PRIMARY AND SECONDARY AMENORRHEA (based on PDF uploaded) Flashcards
(51 cards)
What are the two criteria that define primary amenorrhea?
“Absence of menses by age 15 with normal secondary sexual characteristics or absence of secondary sexual characteristics by age 13.”
At what age is the absence of secondary sexual characteristics concerning for primary amenorrhea?
“Age 13.”
At what age is the absence of menstruation concerning for primary amenorrhea if secondary sexual characteristics are normal?
“Age 15.”
What syndrome is most commonly associated with gonadal dysgenesis causing primary amenorrhea?
“Turner syndrome (45 XO).”
What is the classic karyotype of Turner syndrome?
“45 XO.”
What physical features are seen in Turner syndrome?
“Short stature. webbed neck. shield chest. widely spaced nipples. lymphedema.”
Why does Turner syndrome cause primary amenorrhea?
“Due to streak ovaries and estrogen deficiency.”
What is the first investigation to perform for secondary amenorrhea?
“Pregnancy test.”
Name two hormonal tests ordered after a negative pregnancy test in secondary amenorrhea.
“TSH and prolactin levels.”
Which hormone level helps assess ovarian function in secondary amenorrhea?
“FSH.”
What does high FSH in secondary amenorrhea suggest?
“Primary ovarian failure.”
What does low FSH in secondary amenorrhea suggest?
“Central (hypothalamic or pituitary) dysfunction.”
What is an imperforate hymen?
“Congenital obstruction of the vaginal opening by an unperforated hymen.”
How does imperforate hymen present clinically?
“Primary amenorrhea with cyclic pelvic pain and bulging bluish vaginal mass.”
What imaging modality can confirm imperforate hymen?
“Pelvic ultrasound.”
What is the treatment of an imperforate hymen?
“Surgical incision of the hymen (hymenotomy).”
What is a transverse vaginal septum?
“Congenital membrane within the vagina obstructing menstrual flow.”
What are symptoms of transverse vaginal septum?
“Primary amenorrhea with cyclic pelvic pain and no visible outflow obstruction.”
How do you diagnose a transverse vaginal septum?
“MRI pelvis or ultrasound.”
What is the treatment for a transverse vaginal septum?
“Surgical excision of the septum.”
What syndrome causes absence of uterus with normal breasts and external female genitalia?
“Müllerian agenesis (Mayer-Rokitansky-Küster-Hauser syndrome).”
What is the karyotype in Müllerian agenesis?
“46 XX.”
Do patients with Müllerian agenesis have normal ovarian function?
“Yes. normal ovarian function and hormone levels.”
What is the difference in pubic hair between Müllerian agenesis and androgen insensitivity syndrome?
“Müllerian agenesis has normal pubic hair; androgen insensitivity syndrome has scant or absent pubic hair.”
