Midwifery Boards-GYN Deviations from
Normal – AMCB CNM -Questions and
Answers.
Define primary amenorrhea -
\a female younger than 14 or 16 years old who has never experienced menses and
does not have secondary sex characteristics
Define secondary amenorrhea -
\a menstruating female with the absence of a period for 3 cycle intervals or 6 months
duration
What is the #1 causes of amenorrhea? -
\Pregnancy
What are physiologic causes of amenorrhea? -
\1. pregnancy
2. lactation
3. menopause
What are the 4 anatomic areas that causes amenorrhea? -
\1. outflow area (uterus and vagina)
2. the ovaries
3. pituitary gland
4. CNS
Outflow area problems are--------in nature, whereas ovarian, pituitary, and CNS involve
disruptions in the----- -
\Outflow- obstructive
Pit & CNS are hypothalamus-pituitary ovarian axis
What genetic disorder causes amenorrhea? -
\Turner's syndrome
Describe characteristics of Turner's syndrome -
\-absence of one X chromosome
-45, X
-congenital ovarian failure (streak ovaries)
-short stature, secondary sex traits do not develop
-infertility
Describe characteristics of androgen insensitivity syndrome -
\-x-linked recessive disorder
, - people with this condition are genetically male with an XY chromosome but there is an
absence of androgen receptors so their bodies cannot use androgens at all
-external female characteristics such as breast development
-absence of uterus and vagina
-Gonads are testes that are undescended in the abdomen or pelvis
-normal breast development
-scant pubic and axillary hair
-infertility
Describe Asherman's syndrome -
\-an acquired intrauterine adhesions or scarring that destroys the endometrium
*causes can be due to:
-vigorous curettage
-abortion complicated by an infection
-uterine surgery
-amenorrhea
-SAB
-infertility
***Pt has normal estrogen & progesterone levels
What are the steps in assessing a woman presenting with amenorrhea? -
\1. r/o pregnancy
2. assess for perimenopause/menopause/HRT use
3. collect adequate pt hx, diet/ex, weight changes, herbs, BMI, anorexia, bulimia
4. r/o breastfeeding amenorrhea
What labs should you draw? -
\Do TSH and prolactin levels
Elevated TSH and prolactin levels indicates-------- -
\hypothyroidism
What type of thyroid disorder can cause amenorrhea? -
\Hyperthyroidism (Grave's)
Prolactin levels <100ng/mL usually rules out------ -
\pituitary tumor
In amenorrhea with galactorrhea, prolactin levels are-----and TSH is-----
(normal/ high/low) -
\prolactin levels are high
TSH normal
A progesterone challenge test is initiated with ----- and ------functions are WNL -
Normal – AMCB CNM -Questions and
Answers.
Define primary amenorrhea -
\a female younger than 14 or 16 years old who has never experienced menses and
does not have secondary sex characteristics
Define secondary amenorrhea -
\a menstruating female with the absence of a period for 3 cycle intervals or 6 months
duration
What is the #1 causes of amenorrhea? -
\Pregnancy
What are physiologic causes of amenorrhea? -
\1. pregnancy
2. lactation
3. menopause
What are the 4 anatomic areas that causes amenorrhea? -
\1. outflow area (uterus and vagina)
2. the ovaries
3. pituitary gland
4. CNS
Outflow area problems are--------in nature, whereas ovarian, pituitary, and CNS involve
disruptions in the----- -
\Outflow- obstructive
Pit & CNS are hypothalamus-pituitary ovarian axis
What genetic disorder causes amenorrhea? -
\Turner's syndrome
Describe characteristics of Turner's syndrome -
\-absence of one X chromosome
-45, X
-congenital ovarian failure (streak ovaries)
-short stature, secondary sex traits do not develop
-infertility
Describe characteristics of androgen insensitivity syndrome -
\-x-linked recessive disorder
, - people with this condition are genetically male with an XY chromosome but there is an
absence of androgen receptors so their bodies cannot use androgens at all
-external female characteristics such as breast development
-absence of uterus and vagina
-Gonads are testes that are undescended in the abdomen or pelvis
-normal breast development
-scant pubic and axillary hair
-infertility
Describe Asherman's syndrome -
\-an acquired intrauterine adhesions or scarring that destroys the endometrium
*causes can be due to:
-vigorous curettage
-abortion complicated by an infection
-uterine surgery
-amenorrhea
-SAB
-infertility
***Pt has normal estrogen & progesterone levels
What are the steps in assessing a woman presenting with amenorrhea? -
\1. r/o pregnancy
2. assess for perimenopause/menopause/HRT use
3. collect adequate pt hx, diet/ex, weight changes, herbs, BMI, anorexia, bulimia
4. r/o breastfeeding amenorrhea
What labs should you draw? -
\Do TSH and prolactin levels
Elevated TSH and prolactin levels indicates-------- -
\hypothyroidism
What type of thyroid disorder can cause amenorrhea? -
\Hyperthyroidism (Grave's)
Prolactin levels <100ng/mL usually rules out------ -
\pituitary tumor
In amenorrhea with galactorrhea, prolactin levels are-----and TSH is-----
(normal/ high/low) -
\prolactin levels are high
TSH normal
A progesterone challenge test is initiated with ----- and ------functions are WNL -
