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(4) Reproductive System - Sessions > (3.1&2) Menstural Dysfunction, Puberty & Menopause > Flashcards

(3.1&2) Menstural Dysfunction, Puberty & Menopause Flashcards

1
Q

Dysmenorrhoea = ?

A

Painful period = ?

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2
Q

Amenorrhoea = ?

A

Absence of period >6 months = ?

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3
Q

Oligomenorrhoea = ?

A

Infrequent period (35 days - 6 months) = ?

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4
Q

Cryptomenorrhoea = ?

A

Invisible period due to outflow obstruction = ?

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5
Q

Menorrhgia = ?

A

Excessive (>80ml/day) or prolonged (>7days) period = ?

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6
Q

How do you treat Menorrhgia?

A
  • Progesterone -> maintain Corpus Luteum

- NSAIDs

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7
Q

What is Ovulatory Cycle?

A

Normal period + Dysmenorrhoea or Mastalgia (sore breasts)

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8
Q

What is Anovulatory Cycle?

A

No Ovulation/Luteal phase + Oligomenorrhoea/Amenorrhoea +/- Menorrhgia

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9
Q

What is Primary Amenorrhoea?

A

Never had a period:

  • Girls >14 years old if without secondary sexual characteristics
  • Girls >16 years old if with secondary sexual characteristics
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10
Q

Suggest some hypogonadotrophic and some hypergonadotrophic causes of PRIMARY Amenorrhoea.

A
  • Hypogonadotrophic: Kallmann Syndrome (hypothalamic, inadequate GnRH to stimulate FSH production)
  • Hypergonadotrophic: Androgen insensitivity, Receptor abnormalities, Turner Syndrome
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11
Q

What is Secondary Amenorrhoea?

A

Ceased period:

  • > 3 months if regular period before
  • > 9 months if irregular period before
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12
Q

Suggest some hypogonadotrophic and some hypergonadotrophic causes of SEONDARY Amenorrhoea.

A
  • Hypogonadotrophic: stress, exercise, eating disorder, Hyperprolactinaemia, Hypo/Hyperthyroidism
  • Hypergonadotrophic: Menopause, Polycystic ovary, drugs
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13
Q

Which age groups are Secondary Amenorrhoea most likely to be seen?

A

Women 40-55 years old

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14
Q

What is Dysfunctional Uterine Bleeding?

A

Abnormal bleeding without obvious organic causes

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15
Q

What may the possible causes of Dysfunctional Uterine Bleeding?

A
  • 90% No ovulation -> no Corpus Luteum to release Progesterone -> continuous Oestrogen production -> Uterine overgrowths & bleeds
  • 10% Ovulation -> reduced Oestrogen -> continuous Progesterone secretion -> Uterine sheds irregularly
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16
Q

At what age does male’s puberty normally take place? In what sequence do males produce their secondary sexual characteristics?

A
  • 9-14 years old
  • Genitalia development
  • Adrenarche
  • Spermatogenesis
  • Growth spurt
  • Genitalia adult
  • Pubic hair adult
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17
Q

At what age does female’s puberty normally take place? In what sequence do females produce their secondary sexual characteristics?

A
  • 8-13 years old
  • Thelarche
  • Adrenarche
  • Growth spurt
  • Menarche
  • Pubic hair adult
  • Breast adult
18
Q

What initiates Puberty? What factors may influence its onset?

A
  • Large increase in GnRH production

- Environmental factors e.g. Body weight

19
Q

What is the crucial body weight to initiate growth spurts in male and female?

A
  • Male: 55kg

- Female: 30kg

20
Q

What is the critical body weight to initiate Menarche in females?

A

47 kg

21
Q

How does Growth Spurt ends? Why does and individual with earlier onset ends up shorter?

A
  • Fusion of Epiphyseal plates
  • Constant slower growth before the spurt, earlier starting point, earlier ending point compared to those who start later and grow slower but more before the spurt
22
Q

What do you call it if a child starts his puberty too early? What may be the possible causes?

A
  • Precocious Puberty
  • True: early production of GnRH e.g. Meningitidis/Pineal Tumours
  • Pseudoprecocious Puberty: uncontrolled Gonadotrophins/Steroids e.g. Hormone Secreting Tumours/Steroid drugs/Adrenal hyperplasia
23
Q

What are the differences between menopause in males and females?

A
  • Males later and slower
  • Males continuous spermatogenesis
  • Females run out of follicles
24
Q

Suggest 8 effects of reduced level of Oestrogen in females after menopause.

A
  • Vascular: hot flushes
  • Uterine: Endometrium regresses; Myometrium thins
  • Vagina: reduced Rugae hence distension
  • Breast atrophy
  • Osteoporosis/Posture and height changes/Risk of fracture
  • Changes in lipid/cholesterol -> CHD
  • Emotional distress/poor sleep
  • Vaginal/Urethral atrophy -> Dyspareunia/Dysuria
25
Q

Suggest a treatment for a woman troubles from Menopause.

A

Hormone replacement therapy (both Progesterone and Oestrogen)

26
Q

Why does Hormone Replacement Therapy include both Progesterone and Oestrogen? When may Oestrogen Replacement be used?

A
  • Prevent Endometrial Cancer: if no Progesterone -> no inhibition to high Oestrogen causing +ve feedback -> constant stimulation on Endometrium
  • Oestrogen alone is for those had Hysterectomy
27
Q

What type of hormone is required for Adrenache to take place in both male and female?

A
  • Androgen
  • Male from Testis
  • Female from Adrenal glands
28
Q

What types of hormone is the growth spurt dependent on?

A
  • Growth Hormone

- Steroids

29
Q

What name is given to the development of the breasts? What hormone is responsible for this?

A
  • Thelarche

- Oestrogen

30
Q

Suggest some key parts of the history and investigations that should be carried out to access puberty

A
  • Bone-age (compare hand-wrist films to standard for that age)
  • Genitalia development
  • Family history of Precocious or not
  • Body weight and height
  • Body hair
  • Medications
31
Q

What are the differences between the growth spurts of males and females? Why is it?

A
  • Faster growth in males

- Earlier Epiphyseal plates closure in females due to Oestrogen

32
Q

Describe the Pre-Menopause phase.

A
  • > 40 years old
  • Follicular phase shortens +/- Ovulation
  • Less Oestrogen -> less -ve feedback -> high LH and FSH (FSH more due to lack of Inhibin)
  • Possible but reduced fertility
33
Q

At what age does menopause occur in females?

A

49-51

34
Q

Suggest some disadvantages with Hormone Replacement Therapy.

A

Risks of:

  • Breast cancer
  • Thromboembolism
  • MI
35
Q

Other than HRT, what else can be given to Menopausal women to limit the effects of the Menopause on their bones?

A

Early use of Bisphosphonates & Calcium to combat Osteoporosis

36
Q

What are Fibroids? How is it checked?

A
  • Fibroids = Benign growth of Myometrial smooth muscles

- Checked by Bimanual Exam/Ultrasound/Curretage or Laprascopy

37
Q

What is the most common symptoms of Fibroids?

A
  • Mostly Asymptomatic

- Most common symptom: Menorrhgia

38
Q

Evaluate the benifits and disadvantages of Hysterectomy with Oophorectomy.

A
  • Advantages: prevent Ovarian cancers

- Disadvantages: abrupt Menopause + complete loss of Ovarian Androgens e.g. risk of CVD, HRT required

39
Q

How may you delay a precocious puberty?

A
  • Antagonists of Gonadotrophins/Androgen

- However doesn’t delay Epiphyseal plate closure

40
Q

How do you access Menorrhagia?

A
  • Pad/tampon counts: >80ml/>7days

- Hb or Haematocrit levels

(4) Reproductive System - Sessions (16 decks)

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