\COMPLETE QUESTIONS AND ACCURATE DETAILED
ANSWERS \VERIFIED 100% GRADED A+\Physio-Patho
Basis of Advanced Nsg, University of South Alabama
Most common cause of anovulation and ovulatory
dysfunction; leading cause of infertility in the U.S.
Associated with metabolic dysfunction > dyslipidemia, insulin
resistance, and obesity
Defined at least two of the following features:
irregular ovulation
elevated levels of androgen (ex: testosterone)
appearance of polycystic ovaries on ultrasound—
polycystic ovaries do not have to be present (their
presence alone does not establish the diagnosis)
Pathophysiology of PCOS: strong genetic
component suspected Hyperandrogenic
state is a cardinal feature
Glucose intolerance/insulin resistance run parallel to and
markedly aggravate the hyperandrogenic state > severity of
What is PCOS and what
s/s of PCOS
does it cause? Clinical
manifestations?
Clinical manifestations of PCOS: usually appear within
Treatment?
Causes? Pathophysiology? 2 years of puberty (may present after a variable period
of normal menstruation function and possibly
pregnancy)
Goals of Treatment:
reversing s/s of
androgen excess
,instituting cyclic
menstruation
restoring fertility
ameliorating any associated metabolic or endocrine or both
disturbances
Treatment of PCOS:
First-line > combined oral contraceptives for
management of s/s and to establish regular menses
Overweight or obese women > lifestyle modifications
(regular exercise and weight loss)
Women with insulin resistance, or those women who
do not respond to contraceptive therapy > insulin
sensitizer Metformin
If oral contraceptives are not used and pregnancy
is not desired > progesterone therapy is
recommended to oppose estrogen’s effects on the
endometrium (means to initiate monthly withdrawal
bleeding)
, Primary amenorrhea:
Failure of menarche and the absence of menstruation
by age 13 years, without the development of
secondary sex characteristics, or by age 15
regardless of the presence of secondary sex
characteristics.
It differs from delayed puberty in that most cases of
delayed puberty require on reassurance, but when the
diagnosis of primary amenorrhea is reached, a
What is the difference thorough evaluation is needed.
between primary and
secondary amenorrhea? Secondary amenorrhea:
The absence of regular menses for 3 months or
irregular menses for 6 months in women who have
previously menstruated.
Pregnancy is the most common condition to exclude before
further evaluation.
Common causes (after pregnancy):
thyroid disorders, hyperprolactinemia, HPO
interruption secondary to excessive exercise, stress,
weight loss and polycystic ovary syndrome (PCOS).
Compartment II:
Disorders which involve the ovary and are often linked
with genetic abnormalities. These include gonadal
dysgenesis (Turner Syndrome) or androgen
insensitivity syndrome (AIS).
, Puberty is the onset of sexual maturation and differs from
adolescence.
Adolescence is the stage of human development
between childhood and adulthood.
GIRLS: begins at about 8-9 years of age with thelarche
(breast development, one of the first signs of
puberty in girls)
BOYS: begins at about 11 years of age occurs with
increased weight and body mass index
Influences on timing: genetics, environment, ethnicity,
What are the signs of
general health, and nutrition Reproductive maturation
puberty in girls and boys?
involves the hypothalamic pituitary-gonadal (HPG)
What delays puberty?
axis, the CNS, and the endocrine system
A sequential series of hormonal events promotes
sexual maturation as puberty approaches
About 1 year before puberty in girls > increase in
frequency and amplitude of nocturnal pulses of
gonadotropin secretion, LH, and FSH, and an
increased response in the pituitary to GnRH > stimulates
gonadal maturation (gonadarche) with estradiol
secretion in girls and testosterone secretion in boys
o Estradiol causes breast development (thelarche),
maturation of the reproductive organs, (vagina, uterus,
ovaries) and fat deposit in hips in girls.
o Estrogen and increased production of growth
factors cause rapid skeletal growth in boys and
girls.
o Testosterone causes growth of the testes,
scrotum, and penis. A positive feedback loop is
created with gonadotropins stimulating the gonads
to produce more sex hormones. The most important
hormonal effects occur in the gonads. The testes begin
to produce mature sperm and are capable of
fertilizing an ovum.