Endocrine Reproduction

Question 1

testosterone is low
LH & FSH low-normal

Answer 1

Kallman’s syndrome

Question 2

-low testosterone But
-increased levels of FSH and LH.

Answer 2

Klinefelter syndrome (47,XXY)

Question 3

Acromegaly
Two Causes

Answer 3

• Pituitary adenoma
• Lung or pancreatic Ca = producing GHRH or GH

Question 4

What is BiTemporal hemianopia

Answer 4

• Loss of vision on outer parts of the eyes

Question 5

What ca is Acromegaly related too

Answer 5

Colon rec

Question 6

Rx acromeg

Answer 6

o -If inoperable or surgery unsuccessful then medication may be indicated:
1. somatostatin analogue (octreotide)- directly inhibits the release of GH; effective in 50-70% of pts
2. GH receptor antagonist (pegvisomant)- prevents dimerization of the GH receptor. once daily s/c administration
b. very effective - decreases IGF-1 levels in 90% of patients to normal
d. dopamine agonists -( bromocriptine)- now superseded by somatostatin analogues. effective only in a minority of patients

Question 7

Inhibition of GH2

Answer 7

Somatostatin & Da

Question 8

Two test to ix Acromegaly

Answer 8

IGF test. Levels of GH can change throughout the day. GH stim IGF-I in the blood. high IGF-I level= acromegaly.
Confirm with
Oral glucose tolerance test- Glucose normally reduces GH but in Arco suppression does not occur

Question 9

Explain the Oral glucose tolerance test

Answer 9

drink a sugary liquid. Then measure GH blood every 1/2 hr for 2
Normally sugar = GH levels to fall. In acromeg - Will not fall

Question 10

what are the LH and FSH levels in Kleinfelters and Kallman’s?

Answer 10

Kleinfelters (47 XXY) - raised LH and FSH

Kallman’s (hypogonadotrophic hypogonadism) - inappropriately low-normal LH and FSH

Question 11

What is premature ovarian failure?

Answer 11

onset of menopausal features before 40

elevated FSH and LH