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| Question | Answer |
|---|---|
| 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) |