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thirteenone
13-1
Question | Answer |
---|---|
What ages does precocious puberty occur in males and females? | precocious puberty is defined as <9yo in males, <8yo in females |
difference btwn true and pseudo-precocious puberty in females | true: early activation of pituitary, etc (raised GnRH, FSH, LH). pseudo: autonomous secretion of sex hormones peripherally |
MCC of precocious puberty in males v females | males: adrenal hyperplasia. females: true (pituitary axis activation) |
LH/FSH raised in precocious puberty implies... | central (true) precocious puberty |
low LH/FSH in precocious puberty implies.... | pseudo-precocious (i.e. peripheral sex hormone release) |
Rx of true vs psuedo-precocious puberty? | true= GnRH steady stream (induce menopause). pseudo= surgical removal of source [no treatment if near puberty] |
CAH treatment | cortisol replacement |
Fixed phase of menstrual cycle? | luteal (2nd half...14days) |
mid-cycle pain (not at time of menstruation...rather, about 2 weeks after) | Middlesmurtz...normal peritoneal irritation |
ovarian estrogen is called? placental? | estradiol. placental= |
hCG is secreted by what structure after implantation? What is it's purpose? | from endometrium...purpose is to simulate LH, therefore maintaining corpus luteum..which secretes progesterone |
Corpus luteum secretes what hormone? When does it stop | progesterone (under stimulation of hCG from endometrium)....after 8-12 weeks it stops and placenta takes over |
paradoxical cardiac affect of HRT in menopause? | it improves lipids, but still causes increased cardiac and stroke risk |
menopause stress incontinence treatment? | kegels + estrogen cream |
Rx of hot flashes in menopause? | SNRIs, clonidine (a2 agonist), GABAs. NO ESTROGENS IF BREAST CA RISK |
OCP affect on endometrial ca risk vs ovarian ca risk? | endometrial risk goes UP (due to increased estrogen). Ovaran ca risk goes down (due to no ovulation) |
OCP is c/i in what patients | smokers >35yo, DUB, migraine, liver dz, HTN, DVT history |
best contraceptive during breast feeding? | progestin only. Must take at same time everyday |
What is the 3m injection you use in mentally retarded pt's who need contraception | medroxyprogesterone injxn |
Emergency contraception options? | OCP x5, levoprogestrol (progestin) up to 120h after, copper IUD, Mifepristone (RU-486) |
What has a higher DVT risk than OCP? | the Patch |