positive feedback

A

estrogen

29
Q

also called premature ovarian failure

A

primary ovarian insufficiency

30
Q

premature atresia of ovarian follicles in females of reproductive age

A

primary ovarian insufficiency

31
Q

frequently associated with chromosomal abnormalities so requires karyotype screening

A

primary ovarian insufficiency

32
Q

MOA of letrozole

A

aromatase inhibitor

33
Q

surgical option for PCOS resistant to pharmacotherapy

A

ovarian drilling

34
Q

common etiology for tubal factor infertility and hydrosalpinx

A

untreated STI

35
Q

accumulation of fluid/pus in the fallopian tubes due to chronic inflammation and consequent stenosis

A

hydrosalpinx

36
Q

before a Turner’s patient uses donor oocytes rule out

A

aortic dilation

via cardiac MRI

37
Q

first line therapy for women with WHO 1 amenorrhea

A

behavioral modification

(gonadotropin therapy is next most appropriate)

38
Q

what test should be ordered for low levels of anterior and posterior pituitary hormones

A

pituitary MRI

39
Q

diagnosis of POI is made with […] in menopausal range

A

repeat FSH

40
Q

risk of […] is reduced in women with POI

A

hormonally sensitive breast cancer

41
Q

panhypopituitarism or fractional pituitary failure is also known as

A

Sheehan syndrome

42
Q

history of […] is indication for HSG

A

STI

43
Q

history of […] is indication for AMH

A

smoking

44
Q

the diagnosis of PCOS is a diagnosis of exclusion based on ruling out other causes of […] and […]

A

anemorrhea
hirsutism

45
Q

bilateral salpingectomy should be completed […] IVF

A

before

(eliminates cytotoxic reflux into the uterine cavity)

46
Q

next best step following abnormal karyotype

A

referral to genetics/endocrine

RDS Test 1 (23 decks)

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