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Secondary Amenorrhea and PCOS Essentials
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Secondary Amenorrhea and PCOS Essentials
Secondary Amenorrhea and PCOS Essentials
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1
Question
What is the primary criterion for diagnosing secondary amenorrhea?
Answer
Absence of menses for 3 or 6 months depending on cycle regularity
2
Question
Which hormone must be tested to exclude pregnancy in secondary amenorrhea?
Answer
Human chorionic gonadotropin (HCG)
3
Question
What percentage of secondary amenorrhea cases are due to hypothalamic dysfunction?
Answer
30%-35%
4
Question
What common lifestyle factors can cause hypothalamic amenorrhea?
Answer
Heavy exercise, psychological stress, anorexia nervosa
5
Question
What hormonal change characterizes hypothalamic amenorrhea?
Answer
Reduced GnRH, low FSH, LH, and estrogen
6
Question
Which tumors are most commonly associated with hypothalamic amenorrhea?
Answer
Craniopharyngiomas
7
Question
How does prolactin inhibit GnRH secretion?
Answer
Prolactin elevation suppresses pulsatile GnRH secretion
8
Question
Which medication is most important in treating Sheehan’s disease?
Answer
Cortisone (glucocorticoids)
9
Question
What is the most common ovarian cause of secondary amenorrhea?
Answer
Polycystic Ovary Syndrome (PCOS)
10
Question
What are key features of PCOS upon ultrasound?
Answer
String of pearls appearance with 12+ follicles or increased ovarian volume
11
Question
What hormonal imbalance is typical in PCOS?
Answer
Increased LH/FSH ratio (>2:1) with high androgens
12
Question
Which biometric measurement indicates ovarian enlargement in PCOS?
Answer
Ovarian volume >10 ml
13
Question
What is the primary abnormality causing anovulation in PCOS?
Answer
Elevated androgens disrupting follicle maturation
14
Question
Which is a common clinical feature of PCOS?
Answer
Hirsutism and menstrual irregularities
15
Question
What is the main aim of lifestyle modification in PCOS management?
Answer
Reduce BMI below 25 kg/m2
16
Question
What is first-line medical therapy for hirsutism in PCOS?
Answer
Combined oral contraceptives (COCs)
17
Question
What is the first-line ovulation induction agent in PCOS for women trying to conceive?
Answer
Letrozole
18
Question
How does letrozole induce ovulation?
Answer
Aromatase inhibition reduces estrogen, increasing FSH secretion
19
Question
What is an alternative to letrozole for ovulation induction?
Answer
Clomiphene citrate
20
Question
What monitoring method is used during ovulation induction therapy?
Answer
Ultrasound to check follicle size
21
Question
What is the second-line treatment for PCOS-related infertility if first-line therapy fails?
Answer
Exogenous gonadotropins
22
Question
What is a surgical intervention for PCOS to improve ovulation?
Answer
Laparoscopic ovarian drilling
23
Question
What nonpharmacological methods are first-line for managing hirsutism?
Answer
Electrolysis or laser hair removal
24
Question
Which biochemical marker is elevated in PCOS due to increased preantral follicles?
Answer
Anti-mullerian hormone (AMH)
25
Question
What is a common metabolic condition associated with PCOS?
Answer
Insulin resistance
26
Question
What endocrine change predisposes PCOS patients to endometrial hyperplasia?
Answer
Unopposed estrogen during anovulatory cycles
27
Question
Which genetic syndrome is a cause of primary ovarian insufficiency?
Answer
Turner syndrome (XO)
28
Question
What is the typical level of prolactin in hyperprolactinemia?
Answer
Elevated prolactin levels
29
Question
Which drug is known to cause hyperprolactinemia?
Answer
Haloperidol
30
Question
What is the main hormonal deficiency in premature ovarian failure?
Answer
Estrogen