menstrual cycle and disorders of menstruation Flashcards Preview

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Flashcards in menstrual cycle and disorders of menstruation Deck (42):
1

4 phases of cycle

1. follicular
2. ovulatory
3. luteal
4. menstrual

2

**what happens in follicular

thickening of endo due to estradiol

3

**what is length of follicular

variable

4

what is hormone feedback

rising FSH 2nd to inhibin A
- progressive increase in estradiol due to follicle
- begative feedback to FSH
- rising LH- positive feedback

5

what happens to egg in follicular

- egg is surrounded by granulosa cells
- creates follicle
- selection of single large follicle supresses others
- aromatized androgens

6

what happens in ovulation phase

- rising estradiol causes LH surge and prog. prod
- oocyte relases ~36 after surge
- surge last 48-72 hrs

7

clinical signs of ovulation

- associated temp fall follwed by rise
- clear eggwhite mucus due to E
- maybe twinge of pain
- progesterone porduction - PMS

8

what happens in luteal phase

- empty follicle collapses
- turns into corpus luteum - makes prog.
- CL dependent on LH

9

** length if luteal phase

14 days FIXED

10

what is effect of high estrdiol and prog

supresses FSH so no folliculogenesis

11

what happens in menstruation phase

- if no preg- CL stops producing inhibin A and prog
- FSH and inhib B rise and stim estradiol and next cycle
- lack of prog. restrict spiral arteries and get period

12

def. primary amen

lack of
- sec characteristics by age 14
- menses by 16
- menses by 4 years after breasts
- menses 1 year after pubes

13

def. secondary amen

no menses for 6 months after having had 3

14

6 aspects of compartemental workup

1. hypothal
2. pit
3. thyroid
4. adrenal
5. ovary
6. outflow tract

15

4 issues with hypo

1. CNS lesions
2. anorexia, stress, female athlete
3. kallman's syndrome
4. pregancy***

16

3 issues with pit***

1. proactinoma
2. other lesion
3. sheehan's syndrome - shortly after birth went hypovolemic

17

what is worse in thyroid

hypo worse that hyper

18

3 issues with adrenal

1. cushings
2. adrenal
3. CAH

19

4 probs with ovary

1. dysgenesis
2. PCOS
3. premature ovarian failure
4. neoplasm

20

2 outflow issues

1. no uterus
2. blockage

21

5 things to take on Hx

1. preg
2. nutrition/excersice
3. puberty
4. hormonal sx
5. family Hx

22

6 to look for on physical

1. BMI
2. tanner
3. hisuitism
4. thyroid signs
5. sense of smell - kallman
6. pelvic exam

23

7 labs to take

1. LH/FSH/E*** must be done early in cycle
2. TSH
3. prolactin
4. bone age
5. US
6. B -HCG
7. bone density

24

SX of prolactinemia

- galactrorrea
- amennorea due to decreased GnRH pulses
- inhibited by DOPA

25

pharma causes of prolact.

TCAs, antiHTs, antipsychs,

26

treat of prolactinoma

DA agonists
- surgery

27

signs of PCOS

- hirsuitism
- anovulation and infert
- obesity
- pol;ycystic ovaries

28

risk of PCOS

endometrial hyperplasia

29

treat of PCOS

- lose weight and excercise
- treat SX
- OCP
- cyclic provera to prevent endo growth

30

def. ogiomenorrhea

reduced freq. - between 35 days and 6 months

31

def hypomen

less flow or less days

32

def. menmetrorrhagia

prolonged uterine bleeding at irregular intervals

33

def. menorrhagia

- >80mls
- >7 days
- regular

34

what should define menorrhagia

whether blood loss is a problem should be defined by woman, not amount of blood lost

35

patho pf menorrhagi

- usually secondary to distortion of uterine cavity
- unable to contract down on open venous sinuses in zona basalis

36

4 med cause sof DUB

1. coag defects
2. leukemia
3. ITP
4. thyroid

37

4 gestationsal causes of DUB

1. abortions
2. ectopics
3. trophoblastic disease
4. IUP

38

uterine causes of DUB

- preg
- leiomyomas
- polyps
- hyperplasia
- carcinoma
- IUD

39

cervical causes of DUB

- polyps
- condyloma
- cervicitis
- neoplasia

40

most common causes of abnormal bleeds by age

premenarche- foreign body
reproductive- gestational event
postmeno - atrophy

41

medical mgmt of menorrhagia

1. nsaids
2. danazol - androgen and prog competitor
3. antifibrinolytics
4. OCP
5. oral prog
6. levonorgestrel - mirena
7. GnRH agonist
8. conjugated estrogens

42

how much blood in average period

25-60mls

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