Primary amenorrhea (mechanism of disease) скачать в хорошем качестве

Primary amenorrhea (mechanism of disease)

This is a flowchart on primary amenorrhea, covering the etiology, pathophysiology, and manifestations. ADDITIONAL TAGS: Turner syndrome (45,XO) Ovarian dysgensis (46,XX) Risk factors / SDOH Cell / tissue damage Structural factors Primary amenorrhea Medicine / iatrogenic Infectious / microbial Biochem / metabolic Immunology / inflammation Signs / symptoms Tests / imaging / labs Embryology / development Genetic / hereditary Neoplastic / cancer Pathophysiology Etiology Manifestations Primary amenorrhea: absence of menarche ↓ release of GnRH → ↓ pituitary release of FSH and LH Ovaries fail to produce estrogen and progesterone Hypogonadotropic hypogonadism Hypergonadotropic hypogonadism ↑ GnRH ↑ FSH, LH ↓ estrogen, progesterone ↓ GnRH ↓/nl FSH, LH ↓ estrogen, progesterone Kallmann syndrome: Defective migration of GnRH-releasing neurons from olfactory bulbs to hypothalamic preoptic nuclei → ↓ GnRH secretion and underdevelopment of the olfactory bulbs Anosmia / hyposmia Functional hypothalamic amenorrhea: ↓ leptin and/or ↑ cortisol → ↓ pulsatile release of GnRH Competitive sports Stress Eating disorders CNS tumors (e.g., craniopharyngioma) Prader-Willi syndrome: loss of genes on chromosome 15 Muscular hypotonia, poor feeding Hyperphagia → obesity Short stature, scoliosis Developmental delays Gonadal dysgenesis Swyer syndrome (46,XY) Streak ovaries Short stature Webbed neck Wide-spaced nipples Anatomic anomalies → outflow tract obstruction Vaginal atresia Imperforate hymen Müllerian agenesis Transverse vaginal septum Normal GnRH, FSH, LH, estrogen, progesterone Receptor / enzyme abnormalities 5-alpha-reductase deficiency (“penis at 12”) Complete androgen insensitivity syndrome Congenital adrenal hyperplasia (CAH): 17-alpha-hydroxylase deficiency By Artoria2e5 - Own work, CC BY 3.0, https://commons.wikimedia.org/w/index... Structural abnormalities