Exam 3

Question 1

Normal growth depends on adequate production and function of…

Answer 1

Growth hormone, IGF-1, TH, testosterone and estrogen

Question 2

Serum GH stimulates what?

Answer 2

IGF-1 production by liver, both together= growth

Question 3

Secondary growth disorders

Answer 3

Malnutrition, malabsorption (celiac) or chronic disease (IBD)

Question 4

Primary growth deficiency

Answer 4

Genetic (Turner syndrome)

Question 5

GH resistance due to GH receptor mutation

Answer 5

Laron syndrome

Question 6

Skeletal disorders how diagnose?

Answer 6

Have abnormal limb-to-spine ratio chondrodysplasias= shorter arm span, upper segment>lower segment scoliosis= shorter upper segment, normal arm span

Question 7

A 22 yo male comes into your office after being referred due to an enlarged scrotum. He has no trauma history and no new sexual encounters. He has a normal amount of pubertal and axillary hair. He states that his right scrotum was enlarged to the size of a baseball for the past week but has decreased some recently. He states it is difficult to fully appreciate the testicle on this side but feels more firm than the other side. The left testicle is normal.

What is this likely? Next step?

Answer 7

• Need ultrasound. intra-testicular mass with a reactive hydrocele and blood flow to the testicle and mass.
• Testicle cancer
• 1) labs for testicular cancer (b-HCG, AFP, and LDH)
  2) CT abdomen and pelvis with contrast looking for metastatic disease

Question 8

A 35 yo male comes to see you. He and his wife (age 28) have been trying to get pregnant without success. They are having sex once a month. On examination, he has minimal pubic hair and a small testicular volume (<10 cc bilaterally). He is unsure when he went through puberty. He takes no medications. There is no history of head trauma or headaches or visual disturbances. Low Testosterone, FSH, LH. What does he have? Treatment?

Answer 8

• Secondary Hypogonadism, hypogonadotropic hypogonadism
• injections of LH (in the form of b-hCG) and FSH.

Question 9

25 year old male comes to your office complaining of a few days of scrotal swelling and pain on his right side. Mild but low fevers (99-100F). What have? Treatment?

Answer 9

• Acute epididmitis
• Ceftriaxone 250mg IM once + Doxycycline 100mg twice daily for 10 days

Question 10

Patient has elevated AFP

Answer 10

Yolk sac tumor

Question 11

Patient has elevated beta hCG

Answer 11

choriocarcinoma

Question 12

Patient has elevated hCG and elevated AFP

Answer 12

Embryonic carcinoma

Question 13

Adenomyosis

Answer 13

• Glandular tissue in muscle (myometrium)
• painful periods, extra heavy vaginal bleeding

Question 14

Excess estrogen puts women at risk for what?

Answer 14

Endometrial cancer

Question 15

Older obese woman present with post menopausal bleeding, what is it? Treatment?

Answer 15

• Endometrial cancer
• hysterectomy, remove tubes and ovaries and staging lymph nodes

Question 16

At what age does baby sit?

Answer 16

6 months

Question 17

When do babies walk?

Answer 17

12 months

Question 18

When are babies 3x weight?

Answer 18

1 year

Question 19

Where is progesterone work and what does it regulate?

Answer 19

HypothaLamus, makes ovulate

Question 20

What treat endometriosis with?

Answer 20

• Leuprolide: GnRH agonist
• OCP

Question 21

Patient has ascites with solid unilateral adnexal mass, what is it likely? What test do?

Answer 21

• Epithelial ovarian cyst
• CA-125
• tx: surgery and chemo
• also test for BRCA 1 & 2

Question 22

30 year old female with feeling of pressure, heavier than normal menstrual bleeding

Answer 22

Leiomyoma (fibroids)

Question 23

HPV markers

Answer 23

16 and 18