Term
| A cervical mucus sample that has an arborization pattern indicates...? |
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Definition
| The presence of estrogen (progesterone would inhibit it) |
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Term
| What does progesterone withdrawal bleeding indicate? |
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Definition
| Previous priming of the endometrium with estrogen |
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Term
| What are some ways to evaluate ovarian function? |
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Definition
| H&P; tests (BBT, cornification of the vagina, arborization of mucus, progesterone withdrawal bleeding, biopsy); LH and FSH levels; US; estradiol and progesterone levels |
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Term
What is the most common cause of primary amenorrhea? other causes? |
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Definition
| Gonadal dysgenesis (abnormal (45X) or normal genotype); obstruction, absence of uterus due to mullerian agenesis |
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Term
| Describe complete androgen resistence (testicular feminization). |
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Definition
| breasts but no pubic/axillary hair; high LH; testis; inherited X-linked recessive |
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Term
| What are some types of gonadal dysgenesis? |
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Definition
| Abnormal karyotype; normal karyotype with pure dysgenesis or with enzymatic defects (17 hydroxylase or 17,20 lyase def); male karyotype with 5 alpha reductase deficiency, vanishing testes, or absent testis determining factor |
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Term
| Premature ovarian failure refers to a woman who ceases menstruation prior to... |
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Definition
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Term
| What are some etiologies of primary ovarian failure? |
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Definition
| Irradiation or chemo; resistant ovary syndrome (FSH receptor mutations); autoimmune dz often associated with Addison's; karyotypic problems (loss of part of X) or idiopathic |
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Term
| What are hot flashes caused by and in what % of women do they occur? |
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Definition
| caused by vasomotor dysfunction; in 80-85% |
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Term
| Hot flashes may be more severe in women who... |
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Definition
... have sudden loss of ovarian function |
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Term
| What is the primary estrogen after menopause, and where is it produced? |
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Definition
| estrone made by adipose tissue |
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Term
| What are the four main etiologies of amenorrhea? |
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Definition
| Anatomical defects, primary ovarian failure (gonadal agenesis, gonadal dysgenesis, premature ovarian failure, menopause); chronic anovulation with estrogen present (PCOS, tumors, adrenal and thyroid dz) and chronic anovulation with estrogen absent (HT tumors, pituitary tumors) |
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Term
| What is the risk of bone loss after menopause? |
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Definition
| 1-2%/year with 20-30% lifetime risk of hip fracture |
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Term
| What are some examples of chronic amenorrhea with estrogen present? |
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Definition
| Hyper or hypothyroid; PCOS; Adrenal dz (Cushing's and adult onset CAH); ovarian tumors |
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Term
| What characterizes chronic anovulation with estrogen absent? |
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Definition
| Gonadotropin levels will be low or normal, and estrogen levels will be low |
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Term
| What characterizes anorexia nervosa? |
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Definition
| It causes hypothalamic dysfunction to lead to amenorrhea; LH is high but FSH normal; T3 may be low; cortisol levels normal in morning but loss of diurnal variation; GH high |
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Term
| ? is present in 20% of patients with amenorrhea |
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Definition
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Term
| What is empty sella syndrome? |
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Definition
| Often in multiparous women with a defect in diaphargma sella; CSF flattens pituitary |
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Term
| What is Sheehan's syndrome? |
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Definition
| Hemorrhage or infarct of pituitary following childbirth that often presents with failure of lactation and failure to resume menses |
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Term
| Androgens are secreted by ? cells of the ovary. |
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Definition
| Stromal, thecal, and granulosa cells; DHEA is made only by adrenals though |
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Term
| What % of testosterone is free? |
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Definition
|
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Term
| Which binds more tightly to SHBG -- DHT or T? |
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Definition
| DHT (levels are less than 10% that of T) |
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Term
| What enzyme is found in hair follicles and sebaceous glands? |
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Definition
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Term
| What is the difference in prevalence of hirsutism and virilization? |
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Definition
| Hirsutism is found in 30% of young white females (90% have hyperandrogenism); virilization is rare. |
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Term
| What are the different grades of hirsutism? |
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Definition
mild: fine pigmented hair over extremities and face moderate: coarse pigmented hair over these areas severe: coarse hair even on ears, nose, deep voice, clitoral enlargement |
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Term
| A serum testosterone level of >200 suggests... |
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Definition
| ...adenocarcinoma of the ovary (very rare) |
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Term
| A DHEA of >700 suggests... |
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Definition
| Adenocarcinoma of the adrenals |
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Term
What does hyperthecosis cause? |
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Definition
| this is a non-malignant ovarian disorder characterized by increased testosterone. |
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Term
| How can insulin resistance cause hirsutism or virilence? |
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Definition
| high levels of insulin can work through IGF-1 receptors in the ovary to increase androgen production |
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