Newest Updated Study Guide with Accurate
Solutions | Grade A+
• Late reproductive. Low FSH, Low AMH, Low inhibin B regular cycles -✓✓-3b
• Late reproductive, subtle changes to menses, variable FSH, low amh, low inhibit
B -✓✓-3A
• Variable cycle <= 7 days, variable FSH, low amh, low inhibit b, low af -✓✓-2
early menopause
• 60 days or more amenorrhea, FSH >=25, low amh, low inhibit b, low af -✓✓-1
late menopause
• Variable elevated FSH, low amh, low inhibin b, very low af -✓✓+1a, +1b early
menopause
• FSH stabilizes, very low amh, very low inhibin B, very low af, increasing GSM -
✓✓+1c early menopause
• Decreased estrogen causes more rapid bone resorption by osteoclasts, exceeding
the the ability of osteoblasts to form new bone- bone loss and gradual deterioration
of micro architecture of both trabecular and cortical bone. -✓✓Path of
Osteoporosis in meno
, • 10-12% or 1 t-score across the meno transitions. Starts 1-3 years before
menopause and lasts 5-10 years. Then 0.5% per year. By 80 -30% peak bone mass
is lost. -✓✓Bone loss across memo transition
• Comparing women's bmd to average young white adult. Standard deviations
away from that. +/- 2. Used for diagnosis.
Osteoporosis -2.5 or lowere -✓✓T-score
• Number of SD away from bmd of average person if same age, gender and
ethnicity. -2 to +2. Preferred for those premenopause.
Premenopausal osteoporosis-2.0 -✓✓Z-score
• 40-50% of postmenopausal women -✓✓Fx related to osteoporosis
• 5-8 fold increase in mortality compared to other osteoporosis fx 20% mortality at
1 year symptomatic vertebral 10% -✓✓Hip fracture
• Inflammatory (RA), malabsorption (celiac), endocrinopathies (Cushing, hyper
parathyroid) -✓✓Diseases that increase low bmd
• Aromatics inhibitors (bone resorption), vitamin D impairment (phenytoin),
glucocorticoid (reduce bone formation) -✓✓Drugs that increase risk low bmd
• Hip -✓✓Area of low BMD most correlated with fracture
• Medications Gonadotropin - releasing Excessive thyroxine doses Cytotoxic
agents .Aromatase inhibitors Table 1. Secondary Causes of Bone Loss hormone