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Flashcards in Ovulatory Disorders Deck (47):
1

what is oligmenorrhea?

cycles > 35 days

2

what is amenorrhea

no menstruation

3

what does GnRH do?

stimulate FSH and LH synthesis and release

4

what does FSH do?

follicular development
thickens endometrium

5

what does LH do?

stimulate ovulation
stimulate corpus luteum development
thickens endometrium

6

when does estradiol peak?

before ovulation

7

when does progesterone peak?

after ovulation

8

what does oestrogen do?

thickens endometrium
makes fertile cervical mucus

9

what does progesterone do?

makes infertile thick mucus
maintains endometrium thickness
increases basal body temp
relaxes smooth muscles

10

how can you confirm regular cycles?

midluteal serum progesterone (should be >30nmol/L) take 2 samples

11

group 1 WHO classification ovulatory disorders

hypothalamic pituitary failure

12

what type of ovulatory disorder is hypogonadotrophic hypogonadism

hypothalamic pituitary failure (group 1)

13

is there oestrogen deficiancy in hypogonadotrophic hypogonadism and low FSH and LH?

yes

14

what can cause hypogonadotrophic hypogonadism?

stress
too much exercise
anorexia
brain/pituitary tumours
head trauma
kallmans syndrome
drugs-steroid, opitaes

15

how can you manage hypogonadotrophic hypogonadism?

stabalise weight

gonadotrophin (FSH and LH) daily injections -needs Ultrasound monitoring

16

group 2 WHO classification ovulatory disorders

Hypothalamic pituitary dysfunction

17

what type of disorders account for most (85%) of ovulatory disorders?

Hypothalamic pituitary dysfunction

18

what is the main/ most common Hypothalamic pituitary dysfunction?

PCOS

19

is insulin resistance seen in PCOS?

YES- in 50-80% of cases

20

what is the first line treatment for ovulation induction in PCOS?

clomifene citrate

this can also be taken with metformin to improve insulin resistance

21

second treatment of ovulation induction in PCOS?

gonadotrophin injections (daily)

22

last resort treatment for ovulation induction in PCOS?

laparoscopic ovarian diatherny

23

risk of ovulation induction

multiple pregancy
ovarian hyperstimulation
ovary destruction

24

risk of multiple pregnancy

increase maternal complications
increase miscarriage
increase low birth weight
increase prmaturity
increase disability
increase still birth

twin twin transfusion syndrome

25

lambda sign on USS

dichorionic

26

T sign on USS

monochorionic

27

what causes twin twin transfusion syndrome?

unbalanced vascular communications within placental bed- recipient gets more stuff so gets bigger, grows better and the donor has growth restriction

28

long term disabilities due to prematurity?

cerebral palsy
impaired eye sight
congenital heart disease

struggle with language development

29

medical treatment for hyperprolactinaemia?

dopamine agonist

30

group 2 WHO classification ovulatory disorders

ovarian failure

31

menopause before 40

premature ovarian failure

32

how do you treat premature ovarian failure?

hormone replacement

33

in the progesterone challenge test, if you bleed within 5 day course of progesterone what does this mean|?

oestrogen levels are normal

34

what is primary amenorrhea?

failure of menarche by age 16

35

what is secondary amenorrhea?

cessation of periods >6 months in an individual who previously menstruated

36

what can cause functional hypothalamic amenorrhea?

iatrogenic
weight change
stress
exercise
anabolic steroid
systemic illness
infiltrative disorders e.g sarcoidosis
head trauma
recreational drugs

37

what hormones should be checked in someone with oligo/amenorrhea?

LH
FSH
Oestradial
thyroid function tests
prolactin
testosterrone if hairy/acne

38

difference between primary and secondary hypogondism?

primary- problem with ovaries, high FSH/LH e.g premature ovarian failure

secondary-problem with hypo/pit. low FSH/LH e.g high prolactin/hypopituitarism

39

what happens in kallmans syndrome?

loss of GnRH secretion and ansmia or hyposmia

40

common causes of hyperprolactinemia?

prolactinomas
drugs
hypothyroidism
idiopathic

41

what is hirsutism?

excess hair, females usually get it

42

short stature
webbed neck
shield chest, wide spaced nipples
XO chromosome

turners syndrome

43

difference between primary and secondary male hypogonadism?

primary- low testosterone with high LH and FSH

secondary- low testosterone and low LH and FSH
usually pituitary/hypo disease

44

what is the most common cause of male hypogonadism?

Klinefelters syndrome

45

reduced testicular volume
gynaecomastia
eunuchoidism

low testosterone, high LH and FSH

Klinefleters syndrome

46

health benefits of testosterone therapy?

improved sex function
improved bone health
decrease fat mass
increase muscle strength
small improvement in insulin sensitivity

47

causes of gynaecomastia?

drugs
physiological
hypogonadism
tumours
endocrine disorders
systemic illness
hereditary