Endocrine

Question 1

What causes postpartum telogen effluvium (hair loss)?

Answer 1

High levels of estrogen during pregnancy causes synchronous hair growth. This means that the hair grows in the same phase and is shed at the same time. This can result in significant postpartum hair loss at 1-5 months postpartum.

Question 2

What causes the resurgence of menopause symptoms in a postmenopausal woman with an oophorectomy?

Answer 2

Estrogen levels can be significant in postmenopausal women due to the extraglandular conversion of androstenedione and testosterone to estrogen in peripheral fat cells (so more prominent in larger women). Note that the ovaries do not continue to produce estrogen beyond menopause, but they do continue to produce androgens. This loss of androgens leads to the loss of converted circulating estrogen which causes symptoms like hot flashes post oophorectomy.

Question 3

Does combined hormone replacement therapy increase the risk for ovarian cancer?

Answer 3

No

Question 4

Does combined or estrogen only hormone replacement therapy increase the risk for breast cancer?

Answer 4

Just combined - suggesting that progestins play a role in increased risk

Question 5

How does hormone replacement therapy affect LDL and HDL levels?

Answer 5

Increases HDL and decreases LDL (positive effects)

Question 6

What hormone level should be checked to assess for decreased ovarian reserve?

Answer 6

Anti-mullerian hormone

Question 7

What medication treatment is a good indicator for response to oophorectomy for the treatment of PMDD?

Answer 7

GnRH agonist treatment - mimics premature menopause state

Question 8

What hormone promotes a vaginal pH of <4.5?

Answer 8

Estrogen, it promotes Lactobacilli growth which lowers the pH

Question 9

What form of estrogen is primarily released from adipose tissue?

Answer 9

Estrone

Question 10

How does the LH:FSH ratio change in PCOS?

Answer 10

It is elevated (normally it is 1:1)