Puberty and Menopause Flashcards

(30 cards)

1
Q

State 2 physiological events in puberty and what influences it

A

Gonadarche- HPO axis
Adrenarche- Adrenal glands

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2
Q

Describe what happens during gonadarche x4

A

Release of GnRH by hypothalamus> ant pituitary gland> FSH and LH release > gametogenesis and steroidogenesis in gonads

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3
Q

State the function of estradiol in puberty x2

A

Breast development
Skeletal growth

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4
Q

Which hormone causes cessation of linear growth and how

A

Estradiol by fusion of growth plates

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5
Q

Which part of the adrenal glands produces DHEA

A

Zona reticularis

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6
Q

Purpose of adrenarche x2

A

Induce pubic and axillary hair growth
Apocrine sweat gland maturation

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7
Q

What is the sequence of pubertal maturation x5

A

Growth spurt
Thelarche
Pubarche
Peak growth velocity
Menarche

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8
Q

Hormones that influence growth spurt x4

A

Estradiol
Progesterone
Growth hormone
Insulin like growth factor

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9
Q

What is thelarche and what hormone causes it

A

Appearance of breast tissues
Due to estradiol

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10
Q

Hormones responsible for pubarche x2

A

DHEA- dehydroepindrosterone
Androsterone

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11
Q

Two parts of the secondary mound of the breast

A

Areola and papilla

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12
Q

Why is menarche an anovulatory cycle

A

There is HPO immaturity, the small amounts of FSH and LH produced are not sufficient for follicle development but can influence endometrial cycle

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13
Q

Factors influencing puberty x3

A

Genetics
Social environment
General health and nutrition

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14
Q

What is classified as delayed or interrupted pregnancy x3

A
  1. Failure to develop secondary sex characteristics by age 13
  2. No menarche by age of 15
  3. Not attained menarche 5+ years since onset of puberty
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15
Q

Causes of delayed or interrupted puberty x3

A

Anatomical abnormalities
Hypergonadotropic hypogonadism
Hypogonadotropic hypogonadism

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16
Q

What causes the high levels of FSH in hypergonadotropic hypogonadism

A

Lack of suppression of ant pituitary gland by negative feedback from ovaries

17
Q

What is asynchronous puberty and its cause

A

Puberty that deviates from the normal pattern of puberty
Androgen insensitivity syndrome

18
Q

What is androgen insensitivity syndrome

A

X linked recessive disease with absence of androgen receptors > failure of normal masculinization

19
Q

Classification of precocious puberty x3

A

Central
Peripheral
Benign or non progressive pubertal variants

20
Q

What is benign pubertal variants and what causes it

A

Isolated thelarche or pubarche
Caused by early activation of hypothalamic pituitary adrenal axis

21
Q

Causes of precocious puberty x5

A

Ovarian cyst
Ovarian tumor
CNS lesions
Genetics
Exogenous sex androgens

22
Q

Management of precocious puberty

A

GnRH agonists eg leuprolide, triptorelin

23
Q

Define climacteric period

A

When a woman passes from reproductive to non reproductive stage.
From peri,meno, to post lasting 5 to 10 years

24
Q

What causes high FSH/LH in menopause x4

A

Depletion of oocytes > decreased estrogen and inhibin b > decreased negative feedback on pituitary > increase in FHS

25
Diagnostic criteria of menopause x4
Cessation of menses for 12 months Appearance of menopausal symptoms Low serum estradiol High serum FSH & LH
26
Management of menopause x3
Non hormonal- lifestyle modification Tibolone- reduces bone resorption Selective estrogen receptors modulators - treats osteoporosis
27
Contraindications of hormonal therapy in menopause x5
CHD Active liver disease Previous thromboembolic event Active endometrial cancer Hx of breast cancer
28
3 types of estrogen and when they are produced
E1 estron- produced by aromatisation i peripheral fat E2 estradiol- produced in ovary E3 estriol produced during pregnancy
29
MOA of tibolone in post menopausal women x3
Reduces osteoclastic activity and prevents bone resorption Also reduces vasomotor symptoms eg hot flushes
30
Contraindications for hormonal therapy in post menopausal women x5
Hx of CHD Breast cancer Endometrial Ca Thromboembolic event Acute liver disease