Day 13 - Gyn1 Quiz Flashcards Preview

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Flashcards in Day 13 - Gyn1 Quiz Deck (14):

Distinguishing true (central) precocious puberty from pseudopercocious puberty

CENTRAL - Elevations of LH & FSH, Dose of GnRH further increases LH & FSH; PSEUDO - Low FSH & LH (due to exogenous hormones suppressing them), No response to GnRH.


Definition of precocious puberty

In females, puberty or pubertal changes at younger than 8 yo; In males, its younger than 9 yo


Causes of pseudoprecocious puberty

Exogenous hormone administration, adrenal tumors, congenital adrenal hyperplasia, hormone-secreting tumors (e.g., Sertoli-Leydig tumors, Granulosa-Theca tumors), McCune Albright syndrome


Definition of premature ovarian failure

Absence of menses for at least 6 mo (really 1 yr to be considered "menopasual") at age younger than 40 yo


Hormone level assoc with increase in basal body temp



How increase in basal body temp assoc w/ ovulation

Occurs 24 hrs prior to ovulation


4 different options for emergency contraception

(1) 4-5 estradiol/progestin combined OCPs within 24 hrs (2) Levonorgestrel (Plan B = progestin alone) (3) Copper IUD (4) Mifepristone (RU46, anti-progestin)


Contraindications for OCPs

Pregnancy, History of thromboembolism or thrombophilia, History of estrogen-dependent tumor (e.g., breast/endometrial cancers), History of vascular disease or CAD, Poorly controlled HTN, Smoker over age 35, Hepatic disease, Abnormal vaginal bleeding of unknown etiology, Migraine w/ aura/neurologic sx/vascular involvement


Meds known for reducing effectivness of OCPs

Rifampin, Griseofulvin, Antiepileptics, St. John's wort


Define primary amenorrhea

Absence of menses by age 16 w/ secondary sexual characteristics present OR Absence of menses & secondary sexual characteristics by age 13


First step of any workup for amenorrhea



Basic components of workup for secondary amenorrhea

B-HCG, Prolactin, TSH, FSH; If signs of hyperadrogenism (e.g., deepening of voice, facial hair, clitoromegaly), testosterone level & DHEA-S to rule out adrenal tumor; If all above negative, check progestin withdrawal test


Primary amenorrhea, absent secondary sex characteristics, anosmia (inability to smell)

Kahllmann's syndrome (congenital absence of GnRH secretion)


Initial step in mgt F p/w secondary amenorrhea & new galactorrhea when B-HCG is negative

TSH (r/o hypothyroidism); Prolactin

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