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Reproductive Physiology, Endocrinology, and Infertility

Question
49 out of 56
 

Primary amenorrhea is not seen in: (AIPG 2009)



A Sheehan’s syndrome

B Kallmann’s syndrome

C Mayer Rokitansky Küster Hauser syndrome

D Turner syndrome

Ans. A

Sheehan’s syndrome

a. Sheehan’s syndrome is post-partum pituitary necrosis, the reason of which is attributed to the fact that a pregnant woman Has Hypertrophy and hyperplasia of lactotrophs and this results in the enlargement of the anterior pituitary, without a corresponding increase in blood supply which is in turn generally supplied by a low pressure portal venous system.

b. Even a moderate amount of reduction in flow due to events like PPH can contribute to ischemic necrosis of the pituitary cells.

c. This leads to reduction in LH and FSH production and hence secondary amenorrhea due to non-stimulation of the ovary. The posterior pituitary is usually not affected due to its direct arterial supply.

a. Kallaman’s syndrome is due to hypothalamic dysfunction caused by a deficiency of gonadotropinreleasing hormone (GnRH), causing a Hypogonadotrophic hypogonadism.

b. This is associated with anosmia. It can occasionally be associated with optic problems, such as colour blindness or optic atrophy, nerve deafness, cleft palate, cryptorchidism, renal agenesis, and mirror movement disorder.

1. MRKH syndrome, also known as Mullerian

2. Agenesis is due to anatomical absence of Uterus. This is the most common ‘anatomical’ cause of primary amenorrhea

3. Turner’s syndrome is a type of gonadal dysgeneis (Which is the most common overall cause of Primary amenorrhea) which is associated with lymphedema, web neck, shield chest, low set hair line, cardiac defects and coarctation of the aorta, urinary tract malformations and horseshoe kidney, short stature, cubitus valgus, short neck, short 4th metacarpals, hypoplastic nails, micrognathia, scoliosis, otitis media and sensori-neural hearing loss, ptosis and amblyopia, multiple nevi and keloid formation, autoimmune thyroid disease.

4. OBG 321

5. In adulthood:

6. Pubertal failure and primary amenorrhea, hypertension, obesity, dyslipidemia, impaired glucose tolerance and insulin resistance, autoimmune thyroid disease, cardiovascular disease, aortic root dilatation, osteoporosis, inflammatory bowel disease, chronic hepatic dysfunction, increased risk of colon cancer, hearing loss.

7. 322 AIPG Jan. 2009: Ques. with Explanatory Answers

Reproductive Physiology, Endocrinology, and Infertility Flashcard List

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