Term
| differential for hirsutism (5) |
|
Definition
| idiopathic, PCOS, Cushing's, CAH, neoplasm |
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Term
| pt presents with amenorrhea and galactorrhea; dx? workup? tx? |
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Definition
| prolactinoma. image sella. tx: surgery or bromocriptine |
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|
Term
| pt presents with amenorrhea and elevated TSH; dx? workup? |
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Definition
|
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Term
| pt presents with amenorrhea. pregnancy test is negative. TSH and PRL are normal. next step? |
|
Definition
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|
Term
| pt with amenorrhea, negative pregnancy test, normal TSH and PRL bleeds after progestin test. differential dx? |
|
Definition
| anovulation due to central disease (hypothalamic dysfunction, Kallman's, hypopituitarism), peripheral disease (PCOS, elevated SHBG, adrenal defect), or neoplasm |
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Term
| pt presents with amenorrhea, negative pregnancy test, normal TSH and LH, and no bleeding in response to progestin. next step? |
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Definition
| estrogen and progesterone challenge |
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Term
| pt is worked up for amenorrhea that is unresponsive to progestin or estrogen/progesterone challenges; differential dx? |
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Definition
| unresponsive uterus or defect in outflow tract |
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Term
| pt with amenorrhea bleeds when given estrogen/progesterone challenge but not progestin challenge. next step? |
|
Definition
|
|
Term
| pt with amenorrhea presents with low FSH/LH, low estrogen/progesterone; dx? |
|
Definition
|
|
Term
| 35yo pt with amenorrhea presents with high FSH/LH, low estrogen/progesterone; dx? workup? |
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Definition
| ovarian failure; must karyotype and image for malignant testicular tissue |
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|
Term
| androgen, estrogen, FSH/LH levels in androgen insensitivity |
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Definition
| high androgen, normal estrogen, low FSH/LH |
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|
Term
| estrogen and FSH/LH levels in premature ovarian failure |
|
Definition
| low estrogen, high FSH/LH |
|
|
Term
| etiologies of premature ovarian failure (3) |
|
Definition
| autoimmune, 17a-hydroxylase deficiency, Turner's |
|
|
Term
| what workup must you do for a <40yo female with premature ovarian failure? |
|
Definition
| karyotype, image for malignant testicular tissue |
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|
Term
1. viable oocytes in...
2. non viable oocytes in... |
|
Definition
1. chronic anovulation
2. premature ovarian failure |
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|
Term
| pathogenesis of PCOS, starting with LH |
|
Definition
| excess LH -> excess androgens -| FSH -> androgens are not aromatized into estradiol in ovaries; androgens are aromatized into estradiol in fat -> excess LH -> excess androgens |
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|
Term
| androgen, estrogen, FSH/LH levels in PCOS |
|
Definition
| high androgens, normal estrogens, low FSH, high LH |
|
|
Term
|
Definition
| chronic GnRH, birth control pills, clomiphene, diet |
|
|
Term
| how does insulin exacerbate PCOS? |
|
Definition
| insulin increases testosterone and LH production |
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|
Term
| clinical presentation of Kallman's syndrome |
|
Definition
| no GnRH, anosmia, midline defects, color blindness, eunuchoidal proportions |
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|
Term
| most common cause of amenorrhea after pregnancy |
|
Definition
|
|
Term
|
Definition
| 1. no menses for >3mo in a female who has had menses OR 2. female who has not initiated menses by 16yo |
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|
Term
|
Definition
| mood liability, breast tenderness; >90% sensitive for ovulation |
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|
Term
|
Definition
| female of age that has not had menses for 6-12mo |
|
|
Term
| after implantation, __1__ supports the corpus luteum; corpus luteum produces __2__ to support the endometrium |
|
Definition
| HCG supports corpus luteum; progesterone/estradiol supports endometrium |
|
|
Term
| what causes bleeding in menses? |
|
Definition
| decreased progesterone levels -> arterioles spasm -> endometrium becomes ischemic, necrotic, and sheds |
|
|
Term
| what supports the corpus luteum after ovulation? after implantation? |
|
Definition
|
|
Term
theca cells respond to ___ and produce ___.
granulosa cells respond to ___ and produce ___. |
|
Definition
theca : LH : androstenedione
granulosa : FSH : estradiol |
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