L1 (T2): Disorders of ovulation

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Questions and Answers

What is the diagnosis method for ovulation?

Transvaginal pelvic ultrasound (correct)

LH detection kits

Basal Body Temperature tracking

Day 21 progesterone blood test

What is the term for lack of a period for more than 6 months?

Primary Amenorrhoea

Amenorrhoea (correct)

Secondary Amenorrhoea

Oligomenorrhoea

What is the commonest cause of Hyperandrogenism?

Turner syndrome

Congenital adrenal hyperplasia

Polycystic ovarian syndrome (correct)

Autoimmune disorder

What is the term for excess body hair in a male distribution?

Androgen-dependent hirsutism Signup and view all the answers

What is the primary cause of 'idiopathic hirsutism'?

PCOS Signup and view all the answers

What is the diagnosis method for ovulation if not on hormonal contraception?

LH detection kits Signup and view all the answers

What is the term for never having had a period?

Primary Amenorrhoea Signup and view all the answers

What is the cause of 'Functional' hypothalamic amenorrhoea?

Weight loss/stress related/excessive exercise Signup and view all the answers

What is the cause of HIRSUTISM related to excess body hair in a male distribution?

Polycystic ovarian syndrome Signup and view all the answers

What is the differential diagnosis for hirsutism with 95% occurrence?

PCOS or 'idiopathic hirsutism' Signup and view all the answers

Which hormone is responsible for the production of androgens in the theca cells?

Luteinizing Hormone (LH) Signup and view all the answers

What is the central mediator involved in the regulation of GnRH production?

Kisspeptin Signup and view all the answers

Which hormone has a permissive effect on puberty and reproduction through its influence on the kisspeptin system?

Leptin Signup and view all the answers

Which neurons lack receptors for androgens, progesterone, and estrogens?

GnRH neurons Signup and view all the answers

What is the primary role of KNDy neurons in the regulation of GnRH production?

Mediate both positive and negative central feedback of sex steroids on GnRH production Signup and view all the answers

What is the role of KISS1 neurons in relation to oestrogen?

Highly responsive to oestrogen, implicated in both positive and negative central feedback of sex steroids on GnRH production Signup and view all the answers

What is the primary function of GnRH in the reproductive axis?

Stimulate the release of FSH and LH Signup and view all the answers

What is the primary role of leptin in the context of reproduction?

Mediate metabolic influences on reproduction via the kisspeptin system Signup and view all the answers

What is the function of the theca cells in the ovary?

Produce androgens Signup and view all the answers

What is the typical length of a menstrual cycle?

28 days Signup and view all the answers

Which hormone is produced by the Corpus Luteum if ovulation occurs?

Progesterone Signup and view all the answers

What is the common cause of hirsutism and acne related to male pattern hair growth?

Polycystic Ovary Syndrome (PCOS) Signup and view all the answers

What is the primary hormone responsible for the production of androgens in the theca cells?

Luteinizing Hormone (LH) Signup and view all the answers

What is the term for cessation of menstrual periods?

Amenorrhea Signup and view all the answers

What is the term for a condition characterized by fewer menstrual periods?

Oligomenorrhea Signup and view all the answers

What is the primary method for confirming ovulation?

Measuring progesterone levels Signup and view all the answers

What is the term for not having a period for more than six months?

Amenorrhea Signup and view all the answers

What distinguishes primary amenorrhea from secondary amenorrhea?

Primary amenorrhea refers to never having had a period, while secondary amenorrhea occurs when periods have stopped after having them previously. Signup and view all the answers

What hormone is responsible for the positive and negative feedback in the gonadal axis?

Kis peptide Signup and view all the answers

What is the central mediator at the apex in the hypothalamus, responsive to estrogen, and implicated in both positive and negative feedback of hormones?

Respecting Signup and view all the answers

What is the primary hormone used to confirm ovulation?

Progesterone Signup and view all the answers

What is the primary cause of hirsutism in individuals with PCOS?

High LH secretion stimulating excessive production of adrenal androgens Signup and view all the answers

What is the essential diagnostic feature for PCOS?

Appearance of multiple immature follicles Signup and view all the answers

What is the primary hormonal abnormality in PCOS?

Slightly high testosterone levels Signup and view all the answers

What is the role of insulin resistance in PCOS?

It stimulates excessive production of adrenal androgens Signup and view all the answers

What is the impact of PCOS on menstrual periods?

It causes amenorrhea and infertility Signup and view all the answers

What is the association between PCOS and obesity?

PCOS is more common and severe in obese individuals Signup and view all the answers

What is the primary cause of premature ovarian insufficiency?

Genetic factors Signup and view all the answers

What is the most common cause of hirsutism?

Polycystic ovarian syndrome Signup and view all the answers

What is the primary factor contributing to the increasing prevalence of polycystic ovarian syndrome?

Obesity rates Signup and view all the answers

What can sudden onset of severe symptoms or visual changes, such as male-pattern balding or voice deepening, indicate?

Adrenal tumors Signup and view all the answers

What is the primary role of the hypothalamus in causing menstrual irregularities?

Hypothalamus-related issues Signup and view all the answers

What is the primary factor contributing to functional hypothalamic amenorrhea?

Excessive exercise Signup and view all the answers

Which of the following is a possible consequence of insulin resistance in PCOS?

High cholesterol Signup and view all the answers

What is a common manifestation of increased adrenal androgen production in PCOS?

Hirsutism Signup and view all the answers

How does insulin resistance contribute to the risk of impaired glucose tolerance and type two diabetes in PCOS?

By increasing insulin levels Signup and view all the answers

What effect does PCOS have on the risk of cardiovascular disease?

Does not affect the risk Signup and view all the answers

What percentage of lack of ovulation cases in women of reproductive age is attributed to PCOS?

80% Signup and view all the answers

What is a potential consequence of infrequent menstrual periods and higher estrogen levels in PCOS?

Increased risk of endometrial hyperplasia Signup and view all the answers

To confirm ovulation?

History - 28 menstrual cycle Signup and view all the answers

Study Notes

Understanding PCOS and its Treatment

Insulin resistance leads to metabolic syndrome, including high sugar, high cholesterol, hypertension, and increased risk of vascular disease.
PCOS is associated with increased adrenal androgen production, leading to manifestations like hirsutism and infrequent periods.
Insulin resistance results in higher insulin levels, more ovarian androgen production, and increased risk of impaired glucose tolerance and type two diabetes.
Despite obesity, PCOS does not significantly increase the risk of cardiovascular disease, possibly due to protective effects of estrogen.
PCOS affects women of reproductive age and can cause varying degrees of infertility, with 80% of lack of ovulation cases being attributed to PCOS.
PCOS is associated with an increased risk of early miscarriage, gestational diabetes, and other adverse pregnancy outcomes.
Infrequent menstrual periods and higher estrogen levels in PCOS can lead to endometrial hyperplasia, increasing the risk of endometrial cancer.
Lifestyle changes, including exercise and smoking cessation, can improve insulin resistance, lower testosterone levels, and improve pregnancy outcomes in women with PCOS.
The combined oral contraceptive pill is an effective therapeutic treatment for PCOS, as it lowers testosterone levels and reduces ovarian stimulation, while also providing a regular withdrawal bleed to prevent endometrial hyperplasia.
However, the pill may be relatively contraindicated for obese or smoking women due to increased risk of venous thromboembolism.
Counseling women with PCOS is important, but there is a high frequency of eating disorders, particularly bulimia, associated with the condition.
Alongside diet and lifestyle changes, the combined oral contraceptive pill can be a helpful treatment for hirsutism and menstrual irregularities in women with PCOS.

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Description

Test your knowledge of ovulation disorders with this quiz covering topics such as physiological processes, diagnosis, oligomenorrhea, amenorrhea, hirsutism, acne, polycystic ovarian syndrome, premature ovarian failure, and congenital adrenal hyperplasia. Assess your understanding of the causes, investigation, and management of common ovulation disorders.