primary amenorrhea

Question 1

Primary amenorrhea diagnosis is the absence of menses in which girls ?

Answer 1

*The age of 13 without
secondary sexual
characteristics .

or

• The age of 15 with
  secondary sexual
  characteristics

Question 2

Secondary amenorrhea

Answer 2

when a woman who already menstruates does
not get her period for
3-6 months or more

Question 3

Hypogonadotropic
Hypogonadism

Answer 3

Hypothalamic dysfunction results
in decreased or inhibited GnRH
secretion, which affects the
pulsatile release of pituitary
gonadotropins, LH and FSH,
causing anovulation

**low( FSH,LH,estrogen progesterone )

Question 4

leading causes for Hypogonadotropic
Hypogonadism which lead to amenorrhea

Answer 4

*eating disorders ( anorexia nervosa )
*severe exercise/high levels of prolonged physical
or mental stress.
*CONGENITAL GnRH DEFICIENCY(kallman syndrom)

Question 5

ovarian causes of amenorrhea

Answer 5

*Hypergonadotropic Hypogonadism(high FSH , low estrogen)
*Gonadal dysgenesis ( failure)(turner,swyer syndrome)
*primary ovarian insufficiency

Question 6

Gonadal dysgenesis ( failure)

Answer 6

• In females, the most common form of gonadal dysgenesis is Turner syndrome (45,XO)
• is characterized by the congenital loss of germ
  cells within the gonad during organogenesis.
  The gonads usually contain only fibrous tissue
  and are called streak gonads

Question 7

turner syndrome clinical features

Answer 7

*short stature
*webbed neck
*coarctation of aorta ,bicuspid aortic valve
*horseshoe kidney
*streak ovaries,amenorrhea ,infertility
*wide spaced nipples
*low ewar set
*cubitus valgus

Question 8

gonadal dysgenesis (46,x,y) ?

Answer 8

swyer syndrome

Question 9

gonadal dysgenesis (46,x,x)

Answer 9

female with gonadal dysgenesis

Question 10

gonadal dysgenesis (45x,0)

Answer 10

turner syndrome

Question 11

primary ovarian insufficiency definition

Answer 11

*spontaneous premature failure of ovaries
of normal female 46 XX
*premature menopause

Question 12

primary ovarian insufficiency causes

Answer 12

FRAGILE X.
IRRADIATION.
AUTOIMMUNE.
GALACTOSEMIA.

Question 13

Swyer syndrome

Answer 13

(testicular regression syndrome): 46,XY karyotype but with
mutations of the SRY gene (no testes )and no anti-müllerian hormone
( AMH), thereby resulting in a female phenotype, but no gonads

characterized by :
tall stature, small uterus,no sexual characteristics ,no ovaries

Question 14

amenorrhea caused by -Congenital and anatomical
abnormalities examples :

Answer 14

1) Outflow obstruction&raquo_space; Cyclic pelvic pain
Examples:
o Imperforate hymen (hematocolpos)
o Transverse vaginal septum
o Vaginal agenesis

2) * Müllerian dysgenesis (also known as Mayer-Rokitansky-Kuster
Hauser [MRKH] syndrome)

Question 15

müllerian duct is origin of

Answer 15

fallopian tube ,uterus,cervix,upper third of vagina

Question 16

-enzyme defects as cause of amenorrhea ?

Answer 16

1)Congenital adrenal hyperplasia CAH :deficiency in 21-hydroxylase enzyme
* A defect in 21 hydroxylase leads accumulation of 17
hydroxyprpgestrone
* This leads to virilization
* Is the most common cause of ambiguous genitalia
2)Complete androgen insensitivity syndrome is caused by a defective androgen receptor.
Although patients with this syndrome have a
46,XY karyotype and produce testicularly
derived testosterone, but no receptors for
testosterone, so grow like female