Flashcards in GYN&BREAST Deck (112)
Amenorrhea and + progestin challenge
Anovulatory. Workup for PCOS
Order of events of normal female puberty
Pubic hair dev at tanner stage 1
Prepubertal so no hair growth.
What tanner stage is breast budding seen?
Tanner Stage II
What tanner stage is slight growth of fine labial hair seen?
What do the breasts look like in stage 4 (tanner)
Further breast enlargement: areola and papilla form secondary growth ABOVE level of breast.
Precocious puberty: Increased LH and FH with additional release following administration of GnRH suggest what etiology
Pituitary gland activation
Precocious puberty: low LH and FSH with no response to GnRH suggests what etiology?
Excess sex steroid production
Increased estrogen in the presence of low LH and FSH suggests ?
Exogenous hormone production (neoplasm)
Describe follicular phase
FSH stimulates GROWTH of OVARIAN FOLLICLE (granolas cells) which in turn secretes estradiol.
ESTRADIOL induces ENDOMETRIAL PROLIFERATION and further increases FSH and LH secretion from positive feedback of pituitary
Describe luteal phase
Residual follicle (i.e., CORPUS LUTEUM) secretes estradiol and progesterone to MAINTAIN ENDOMETRIUM and induce devo of secretory ducts.
High estradiol levels inhibit FSH and LH.
IF egg is NOT fertilized, corpus lute degrades, progesterone and estradiol levels decrease, and the ENDOMETRIAL LINING DEGRADES.
Diagnosis of menopause requires how long of amenorrhea?
Which hormone induces LH surge?
What hormone is responsible for increasing the basal body temperature?
What is Asherman syndrome
Scarring of the uterus that follows infection or postpartum infection
Primary amenorrhea: no secondary sexual characteristics, high FSH, LH. Dx?
Next step in primary amenorrhea with no secondary sexual characteristics and LOW FSH, LH
Prolactin level. If normal, its a GnRH deficiency or other hypothalamic-pituitary dysfunction
If estrogen-progesterone challenge is negative, dx?
If estrogen-progesterone challenge test is positive, next step?
Check FSH, LH.
If high: ovarian failure
If low: HPA axis disfunction
Tx for PMS and PMDD
SSRIs with or without alprazolam
"Powder burn" lesions and cysts on laparoscopy
Define abnormal uterine bleeding
Menses with 35 day intervals
Lasting >7 days
blood loss > 80 mL
most common cause of androgen excess in women
What causes ovarian cysts in PCOS?
A result of androgen hyper secretion; do NOT cause the disease!!!
Labs in PCOS
LH:FSH ratio >3
Positive progestin challenge
What kind of cancer are patients with PCOS at higher risk for?
Endometrial cancer, secondary to chronically high estrogen levels.
2 infections that cause vaginal pH >4.5
Gardnerella and trichomonas
What are gumbos?
Granulomatous lesions of skin, bone, and liver seen in tertiary syphilis
Labs FOLLOWING syphilis tx
RPR and VDRL will become negative
FTA-ABS will remain positive FO LIFE