Menarche, Puberty and Menstrual Disorders

Question 1

Menarche

Answer 1

1st occurrence of menstruation

Question 2

Primary Amenorrhea

Answer 2

• Absence of menarche by age 13 WITHOUT secondary sexual development
  OR
• Absence of menarche by age 15 WITH secondary sexual development

Question 3

Secondary Amenorrhea

Answer 3

Absence of menstruation for at least 6 months

Question 4

With secondary amenorrhea, levels of what should be checked to rule out pregnancy?

Answer 4

hCG

Question 5

It is rare to remain amenorrheic for greater than?

Answer 5

90 days

Question 6

Polymenorrhea

Answer 6

Abnormally frequent menses @ intervals of < 21 days

Question 7

Oligomenorrhea

Answer 7

Abnormally infrequent menses @ intervals of > 35 days

Question 8

Menorrhagia

Answer 8

Excessive bleeding and/or prolonged menses occurring at regular intervals

Question 9

Metrorrhagia

Answer 9

Irregular episodes of uterine bleeding

Question 10

Menometrorrhagia

Answer 10

Heavy AND irregular uterine bleeding

Question 11

Intermenstrual bleeding

Answer 11

Scant bleeding at ovulation for 1 - 2 days

Question 12

With Menorrhagia, the excessive bleeding is usually defined as > ___ mL

Answer 12

80

Question 13

AUB

Answer 13

Abnormal Uterine Bleeding

Question 14

What is the classification system for AUB?

Answer 14

PALM-COEIN

Question 15

What is AUB?

Answer 15

Abnormal uterine bleeding that is NOT attributed to:

• medications
• blood disease
• systemic disease
• trauma
• organic conditions

Question 16

When do most AUB occur?

Answer 16

Around Menarche or Premenopausal

Question 17

AUBs are usually caused by disruptions to the?

Answer 17

Hypothalamic-Pituitary-Ovarian axis that results in Anovulation (no egg released)

Question 18

Structural changes in the classification system for AUB?

Answer 18

PALM

Question 19

P in PALM-COEIN

Answer 19

Polyps

Question 20

A in PALM-COEIN

Answer 20

Adenomyosis

Question 21

What is adenomyosis?

Answer 21

Extension of endometrial glands into the myometrium

Question 22

L in PALM-COEIN

Answer 22

Leiomyoma

Question 23

What is leiomyoma?

Answer 23

Fibroids - usually benign tumor in myometrium

Question 24

M in PALM-COEIN

Answer 24

Malignancy

Question 25

C in PALM-COEIN

Answer 25

Coagulopathy

Question 26

O in PALM-COEIN

Answer 26

Ovulatory dysfunction

Question 27

E in PALM-COEIN

Answer 27

Endometrial

Question 28

I in PALM-COEIN

Answer 28

Iatrogenic

Question 29

N in PALM-COEIN

Answer 29

Not yet classified

Question 30

Tanner stages classify normal?

Answer 30

Pubertal development

Question 31

What is puberty?

Answer 31

Development of secondary sex characteristics and the ability to reproduce

Question 32

Average duration of puberty?

Answer 32

4-5 years

Question 33

Between what ages does puberty usually occur?

Answer 33

10-16

Question 34

What 3 things can determine the onset of puberty?

Answer 34

Genetics Geographic location Nutritional status

Question 35

What race normally begins puberty earlier?

Answer 35

African Americans

Question 36

What geographic location normally begins puberty earlier?

Answer 36

Metropolitan areas at sea level

Question 37

What nutritional status level will begin puberty earlier?

Answer 37

Obese children

Question 38

What nutritional status level will begin puberty later?

Answer 38

Malnourished

Question 39

What inhibits the H-P-O axis between 4 and 10 years of age

Answer 39

CNS (Gonadostat)

Question 40

Main 4 stages of puberty

Answer 40

1. Thelarche 2. Pubarche/Adrenarche 3. Maximal growth 4. Menarche

Question 41

Thelarche

Answer 41

Breast development

Question 42

Pubarche/Adrenarche

Answer 42

Pubic and axillary hair growth

Question 43

Tanner stages for female breast development

Answer 43

1. Preadolescent 2. Enlargement of areolar region 3. Further enlargement of breast and areolar region 4. Projection of areola and papilla 5. Mature

Question 44

Tanner stages for female pubic hair growth

Answer 44

1. Preadolescent - no hair 2. Sparse hair along labia 3. Hair spreads and is darker and coarser 4. No spread to medial thigh 5. Inverted triangle pattern WITH some on medial thigh