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GU Survey > Test 1 > Flashcards

Test 1 Flashcards

1
Q

Amenorrhea

A

Absence or abnormal cessation of the menses for more than 3 months

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2
Q

Oligomenorrhea

A

Scanty menstruation; menstrual periods occur at intervals of greater than 35 days, with only 4-9 periods in a year.

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3
Q

Polymenorrhea

A

Occurrence of menstrual cycles of greater than usual frequency.

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4
Q

Menorrhagia

A

Excessively prolonged or profuse menses

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5
Q

Metrorrhagia

A

Any irregular, acyclic bleeding from the uterus between periods

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6
Q

Menometrorrhagia:

A

Irregular or excessive bleeding during menstruation and between menstrual periods

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7
Q

Dysmenorrhea

A

Painful menses

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8
Q

Mittelschmerz

A

One sided lower abdominal pain that occurs in women at or around the time of ovulation

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9
Q

Tool for: Magnification and viewing of cervix, vulva, vagina, and perianal

A

Colposcopy

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10
Q

Indication for Endometrial Biopsy (EMB)=

A

Abnormal vaginal bleeding

Postmenopausal bleeding

Fertility Issues

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11
Q

Waht does a Hysteroscopy view?

A

Direct Intrauterine viewing (camera through cervix)

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12
Q

What are indications for Hysteroscopy?

A

Abnormal bleeding

Intrauterine Mass (fibroid/CA)

Pelvic Pain

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13
Q

What is a hysterosalpingogram?

A

Radiopaque dye outlines interior of uterus and fallopian tubes.

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14
Q

Indications for Laparoscopy?

A

Pelvic masses-uterus, ovaries, tibes

Pelvic pain PID, endometriosis, fibroids

Fertility issues

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15
Q

What is a Laparotomy?

When is it used?

A

Open abdominal surgery

Hysterectomy, Pelvic cancers, Pelvic masses, C-section.

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16
Q

When is are of menarche?

A

12-13

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17
Q

% of women with infertility=

A

20%

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18
Q

What does normal menses require?

A

Normal hypothalamic pituitary ovarian (HPO axis)

Responsive Endometrium

Unobstructed outflow tract

19
Q

Effects of Estrogen

A 
Endometrial proliferation
Myometrial cell growth
Vaginal cornification
Reduced vaginal pH
Increased cervical mucus
20
Q

Estrogen in excess Sx

A 
Dysmenorrhea
Nausea
Edema
Enlarged uterus
Fibroids
Fibrocystic Breasts
Menorrhagia
21
Q

Estrogen Deficiency Sx

A

Scant menses

Mid cycle spotting

22
Q

Progesterone effects

A 
Endometrial secretory changes
Decrease pH of cervical mucus
Help maintain pregnancy
Breast, uterine, tubal mm activity
Thermogenic effects
23
Q

Progesterone in excess Sxs

A 
Edema
Bloating
Headache
Depression
Weight gain
Fatigue
Hypertension
Vericose Veins
(Sxs of pregnancy)
24
Q

Progesterone Deficiency Sxs

A

Prolonged menses
Heavy menses
Severe cramps
Luteal spotting

25
Q

Normal cycle length=

Flow=

Amount=

A

Cycle=21-45 days

Flow= 7 days (3-5 ave)

Amount= 80ml (16tsp)

26
Q

Estradiol is highest in what phase?

Progesterone is highest in what phase?

A

Estrogen= Follicular

Progesterone= Luteal

27
Q

Causes of primary amenorrhea (0.3% prevalence)

A

-CNS hypothalamic pituitary disorder
-Membranous blockage of vagina (hyman)
-Drastic weight loss/malnutrition
-Hypoglycemia
-Extreme obesity
-Thyroid disease
-Anemia
Congenital

28
Q

Causes of Secondary Amenorrhea

A
  • Pregnancy
  • Weight reduction/gain
  • Stress/depression
  • Hypothyroidism
  • PCOS
  • Obesity
  • Increased prolactin (inhibit GnRH)
  • Early menopause
  • Drugs
29
Q

Medications that may cause Amenorrhea

A 
Hormonal contraception
Antipsychotics
Antidepressants
Cardiovascular meds
Marijuana
30
Q

Risks of long term amenorrhea:

If Hypoestrogenic Amenorrhea=

If Hyperestrogenic Amenorrhea=

A

Hypo=
- Bone mineral density loss

Hyper=

  • Abnormal lipid levels
  • DM
  • Obesity
  • Breast Cancer
31
Q

Initial labs to check diagnose reason for amenorrhea=

A

B-hCG (Pregnancy)
TSH (Thyroid)
PRL (Inhibits GnRH)
Estrogen/ Progesterone challenge test

32
Q

HPO axis and Amenorrhea:

If FSH >30 or LH>40=

If >45y=

If <40yo=

Low FSH/LH=

A

If FSH >30 or LH>40= ovarian failure

If >45y= menopause

If <40yo= premature ovarian failure

Low FSH/LH= pituitary or hypothalamic dysfunction

33
Q

Exercise induced Amenorrhea can be cause by:

A

Body fat <15-18%

BMI <18

Nutritional deficient state: energy output exceeds input. Exercise alone does not lead to amenorrhea

34
Q

Causes of Premature Ovarian Failure (early menopause <40)

A 
Autoimune
Chemo/radiation
Family Hx
Surgical removal/damage
Chromosomal (fragile X/Turners)
35
Q

Management of Premature Ovarian Failure (estrogen deficiency symptoms)

A

1) Hormone Replacement
2) SSRIs
3) Botanicals (black cohosh, red clover)
4) Diet, Exercise, Stress Mgmt

36
Q

What diseases do you need to watch out for with Premature Ovarian Failure Management?

A

Osteoporosis
- DEXA, Cal/mag/D, Exercise, Meds

CAD
- Monitor BP, Lipids

Estrogen Deficiency
- Vaginal Atrophy, Libido, Insomnia, mood swings

37
Q

What diseases do you need to watch out for with Premature Ovarian Failure Management?

A

Osteoporosis
- DEXA, Cal/mag/D, Exercise, Meds

CAD
- Monitor BP, Lipids

Estrogen Deficiency
- Vaginal Atrophy, Libido, Insomnia, mood swings

38
Q

3 criteria for PCOS

A

1) Oligo-menorrhea
2) Hyperandrogenism
3) Exclusion of other disorder
* Polycystic varies are NOT required for diagnosis*

39
Q

What % of women have full blown clinical picture of PCOS?

What is full blow?

A

1/3

Amenorrhea (50%)
Hirsutism (50%)
Obesity (40%)
Infertility (20%)

40
Q

What do woment with PCOS usually seek medical care for?

A 
Menstrual cycle Irregularities &amp; infertility
Metabolic issues:
- Hypoglycemia
- Insulin resistance
- Hyperlipidemia
-Hypertension
41
Q

PCOS increases your risk for what 4 diseases?

A

Infertility
DM
CVD
Endometrial cancer

42
Q

Making the diagnosis of PCOS.

Symptoms=
Tests=

A

Symptoms= hirsutism, anovulation, irregular menses

Tests= Free testosterone/DHEA, & Fasting glucose/insulin

Pelvic ultrasound NOT NECESSARY

43
Q

How do you manage PCOS?

A

Treat disease and symptoms associated with it.

  • Insulin resistance
  • Androgen excess
  • Fertility
  • Diabetes, cancer, CVD, obesity.
44
Q

Treating PCOS

Meds=

Supplements=

Lifestyle=

A

Meds=

  • Progesterone for E:P
  • Spironolocatone for androgens
  • Metformin for BS

Supplements=
-SHBH (soy, flax, nettles, green tea)
-Decrease androgens: Saw palmetto, green tea
- Improve Insulin Resistance: Vit C, Chromium
Increase Ovulation: Vitex, Rhodiola

Lifestyle=

  • High protein, low carm, low bad fats.
  • EXERCISE

GU Survey (1 decks)

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