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Flashcards in Menstrual Disorders Deck (61)
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1

How is primary amnorrhea defined?

Absence of menarche by age 15

2

How is secondary amenorrhea defined?

Absence of menses for 6 months or greater in a woman previously menstruating

3

What is the most common chromosomal cause of primary amenorrhea?

Turner's Syndrome

4

What are the FOUR most common manifestations of Turner's Syndrome?

Short Stature
Infertility
Primary Gonadal Failure
Osteoporosis

5

What are THREE structural causes of primary amenorrhea?

Absence of uterus, cervix, vagina
Transverse vaginal septum
Imperforate Hymen

6

The absence of a uterus, cervix, or vagina would result from __________ (mullerian/wolffian) abnormalities

Mullerian

7

What is another name for the syndrome that results in mullerian agenesis?

Mayer-Rokitansky-Kuster-Hauser Syndrome

8

Transverse vaginal septums occur from _______ (agenesis/apoptosis) of the vaginal plate

Apoptosis

9

Which is more common.....

Imperforate Hymen or Mullerian Abnormalities

Imperforate Hymen

10

How are sturctural causes of primary amenorrhea managed?

Resection (Imperforate Hymen, Vaginal Septums)
Hysterectomy (Absent Cervix)
Creation of a Neovagina

11

What are FOUR 'conditions' that may lead to hypothalamic malfunction that results in amenorrhea?

1. Eating Disorders (Anorexia)
2. Vigorous Exercise
3. Low Body Fat
4. High Stress

12

_________ Syndrome is described as a congenital GnRH deficiency classically associated anosmia

Kallmann Syndrome

13

What are TWO causes of ovarian caused primary amenorrhea?

PCOS
Premature Ovarian Failure

14

What is the name of the syndrome that results in primary amenorrhea in females and often is associated with the presence of testis in the labia?

Androgen Insensitivity Syndrome

(46 XY with non functional androgen receptors)

15

When working up primary amenorrhea what labs should you order if a uterus is present?

Absent Uterus?

Present: B-Hcg, FSH, FSH, Prolactin

Absent: Karotype, Serum Testosterone

16

What is the most common cause of secondary amenorrhea?

Pregnancy

17

What ALWAYS needs to be ruled out when working up secondary amenorrhea?

Pregnancy

18

What are the THREE most common 'sources' for secondary amenorrhea?

Hypothalamic
Pituitary
Ovarian

19

T/F: Secondary amenorrhea cannot be iatrogenic

False

It can be

(ex: OCPs, Metocloparmide, Antipsychotics)

20

How does functional hypothalamic amenorrhea occur?

Decreased GnRH secretion commonly due to anorexia, low body fat, or excessive exercise

21

T/F: Celiac disease can impact hypthalamic function leading to secondary amenorrhea

True

22

What is the most common pituitary adenoma?

Prolactinomas

23

Can secondary amenorrhea result from hypothyroidism or hyperthyroidism?

Both!

24

PCOS is the cause of about __% of amenorrhea

20%

25

What ovarian disroder is classified as a depletion of functional oocytes before the age of 40?

Premature Ovarian Failure

26

What is Asherman;s Syndrome?

Acquired scarring of the endometrial lining from prior surgery or infection

27

What is the first lab always ordered when working up amenorrhea?

Beta-Hcg

28

If a patient underwent the progestin withdrawal test for secondary amenorrhea and no bleeding occurred what would it indicate?

Asherman's Syndrome

29

When working up secondary amenorrhea, why are the following ordered......

MRI?

Karyotype?

MRI: Pituitary Adenoma

Karyotype: If FSH elevated to r/o partial chromosome deletion

30

What is the mainstay of treatment for hypothalamic causes of secondary amenorrhea?

Lifestyle Changes