Kallman Syndrome
- Mutation in KAL-1 or FGFR-1 Gene
- Failure of GnRH Secreting Neurons
- Delayed Puberty
- Anosmia
- Hypogonadism
- Infertility
Turner Syndrome
- Female (XO)
- Short stature
- Shield Chest
- Cystic Hygroma (Webbing of Neck)
- Lymphedema in Hands and Feet
- Ovarian Dysgenesis
- Streak Ovary
- Decreased Estrogen
- Increased FSH
- Increased LH
- Dysgerminoma
- Bicuspid Aortic Valve
- Preductal Coarctation of the Aorta
- Horseshoe Kidney
- Menopause before Menarche
- Amenorrhea
Imperforate Hymen
- Often Asymptomatic until Puberty
- Hematocolpos
- Primary Amenorrhea
- Lower Abdominal Pain
- Diagnosis by Clinical Impression
- Surgery
Androgen Insensitivity (Complete)
- Defect in Androgen Receptor
- Phenotypically Female
- (46, XY)
- Female External Genitalia
- Rudimentary Vagina
- Scant Sexual Hair
- Testes Often in Labia Majora
- Testes Surgically Removed to Prevent Malignancy
- Increased Estrogen, Testosterone, and LH
- Absent Uterus and Fallopian Tubes
21 Hydroxylase Deficiency
- Decreased Cortisol
- Increased 17 Hydroxyprogesterone
- Decreased Aldosterone
- Hypotension
- Increased Renin
- Hyperkalemia
- Female Pseudohermaphroditism
17 Alpha Hydroxylase Deficiency
- Decreased Cortisol
- Decreased Sex Hormones
- Increased Mineralocorticoids (DOC)
- Hypertension
- Hypokalemia
- XY Externally Phenotypic Female
- No Internal Reproductive Structures Due to Mullerian Inhibitory Factor
- XX Externally Phenotypic Female
- Sexual Infantilism
11 Beta-Hydroxylase Deficiency
- Decreased Cortisol
- Decreased Aldosterone
- Increased Sex Hormones
- Increased 11 Deoxycorticosterone (11 DOC)
- Hypertension
- Masculinization
Polycystic Ovarian Syndrome (PCOS) Mechanism
- Hyperinsulinemia Increases GnRH Pulse Frequency
- Large Increase in LH
- Small Decrease in FSH
- Increased Androgen Production From Theca-Lutein Cells
- Decreased Steroid Hormone-Binding-Globulin (SHBG) Causes Increased Free Testosterone
- Obese Patients Have Increased Estrogen
- Increased Risk of Endometrial Cancer
Polycystic Ovarian Syndrome (PCOS) Symptoms and Diagnosis
- Most Common Cause of Infertility in Women
- Amenorrhea
- Acne
- Hirsutism
- Obesity
- Enlarged, Cystic Ovaries
- LH:FSH Ratio of 3:1
- "String of Pearls" on Ultrasound
Polycystic Ovarian Syndrome (PCOS) Treatment
- Weight Loss
- Oral Contraceptives
- Clomiphene Citrate
- Anti-androgens
- Cyclic Progesterone for Endometrial Protection
- Metformin
Endometriosis Symptoms and Treatment
- Dysmenorrhea
- Cyclic Pelvic Pain
- Dyschezia
- Dysuria
- Dyspareunia
- 30-40% are Infertile
- Surgery
- NSAIDs
- OCPs
- Progesterone (Progestins)
- GnRH Agonists
Endometriosis Characteristics
- Endometrial Tissue Outside of Uterus
- Glands and Stroma
- Most Common in Ovary, Pelvis, Peritoneum and Bowels
- "Chocolate Cyst" in Ovary
- Adenomyosis
- Retrograde Flow
- Metaplastic Transformation
- Mullerianosis
Pelvic Inflammatory Disease (PID)
- Neisseria gonorrhoeae
- Chlamydia Trachomatis
- Cervical Motion Tenderness
- Chandelier Sign
- Salpingitis
- Tubo-ovarian abscess
- Hydrosalpinx
- Ectopic Pregnancy
- Infertility
- Adhesions
- Fitz-Hugh-Curtis Syndrome
Pelvic Inflammatory Disease (PID) Interventions
- Antibiotics
- No Intercourse for 3 Weeks
- Semi-Fowler's Position
- Analgesics
- Monitor Temperature
- Treat Partners
Endometritis
- Postpartum Endometritis
- Cesarean Birth
- Fever
- Uterine Tenderness
- Acute Endometritis
- Neutrophils
- Pelvic Inflammatory Disease (PID)
- Chronic Endometritis
- Plasma Cells
- Idiopathic
- Gentamicin + Clindamycin
- Ampicillin-Sulbactam
Dysfunctional Uterine Bleeding
- Bimodal Age Distribution
- Painless Vaginal Bleeding
- Amenorrhea
- Menorrhagia (Heavy Menstrual Bleeding)
- Metrorrhagia (Bleeding Between Menses)
- Balloon Thermotherapy
- Hormone Medications
- Dilation and Curettage (DandC)
- Monitor for Anemia