2: Ovulatory disorders (gynae) Flashcards Preview

Endocrine Week 5 2017/18 > 2: Ovulatory disorders (gynae) > Flashcards

Flashcards in 2: Ovulatory disorders (gynae) Deck (53)
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1

What is oligomenorrhoea?

Menstrual cycles lasting longer than 35 days

2

What is amenorrhoea?

Absent menstruation

3

Amenorrhoea can be either ___ or ___.

primary

secondary

4

Which abnormal event of the menstrual cycle can cause oligomenorrhoea or amenorrhoea?

Anovulation

5

GnRH is released from the hypothalamus in a pulsatile manner.

Which types of pulses cause the secretion of

a) FSH

b) LH?

a) FSH is secreted by low frequency GnRH pulses

b) LH is secreted by high frequency GnRH pulses

6

Which hormones cause thickening of the endometrium during the menstrual cycle?

Oestradiol

FSH

LH

Progesterone

hCG

basically all of them

7

Which organs secrete oestrogens?

Ovaries

Adrenal cortex

Placenta

8

Oestrogens cause the (thickening / thinning) of the cervical mucus.

thinning

9

Which process does high concentrations of oestrogen cause?

Which hormones are affected?

Negative feedback AND Positive feedback

FSH, Prolactin secretion inhibited

LH secretion stimulated

10

Secretion of which hormone is inhibited by progesterone?

LH

seeing as LH surges to cause ovulation, and progesterone secretion marks the luteal phase and menstruation

11

What effect does progesterone have on body temperature?

Increases body temperature

12

Progesterone is a smooth muscle (relaxant / contractor).

smooth muscle relaxant

presumably to make menstruation easier

13

Regular menstrual cycles suggests that ___ is occuring as normal.

ovulation

14

Irregular menstrual cycles indicate that which abnormal event is occuring?

Anovulation

15

___ disorders are a common cause of presumed infertility.

Ovulatory disorders

16

What are three causes of anovulation according to the World Health Organisation?

I - Hypothalamic-pituitary failure - hypogonadotrophic hypogonadism

II - Hypothalamic-pituitary dysfunction - PCOS, hyperprolactinaemia

III - Ovarian failure - menopause, premature

17

What is hypothalamic-pituitary failure, causing anovulation, also known as?

Hypogonadotrophic hypogonadism

18

What are four important causes of hypogonadotrophic hypogonadism?

Stress

Low BMI (e.g anorexia nervosa)

Excessive exercise (often goes with the above, or eating disorders)

Kallmann syndrome (associated with anosmia)

19

What hormone abnormalities are seen in hypogonadotrophic hypogonadism?

Low GnRH

Low FSH and LH

so low oestrogen

20

What is the main symptom of hypogonadotrophic hypogonadism?

Amenorrhoea

21

How can hypogonadotrophic hypogonadism be diagnosed?

Progesterone challenge test

22

How is hypogonadotrophic hypogonadism treated?

Treat underlying causes (stress, sort BMI, hormone tests/USS for tumours)

GnRH pump

IV FSH/LH injections

23

What are two ovulatory disorders which come under WHO II: Hypothalamic-pituitary dysfunction?

Polycystic ovary syndrome (PCOS)

Hyperprolactinaemia

24

What is PCOS?

Polycystic ovary syndrome

Causes hyperandrogenism (acne, hirsutism) and oligo- or amenorrhoea

25

What are the three diagnostic criteria for PCOS?

1. Oligo- or amenorrhoea

2. Evidence of polycystic ovaries on USS

3. Hyperandrogenism symptoms (acne, hirsutism)

26

What is an endocrine complication of PCOS?

Insulin resistance

27

What two effects does hyperinsulinaemia have on the HPO axis?

Elevates LH

Reduces SHBG levels, leading to increased levels of free testosterone hyperandrogenism

28

What BMI must patients be under before they are considered for any sort of infertility treatment?

< 35, <30 depending on some places

29

What supplement are all pregnant women given?

Why?

Folic acid

Helps to prevent birth defects

30

What general type of treatment is used for patients with PCOS?

Ovulation induction