TopNotch Medical Board Prep - OB-GYNE Digital Handout
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TopNotch Medical Board Prep - OB-GYNE Digital Handout

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Questions and Answers

What is the most common cause of secondary amenorrhea?

  • CNS tumors and infections
  • Hyperprolactinemia and prolactinomas
  • Functional hypothalamic amenorrhea
  • Polycystic ovarian syndrome (PCOS) (correct)

    • What is the key feature of Müllerian agenesis (Mayer-Rokitansky-Küster-Hauser syndrome)?

  • Present uterus and ovaries
  • Present uterus and absent ovaries
  • Absent uterus and ovaries
  • Absent uterus and present ovaries (correct)

    • What is the most appropriate treatment for a patient with Müllerian agenesis?

  • Hormonal therapy
  • Uterine transplantation
  • Creation of a neovagina (correct)
  • Removal of gonads

    • Which condition is characterized by the presence of female external genitalia, absent internal genitalia, and a male karyotype?

    <p>Androgen insensitivity syndrome</p> Signup and view all the answers

    Which of the following is a feature of Asherman syndrome?

    <p>Intrauterine adhesions</p> Signup and view all the answers

    What is the most common cause of primary amenorrhea with the presence of breast development and a uterus?

    <p>Hypothalamic-pituitary dysfunction</p> Signup and view all the answers

    What is the most frequent antecedent factor of intrauterine adhesions (Asherman syndrome)?

    <p>Endometrial curettage from pregnancy</p> Signup and view all the answers

    Which of the following is NOT a cause of premature ovarian failure (hypergonadotropic hypogonadism)?

    <p>Polycystic ovarian syndrome</p> Signup and view all the answers

    Which of the following is a diagnostic test for intrauterine adhesions (Asherman syndrome)?

    <p>Hysterosalpingogram</p> Signup and view all the answers

    What is the main pathophysiology of polycystic ovarian syndrome (PCOS)?

    <p>Insulin resistance leading to hyperglycemia and increased androgens</p> Signup and view all the answers

    What is the most common symptom of premature ovarian failure (hypergonadotropic hypogonadism)?

    <p>Menopause before age 40</p> Signup and view all the answers

    Which of the following is NOT a recommended approach to diagnosing the cause of ovarian or uterine dysfunction?

    <p>Measurement of blood glucose levels</p> Signup and view all the answers

    What is a common cause of hypothalamic dysfunction resulting in decreased LH pulses?

    <p>Phenothiazine derivatives</p> Signup and view all the answers

    Which condition presents with amenorrhea, polycystic ovaries, and hyperandrogenism due to hypothalamic dysfunction?

    <p>Anorexia nervosa</p> Signup and view all the answers

    What is a common feature of neoplastic causes of hypostrogenic amenorrhea?

    <p>ACTH-secreting adenomas</p> Signup and view all the answers

    Which syndrome is characterized by pituitary cell destruction due to hypotensive episodes during pregnancy?

    <p>Simmonds disease</p> Signup and view all the answers

    Which condition may also present with acromegaly or Cushing's disease in addition to hypostrogenic amenorrhea?

    <p>ACTH-secreting adenomas</p> Signup and view all the answers

    Study Notes

    Amenorrhea

    • Secondary amenorrhea is most commonly caused by pregnancy-related complications, contraception, and polycystic ovarian syndrome (PCOS).

    Müllerian Agenesis (Mayer-Rokitansky-Küster-Hauser Syndrome)

    • The key feature of Müllerian agenesis is the absence of the uterus and vagina due to failed development of the Müllerian ducts.
    • Treatment for Müllerian agenesis involves creating a neovagina through surgical or nonsurgical methods.

    Disorders of Sex Development

    • Androgen insensitivity syndrome is characterized by the presence of female external genitalia, absent internal genitalia, and a male karyotype.

    Asherman Syndrome

    • Asherman syndrome is characterized by the presence of intrauterine adhesions.
    • The most frequent antecedent factor of intrauterine adhesions is uterine curettage.
    • Hysteroscopy is a diagnostic test for intrauterine adhesions.

    Ovarian Dysfunction

    • The most common cause of primary amenorrhea with breast development and a uterus is gonadotropin-releasing hormone (GnRH) receptor mutations.
    • Premature ovarian failure is not caused by androgen insensitivity syndrome or Turner syndrome.
    • The main symptom of premature ovarian failure is amenorrhea.

    Polycystic Ovarian Syndrome (PCOS)

    • The main pathophysiology of PCOS involves insulin resistance and hyperandrogenism.

    Hypothalamic Dysfunction

    • A common cause of hypothalamic dysfunction resulting in decreased LH pulses is weight loss or anorexia nervosa.
    • Hypothalamic dysfunction can present with amenorrhea, polycystic ovaries, and hyperandrogenism.

    Neoplastic Causes of Hypoestrogenic Amenorrhea

    • A common feature of neoplastic causes of hypoestrogenic amenorrhea is the presence of a pituitary tumor.

    Pituitary Disorders

    • Sheehan's syndrome is characterized by pituitary cell destruction due to hypotensive episodes during pregnancy.
    • Hypopituitarism may also present with acromegaly or Cushing's disease in addition to hypoestrogenic amenorrhea.

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    Description

    Prepare for the September 2021 PLE batch with this digital handout from TopNotch Medical Board Prep focusing on topics like ovarian hypergonadotropic hypogonadism, uterovaginal parameters, and androgen resistance. Stay updated as handouts are regularly revised.

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