Oligomenorrhea And Hypothyroidism Flashcards Preview

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Flashcards in Oligomenorrhea And Hypothyroidism Deck (17):
0

Oligomenorrhea?

Fewer than nine menses a year or intervals of more than 40 days between periods

1

Secondary amenorrhea?

No periods for three consecutive months

2

Causes of oligomenorrhea and amenorrhea?

1. Hypothalamus issues (excessive exercise, stress, infiltrative diseases)
2. Diseases of the pituitary ( prolactinomas, adenomas)
3. Empty sella syndrome and Sheehan syndrome
4. Premature ovarian failure
5. Diseases of the thyroid
6. Adult onset Adrenal hyperplasia

3

Polycystic ovarian syndrome: history? Labs? Therapy?

Irregular menses since menarche, obesity, hirsutism

Elevated testosterone, elevated LH and FSH

Oral contraceptive agent

4

Hypothyroidism: history? Labs? Therapy?

Fatigue, cold intolerance

Elevated TSH

Thyroxine replacement

5

Hyperprolactinemia: history? Labs? therapy?

Headache, bitemporal hemianopsia, galactorrhea, hypothyroidism

Elevated prolactin level

Depends

6

Ovarian failure: history? Labs? Therapy?

Hot flashes, hypoestrogenism

Elevated FSH and LH

Replacement hormones

7

Sheehan syndrome: history? Labs? Therapy?

Postpartum hemorrhage, unable to breast-feed

Low pituitary hormones

Replacement of pituitary hormones

8

Most cases of hypothyroidism (95%) are caused by?

In the US, the most common cause of hypothyroidism is?

Worldwide, the most common cause of enlarged thyroid hypothyroidism is?

Primary thyroid gland failure

Hashimoto thyroiditis>> Graves disease

Iodine deficiency

9

Myxedema?

Dull facies, swollen eyes, sparse hair, thickened tongue and doughy extremities (from the accumulation of hydrophilic polysaccharides)

10

Effect of hypothyroidism on the heart? Intestines? Reflexes?

Enlarged heart, intestinal obstruction, delayed relaxation phase of deep tendon reflexes

11

Way to estimate free T4?

One T4 and T3 uptake both are high patient is? When both are low patient is? If one is high and the other low?

T3 uptake (High T3 uptake means low T4 level)

Hyperthyroid, hypothyroid. Problem with binding proteins.

12

In mild cases when the TSH level is moderately elevated but the measured free T4 is within the normal range, how many of these patients progress to hypothyroidism within five years? These patients often have?

50%. Often have elevated total and LDL-cholesterol

13

Treatment of hypothyroidism? Half-life?

Once daily dose of synthetic levothyroxine. 6-7 days.

14

Dosing considerations with levothyroxine? (why?)

In older patients or those with cardiovascular disease, start a low-level dose (25 to 50) and increase once every 4 to 6 weeks

Rapid replacement can overwhelm the coronary or cardiac reserve

15

After treatment of hypothyroidism when is follow-up labs necessary?

6-8 weeks - when the TSH level readjusts

16

Hashimoto thyroiditis presents with?

Rubbery, nontender goiter

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