Ovulation Disorders Flashcards Preview

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Flashcards in Ovulation Disorders Deck (26):
1

Oligomenorrhea.

Reduction in frequency of periods to >9 a year (cycles >35 days)

2

Primary amenorrhea.

Failure of menarche by the age of 16 years

3

Secondary amenorrhea.

Cessation fo periods for >6 months in an individual who has previously menstruated

4

What are the physiolgical causes of amenorrhea?

Pregancy or post-menopausal

5

Give the causes of primary amenorrhea?

Congenital problems:
Turner's syndrome
Kallman's syndrome

6

What can cause seconary amenorrhea?

Ovarian problem
Uterine problem
Hypothalamic dysfunction

7

What should be looked at in someone who presents with amenorrhea?

Body shape - Turner's
Visual fields
Ansomia - Kallman's
Breast development
Hirsuitism - PCOS
Acne - PCOS
Galactorrhoea - hypopituitarism/ pituitary tumour

8

What symptoms are suggestive of oestrogen deficiency?

Flushing
Libido
Dyspareunia

9

What investigations do all that present with oligo/amenorrhea undergo?

LH
FSH
Oestradiol
TFT's
Prolactin

10

What additional investigations can be used to determine the cause of oligo/amenorrhea?

Ovarian US +/- endometrial thickness
Testosterone - if hirsuitism
Pituitary funtion tests and MRI pituitary - if hpituitary problem suspected
Karyotype - Turner's syndrome

11

In terms of LH/FSH how does primary hypogonadism preset and what can cause it?

High LH/FSH - hypergonatrophic hypogonadism
Premature ovarian failure

12

In terms of LH/FSH how does secondary hypogonadism preset and what can cause it?

Low/ normal LH/FSH and low oestradiol
Problem with hypothalamus or pituitary

13

What are the signs of premature ovarian failure?

Secondary amenorrhea
Oestrogen deficiency
Elevated gonadotrophins occurring < 40 years of age

14

How is premature ovarian failure diagnosed?

FSH 430 on 2 separate occasions >1 month apart

15

What can cause premature ovarian failure?

Chromosomal abnormalities (e.g. Turner’s syndrome, Fragile X)
Gene mutations (e.g. FSH receptor/LH receptor)
Autoimmune disease (e.g. association with Addison’s, thyroid, APS1/2)
Iatrogenic (radiotherapy/chemotherapy)

16

What is secondary hypogonadism?

Hypogonadism as a result of hypothalamic or pituitary disease

17

What can cause secondary hypogonadism?

Hypothalamic problem (Functional hypothalamic disorders, Kallman’s syndrome, Idiopathic hypogonadotrophic hypogonadism (IHH), Pituitary problems)
Pituitary problems
Prader-Villi
Haemochromatosis

18

Give causes of functional hypothalamic amenorrhea?

Anabolic steroids
Systemic illness
Iatrogenic (surgery/radiotherapy)
Recreational drugs
Head Trauma
Infiltrative disorders e.g sarcoidosis

19

What is Kallman's syndrome?

A genetic disorder characterised by a loss of GnRH secretion +/- anosmia

20

How does pituitary dysfunction present in terms of LH/FSH?

Loss of LH/FSH stimulation leads to low or low normal LH/FSH and low oestradiol

21

What is the most common cause of hirsutism?

PCOS

22

What is Turner's syndrome?

Women with Turner syndrome are XO

23

To diagnose PCOS, the Rotterdam criteria is used. What is it?

At least 2 of:
Menstrual irregularity
Hyperandrogenism (hirsutism, elevated free testosterone)
Polycystic ovaries

24

What cases Hirsuitism?

Due to excess circulating androgencausing increased peripheral conversion at the hair follicle

25

Give some clinical features of Turner's syndrome?

Short stature
Webbed neck
Shield chest with wide spaced nipples
Low hairline
Underdeveloped breasts
Lymphoedema

26

What is Congenital Adrenal Hyperplasia?

an inherited group of disorders characterized by a deficiency in one of the enzymes necessary for cortisol synthesis