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gyn-menstrual disord
| Question | Answer |
|---|---|
| MC cause of ovarian insufficiency | Turner Syndrome (single X). sx: underdeveloped breasts, shield chest, genital hypoplasia, webbed neck, cardio abnormalities, short stature |
| failure of the uterus, fallopian tubes and vagina to develop | Mullerian agenesis |
| MC common cause for 2ndary amenorrhea | pregnancy! |
| female athlete triad | insufficient caloric intake, amenorrhea, and low bone density or osteoporosis |
| hyperprolactinemia can be a SE of what? (3) | many dopamine-lowering meds, pituitary tumor or hypothyroidism |
| in a pt w/ 2nd amenorrhea (and - preg test and med review) order _____ and _____ levels as an initial work up | TSH and prolactin |
| if prolactin is high, order_______ | MRI of sella turcica |
| premature ovarian failure can be associated with? (4) | radiation, chemo, infx, autoimmune process |
| should pts w/ premature ovarian failure be considered infertile? | NO! |
| FSH values of _______ on 2 occasions confirms ovarian failure | FSH >40 IU/mL |
| pts w/ POF should be tx with _______ until normal age of menopause to reduce risk of _______ and _________ | hormones; osteoporosis and heart dz |
| PCOS is a multifactorial disorder that usually includes ________ | hyperandrogenism |
| what are the Rotterdam Criteria? | for PCOS (must have 2 of 3): clinical OR lab hyperandrogenism, oligo-ovulation or anovulation, polycystic ovaries |
| how do you test for lab hyperandrogenism? | total testosterone >50 ng/mL (but if >200 ng/mL it suggests an androgen secreting tumor) |
| other common findings in pts w/ PCOS | obesity, central adiposity, insulin resistance, acanthosis nigricans, skin tags, abnormal LH:FSH ratio where the LH is 2-3x the FSH |
| pts w/ PCOS are at higher risk for what? (4) | T2DM, atherosclerosis, dyslipidemia, and cardiovascular dz |
| ______ is a common cause of infertility | PCOS |
| tx of PCOS? | 1st line: weight loss and exercise, OCPs, Metformin, spironolactone (hirsutism) |
| pts w/ PCOS should be screened for _____ and ______ | dyslipidemia and diabetes |
| 4 causes for secondary amenorrhea | PCOS, hyperprolactinemia, hypothalamic dysfunction, premature ovarian failure |
| ______ and ______ are effective tx for PMS and PDD | SSRIs and SNRIs |
| causes for menorrhagia (5) | fibroids, adenomyosis, endometrial hyperplasia, von Willebrand dz, thrombocytopenia |
| spotting (metrorrhagia) can be caused by? (3) | cervical polyps, cervical CA, infection |
| causes of AUB w/ anovulatory pattern (7) | PCOS, thyroid dysfunction, hyperprolactinemia or med, uncontrolled DM, hypothalamic dysfunction/athlete triad, first 1-2 yrs after menarche or perimenopause, pregnancy |
| causes of AUB w/ ovulatory pattern (5) | thyroid dysfunction, coag defects/bleeding disorder, fibroids, polyps, advanced liver disease |
| first 3 tests ordered for AUB? | pregnancy, TSH, prolactin level |
| if the etiology of AUB can't be determined, pt has _________ | DUB (dysfunctional uterine bleeding) |
| primary tx for anovulatory DUB | hormonal therapy |
| occurs when simple proliferation advances to abnormal proliferation that involves glandular and stromal elements of the endometrium | endometrial hyperplasia |
| endometrial hyperplasia is caused by continuous exposure to endogenous or exogenous ________ stimulation in the absence of ________ | estrogen, progesterone |
| endogenous and exogenous source of estrogen? | endogenous: obese women (commonly seen in PCOS) exogenous: HRT w/o progesterone |
| additional RF of endometrial hyperplasia? | HTN and DM |
| which histologic variation has the highest and lowest chance of progressing to CA? | highest=atypical complex hyperplasia lowest: simple hyperplasia |
| US can be utilized to evaluate _______ ______ | endometrial stripe (<4mm in postmenopausal women) |
| test of CHOICE in endometrial hyperplasia | endometrial biopsy |
| tx of endometrial hyperplasia | hysterectomy (atypical complex hyperplasia) REFER ALL ATYPICAL PTS, progestin therapy (but relapse is common in atypical types after therapy stops), D&C (pts w/o atypical changes) |
| who should be evaluated for endometrial hyperplasia or CA? (4) | >45yo w/ AUB, <45yo w/ AUB, anovulation and obesity, pts who fail to respond to med tx for AUB, certain findings on Pap |
| endometrial CA has a ______ prognosis | good! |
| endometrial CA mostly occurs in _______ women | postmenopausal |
| Type 1 endometrial CA is usually related to prolonged exposure to _______ w/o _______ | estrogen, progesterone |
| Type 2 endometrial CA are not preceded by _______ ________ and have a ______ prognosis than Type 1 | endometrial hyperplasia, worse! |
| gold standard for dxing endometrial CA? | endometrial biopsy |
| tx for endometrial CA? | total abd hysterectomy and bilateral salpingo-oophorectomy |
| f/u time for endometrial CA? | every 3-6months for 2yrs, then annually after that |
| what does staging and grading mean? | stage I-IV describes extend of CA spread. Grade describes the % of tumor that is solid |
| most common finding of endometrial CA? prognosis? | adenocarcinoma, positive prognosis |
Created by:
rjerome09
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