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What is Asherman's syndrome uterine scars from infection causing secondary Ammenorrhea
definition of primary amenorrhea in 16yo, 13yo? 13yo: no secondary sex changes at all. 16yo: normal secondary sex KKs
1st test in all cases of amenorrhea (primary AND secondary)? BhCG for pregancy
in amenorrhea, after you check for Uterus (once youve ruled out other causes like androgen secreting tumor, prolactinoma, etc), what do you do if uterus is 1)present 1) uterus+: serum BhCG/FSH= BhCG: pregant, low FSH: MRI brain for pituitary defect. high FSH: ovarian failure (check for 45XO). normal FSH: check TSH/Prolactin if haven't already.
in amenhorrea, you USG for uterus and it is NOT present. next step? testosterone levels + karyotype. 46XY= androgen insensitivity syndrome [remove testicles d/t cancer risk!]. 46XX/normal testosterone: Mullerian dysgenesis during fetal life
in secondary amenorrhea, if all tests are normal, how do you check if Asherman's is the cause? progesterone withdrawal test (normal=bleed)
3 d's of endometriosis? 3 modes of acquiring it? dyspyruenia, dysmenorrhea, dyschezia. Acquired through retrograde menses, vascularly, and surgically
Endometriosis Rx if pt wants kids? if pt doesnt want kids? wants kids: laproSCOPY (not laprotomy) + ablation. doesn't want kids: NSAIDs and OCPs or Hysterectomy if family is done/severe
Enlarged uterus + increased cycles w/ large volume of bleed fibroids
vag bleed after sex, no pain, normal uterus polyp
depression, constipation, abnormal uterine bleeding hypothyroid
MCC of infertility in women? endometriosis
underlying mechanism of PCOS? very high LH release, forming cysts of androgens
what CA risk with PCOS? endometrial CA, because androgens-->estrogen peripherally
1st line rx for PCOS weight loss (OCPs second)
Created by: jsad



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