esterilidad Flashcards

1
Q

define esterilidad

A

Incapacidad de que de produzca la fecundación

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2
Q

define hiperandrogenismo+3 fisiopatologias

A

-aumento prod endogena(suprarrenal,ovarico y periferico
-aumento biodisponibilidad (reduccion SHBG)
-

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3
Q

4 etiologias hiperandrogenismo

A

-suprarrenal
-ovarico
-periferico
-farmacos

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4
Q

dx hiperhirsutismo

A

clinica+analisi BQ

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5
Q

como evaluar hieprhirsutismo

A

Escala de Ferriman Galway

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6
Q

14 elementos en analisis BQ de hiperhirsutismo

A

FHS
LH
PRL
estradiol
TSH
T4
Testosterona
Androstendiona
SHBG
DHEAS
17-OH-progesterona

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7
Q

origen%+transp plasmatico de …
-testosterona
-androstenediona
-DHEAS

A

Testosterona: 50 periferico+ 50 de suprarrenal y ovárico. Transporte por SHBG
Androstendiona: 50 periferico+50 gonadal. Transporte libre
DHEAS:90% suprarrenal- Transporte libre

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8
Q

2 objetivos tto de hiperandrogenismo

A

-disminuir producc androgenos
-neutralizar efectos perifericos

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9
Q

6 farmacos disminuir prod androgenos en hiperandrogenismo

A

estroprogestativos
analogos GnRh
corticoesteroides
ketoconazol
drilling
disminuir IMC

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10
Q

7 farmacos para neutralziar accion periferica en hiperandrogenismo(EFFPADD)

A

-espironolactona
-flutamida
-finasterida
-progestagenos antiandrogenicos
-acetato de ciproterona
-dienogest
-drospirenona

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11
Q

define SOP+ 3 CSQ

A

sindr metabolico caracterizado por:
-disf esteroidogenesis
-hiperproducc LH
-altr metab de hiperinsulinismo+R.insulina
CSQ
-altr ovulacion(tto menstruales+esterildiad)
-exceso androgenos(hiperandrogenismo)
-Obesidad ,altr cardio y DM

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12
Q

4 genes involucrados en SOP

A

-esteroidogenesis
-regulacion geonadotrofinas
-secrecion insulina
-metab tej adiposo

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13
Q

descartar 4 enf para SOP+3 signos clinicos

A

enf:
-hiperplasia suprarrenal congenita
-hiperPRL
-Sindr Cushing
-disfuncion tiroidea
3 singos:
-anovulacion/oligo
-signos clinicos/BQ hiperandrogenismo
-ECO: ovarios+12folic

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14
Q

4 fenotipos SOP

A

-tipico/grave(46-71%)
-hiperandrogenismo+Ovulacion(7-40%)
-Leve(16%)
-Ovulatorio(16%)

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15
Q

4 elementos que determinan los fenotipos de SOP

A

-anovualcion/oligoovulacion
-hiperandrogenismo
-hiperinsulinismo
-signos ECO

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16
Q

tto segun fertilidad/no fertilidad SOP

A

fertildiad:
-citrato de clomifeno
-gonadotrofinas
-metformina
-drilling ovarico
NO fertilidad:
-estrogenoporgestagenos(disminuir estrogenos y aumentar SHBG

17
Q

4 TRA

A

-inseminacion artificial
-GIFT
-FIVET
-ICSI

18
Q

define sindr hiperestimulacion ovarica

A

inestabilidad hemodinamica causada por ttos de estimulacion ovarica. dx por ECO y niveles de estradiol+clinica(cefalea,nauseas,vomitos,altr coagulacion,altr renal…)

19
Q

5 ttos de induccion a ovulacion esterilidad

A

citrato de clomifeno
gondaotrofinas
drilling
inhb aromatasa
metformina

20
Q

explica mecanismo citrato de clomifeno

A

inh feddback negativo de estradiol y provoca aumento de GnRH y por lo tanto de FSH y LH