Female Repro pathophys Flashcards Preview

Unit 1 ID+LC > Female Repro pathophys > Flashcards

Flashcards in Female Repro pathophys Deck (16):
1

Anorexia nervosa is a ______ generator defect

Acquired GnRH pulse generator defect (leading to amenorrhea)

- hardware is there, but no software coming down

2

GnRH pulse generator alterations (leading to amenorrhea) can due to:

1. excessive exercise
- no fat

2. eating disorders

3. stress

4. genetic?

3

Infiltrative diseases that can lead to low estrogen and amenorrhea by affecting the pituitary

1. Hemochromatosis
2. Sarcoidosis
3. Lymphocytic hypophysitis

4

Tx of prolactin elevation

dopamine agonists
- bromocriptine or
cabergoline

or change OCPs

5

Fertility drugs

Clomiphene (SERM)
- tricks body

Gonadotropins
Pulsatile GnRH

6

Autoimmune disorders that can cause premature ovarian failure

1. Autoimmune thyroid diseases
- Hashimotos, or Graves
2. Pernicious anemia
-B12 def
3. Addison's disease
- primary adrenal insuff
4. RA, Lupus, Myasth gravis, celiac sprue

7

CAH 17OH levels

test: Give cosyntropin (ACTH) --> measure 17OH after 30 min > than 1000 ng/ml = CAH

tx: OCPs and antiandrogens

8

Women with rapid onset of sx + sz in a women with nl menses. See Hirsutism and virilzation.
- temporal recession
- anabolic phenotype
- loss of breast tissue
- clitoromegaly >2.5 cm

Hyperandrogenic anovulation tumors (rare)

9

Ovarian Hyperandrogenic anovulation tumors

Testosterone >200 ng/dl

Accounts for ~ 10% of ovarian tumors
- Sertoli-leydig cell tumor
- Hilar cell tumor
- Lipoid cell tumor

*there are also adrenal hyperandrogenic anovulation tumors

10

Adrenal Hyperandrogenic Anovulation tumors

DHEAS > 8-900 ng/ml

1. Adrenocortical adenoma or r carcinoma
2. Virilizing T secreting tumor

11

Is PCOS Hyper or Hypor androgenic?

Hyperandrogenic

- hirsutism
- acne
- insulin resistance
- acanthosis nigricans

12

Tx for PCOS if pregnancy is desired vs not desired

Preggo desired:
- Clomiphene citrate (SERM) w/ metformin (hypoglycemic drug: halts weight gain)
- Letrozole (aromatase inhibitor)

No preggo:
- OCPs w/ less androgenic progestin or cyclic progesterone for regular menses
- Spirinolactone (antiandrogen) for hirsutism
- Metformin (insulin sensitizer)

13

Fragile x show early menopause?

Yes. Can cause low E due to premature ovarian failure.

Make sure you screen if persons mom had early menopause.

* high FSH, LH, low E

14

Premature menopause

cessation of menses before age 40

15

Addisons disease
- what is it?
- blood levels
- tx

primary adrenal insufficiency/atrophy resulting in premature ovarian failure
- causes High ACTH

tx: glucocorticoids

16

Do women with PCOS have oligo - or amenorrhea

What is the rotterdam criteria that is added to PCOS?

Either

*rotterdam criteria adds:
- multiple small cysts and/or ovarian volume on us