Final Exam (Previous Quiz Questions) Flashcards
1
Q
The tropic hormone secreted from the ANTERIOR pituitary that stimulates thyroxine (T4) release from the thyroid gland is?
A
Thyroid-Stimulating Hormone (TSH, thyrotropin)
2
Q
These types of hormone are easily absorbed through the skin via gel, cream, or patch - what are they?
A
steroid hormones
3
Q
Human Growth Hormone (HGH) exerts its effects on cells via what?
A
Insulin-like Growth Factor (IGF-1)
4
Q
A 25 year old female presents to your office with her 4 month old son. She reports to you that two months ago after delivering her son, she began noting diminished milk production. Upon further questioning, she also complains of fatigue, diminished libido and abnormally dry skin. Physical exam is remarkable for diminished amount of pubic and axillary hair. What is your most likely DX?
A
Sheehan's Syndrome common ssx: - Inability to breast-feed (breast milk never "comes in") - Fatigue. - Lack of menstrual bleeding. - Loss of pubic and axillary hair. - Low blood pressure.
5
Q
A surge in which anterior pituitary hormone triggers ovulation?
A
Luteinizing hormone (LH) - triggers ovulation, stimulates corpus luteum and secretion of PROGESTERONE*
MALES:
- stimulates Leydig cells to produce testosterone
- released in response to HIGH frequency pulses of GnRH
6
Q
Severing neuronal connections between the hypothalamus and the pituitary would affect the secretion of which pituitary hormone? Why?
A
Oxytocin
- secreted from POSTERIOR pituitary which is connected by NEURONS to the hypothalamus
7
Q
Agents that are secreted by a cell and act only on nearby or neighboring cells are known as what?
A
Paracrine agents
8
Q
A 42 y/o while male PTC with complaints of “sugar problems.” He brings a copy of the report that was obtained on his routine insurance screening test. The report shows fasting glucose of 136 mg/dL (normal range: 70-100 mg/dL) and a follow-up fasting glucose level of 142 mg/dL. During a review of systems the patient complains of weight gain, trouble speaking and vision problems over the past several months. He specifically comments that his favorite hat is now too small on him. During examination of the patients cranial nerves - which visual field cut would be expected?
A
Bitemporal hemianopia (visual field deficit on the lateral visual field BL)
- patients presenting with bitemporal hemianopsia or unexplained visual field deficits or visual loss should be considered to have a pituitary OR hypothalamic disorder until proven otherwise*
9
Q
This hormone:
- has elevated levels during the evening and early morning hours
- acts as an immunomodulator
- acts on peripheral receptors to maintain body wide circadian rhythms
- and is secreted by the pinealocytes
which hormone is this and what amino acid is it synthesized from?
A
Melatonin
- synthesized from TRYPTOPHAN
(his quiz says: synthesized from tyrosine - we all know that’s wrong ie - that’s the answer, NOT SYNTHESIZED FROM TYROSINE)
10
Q
This hormone, does NOT require carrier proteins to be transported in the plasma, which hormone is it?
A
Insulin
all of the following require transport proteins:
- pregnenolone
- 1,25(OH)2 Vitamin D
- Thyroxine (T4)
- Cortisol
11
Q
This hormone binds directly to intracellular/intranuclear receptors to exert its action on cell function - which hormone is it?
A
Thyroxine (T4)
12
Q
T/F - pituitary microadenomas are often managed medically using dopamine antagonists?
A
False
- managed with dopamine AGONISTS
Other fun facts:
- pituitary adenomas can be life-threatening
- hypogonadism is a frequent manifestation of pituitary adenomas
- Mass effects from pituitary adenomas may increase intracranial pressure
- achondroplastic dwarfism is NOT the result of an endocrine disorder (it’s genetic)
13
Q
Dopamine agonists (such as cabergoline) would have what effect on prolactin secretion from the anterior pituitary?
A
it would DECREASE release of Prolactin
14
Q
Which condition is most commonly found in obese females with a history of multiple pregnancies and HTN?
A
Empty Sella Syndrome
common ssx:
Empty sella is often an incidental imaging finding w/out associated symptoms.
If symptoms:
- headaches, symptom of elevated spinal fluid pressure
- symptoms of hypopituitarism
- visual symptoms, can sometimes be due to downward, prolapse of the optic chiasm into the empty sella.
15
Q
ACTH stimulates release of which hormones from the adrenal cortex?
A
Cortisol
DHEA-S (androgens)
16
Q
Which hormone is most commonly hyper-secreted in pituitary adenomas?
A
Prolactin
17
Q
What is the most common cause of dwarfism in children?
A
Achondroplastic Dwarfism
- a spontaneous mutation of the fibroblast growth factor receptor
18
Q
A 43 y/o F patient presents with a moon face, truncal obesity, HTN, purple striae, buffalo hump, fragile skin and impaired glucose tolerance. In addition, a visual exam reveals bitemporal hemianopsia - what does she most likely have?
A
Cushing’s disease
19
Q
A 35 y/o F PTC with thick jaw, prominent brow, large hands, HTN, arthritis, menstrual disturbances and diabetes mellitus. A 5 mm pituitary adenoma was detected on MRI of her head. This adenoma is most likely hyper-secreting which hormone?
A
Growth Hormone
- ie ACROMEGALY
- occurs after epiphyseal plates are closed, causing thick jaw bones, fingers and toes.
20
Q
Which of the following DOES NOT increase growth hormone secretion? - low blood glucose - estrogen - cortisol - strenuous exercise - deep sleep ?
A
Cortisol does not increase the release of GH.
- things that stimulate GH hypoglycemia, fasting glucagon ghrelin estrogen androgens (in puberty) strenuous exercise nicotine vitamin B3 deep sleep
21
Q
antidiuretic hormone (ADH) is primarily released in response to what?
A
increased serum OSMOLALITY
osmolality:
the concentration of a solution expressed as the total number of solute particles per kilogram.
22
Q
The two hormones released from the neurohypophysis are manufactured where?
A
Paraventricular and Supraoptic Nuclei of the Hypothalamus
23
Q
These can all be precipitating factors for this condition: - meningitis - pneumonia - pulmonary carcinoma (SCC) - head trauma what is this condition?
A
Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH)
- characterized by excessive release of ADH (from posterior pituitary or other source)
- increase in blood volume (hypervolemia) often results in dilutional hyponatremia where plasma sodium levels are lowered and total body fluid is increased.
- lithium medications are NOT an etiology
24
Q
This may result from SIADH, adrenal insufficiency (Addison’s disease), or “beer potamania”
A
Euvolemic Hyponatremia
if associated with CHF or renal failure - hypervolemic hyponatremia
25
In pregnancy, this hormone is primarily responsible for uterine contraction at delivery as well as milk ejection from the breast - which hormone is this?
oxytocin
26
A 66 y/o M with a 50-pack year history of cigarette smoking comes to the clinic complaining of chronic cough, with dyspnea, and blood in his sputum. He says he has been feeling lethargic and has lost 40 lbs over the past 3 months with no changes in diet or exercise. While awaiting an x-ray of the chest, the patient suffers a seizure and is rushed to the emergency department of the nearest hospital. Lab studies show a serum sodium level of 120 mEq/L (N = 135-145 mEq/L) - what is most likely to be elevated in this patient?
ADH (anti-diuretic hormone)
27
Diabetes insipidus is a disease characterized by the passage of what?
large volumes of dilute urine
28
In this specific illness, urine concentrates when synthetic ADH is administered - what is it?
Neurogenic (central) diabetes insipidus
- synthetic ADH is given orally or by nasal spray
29
Too rapid IV infusion of SODIUM can result in what?
Central Pontine Myelinolysis
30
35 y/o M ptc complaining of increased urinary frequency, polyuria, and an insatiable thirst. He was recently started on a new mediation by his psychiatrist. Labs show the patient is hypernatremic and has decreased urinary osmolarity. Which of the following drugs is most likely contributing to this patients current condition?
- carbamazepine
- lithium
- fluoxetine
- phenobarbital
- clomipramine
Lithium
31
Dipsogenic diabetes insipidus is caused by a defect or damage to what?
HYPOTHALAMUS
| - causes malfunction of the thirst mechanism
32
In the anterior pituitary, hypothalamic neurons regulate endocrine cells, how??
hypothalamic neurons release peptide hormone into the hypophyseal portal blood system to the anterior pituitary
33
In a 35y/o F with SIADH, lab findings would typically including all of the following except what?
- serum sodium < 135 (N is 135-145 mEq/L)
- BUN < 10 (N is 7-20mg/dL)
- Serum potassium > 5.0 (N is 3.5-5 mEq/L)
- Uric acid < 4 mg/dL (N is 2.4-6 mg/dL)
- Reduced anion gamp
Serum potassium levels are usually unaffected in SIADH.
| - this with hyponatremia might suggest TRUE adrenal fatigue ie Addison disease
34
True or False
| Oxytocin is secreted exclusively by the posterior pituitary gland.
FALSE
oxytocin is secreted by several other tissues such as
- adrenal medulla
- thymus
- pancreas
35
What is the most metabolically active thyroid hormone?
Triiodothyronine
36
What is the most common cause of hypothyroidism in the USA?
Autoimmune Thyroiditis
37
Inhibitors of thyroid hormone secretion, function and metabolism include all of the following EXCEPT:
- estrogen
- growth hormone
- dopamine
- cortisol
- somatostatin
Growth Hormone
thyroid hormone exerts a permissive effect upon the anabolic and metabolic effects of GH and increases pituitary synthesis of GH, GH increases peripheral conversion of T4 to T3.
38
Tremors, nervousness and increased heart rate can be symptoms of all the following EXCEPT:
- increased activation of the SNS
- excessive secretion of Epi from the Adrenal medulla
- Myxedema coma
- Postpartum thyroiditis
- Thyroid storm
Myxedema coma
39
Which statement is not true regarding thyroid parafollicular cells?
- secrete a peptide hormone involved in inhibiting bone resorption
- are the cell type found proliferating in medullary thyroid cancers
- contain Na/I symporters
- found in the spaces between thyroid follicles
- none of the above
Parafollicular cells of the thyroid DO NOT contain Na/I symporters, these are ONLY found on thyroid follicular cells to concentrate iodine
40
A 44 y/o F with a history of pernicious ptc complaining of anxiety and occasional palpitations. She has unexplained weight loss of 10lbs and multiple daily bowel movements. She has not had a menstrual period in four months. She has a thyroid bruit and a 4x3cm oval, NT soft-tissue mass lateral to the thyroid cartilage. What is a possible etiology?
thyroid adenoma
41
```
True or False
In Grave's disease
- TSH levels are elevated,
- free T3 and T4 levels are increased and
- TPOAb's are elevated.
```
FALSE
42
True or False
| Thyroglossal duct cysts are nearly always malignant
False
- they may, however be HYPER-secreting thyroid hormone
43
According to the WHO, the daily required intake of iodine for adult men and non-pregnant women is what?
150 mg
- typical upper limit is set at 300mcg/day
- pregnant and lactating women gen. need b/w 250-300 mcg/day to ensure proper thyroid hormone synthesis
44
Which of the following is not a typical symptom of hypothyroidism?
- weight gain
- diarrhea
- cold intolerance
- hair loss
- bradycardia
Diarrhea
45
Graves disease is associated primarily with elevated plasma levels of what?
Anti-TSH (thyroid stimulating) antibodies
46
Which of the following is NOT associated with Cretinism?
- delayed mental development
- short stature
- delayed puberty
- atrial fibrillation
- myxedema
atrial fibrillation
47
25 y/o F ptc with a recent diagnosis of hypothyroid for a follow-up examination. In addition to levothyroxine, she has been taking a number of daily supplements to help accelerate her recovery. Although she intially reported improvement in her symptoms, the patient now complaints of
- constipation
- brittle hair and
- fatigue
What supplement could best account for the decline in the patient's clinical course?
Iodine
- via the Wolff-Chaikoff effect
XS iodine suppresses thyroid hormone secretion - inducing hypothyroidism
Pts w/ healthy thyroid glands usually recover from this effect in 5-10 days
Pts w/ AI thyroiditis - effect continues with continued iodine ingestion
48
34 y/o non-pregnant female ptc with a TSH of 0.3 mlU/L, a free T4 of 0.6 ng/L (N: 0.8-1.8 ng/L) and a free T3 of 2.5 (N: 2.3-4.2 pg/mL). Her TgAb and TPOAb levels are WNL. Without knowing her clinical history, these lab values suggest what?
Central Hypothyroidism
49
Which statement is most true regarding malignant thyroid nodules?
- tend to be MC in older women with multi-nodular goiter
- tend to be more likely to occur in young adult males than older males
- more likely to be HOT vs COLD nodules as detected by RAIU testing
- typically cystic vs solid
Malignant thyroid nodules tend to be more likely in young adult males than in older males
50
Which statement is true regarding thyroid carcinoma?
- medullary carcinoma accounts for the majority of thyroid cancers
- anaplastic carcinoma of the thyroid has a 5yr survival rate > 80% following biomedical treatment
- papillary thyroid cancer tends to mets via lymph nodes instead of blood
- all thyroid masses < 1cm should be referred for fine needle aspiration biopsy (FNAB)
- none of the above
papillary thyroid cancer tends to mets via the lymph, instead of through the blood
51
All of the following would be indicated therapies for patients with thyrotoxicosis in Grave's disease, except
- liothyronine
- methimazole
- I-131 therapy
- propranolol
- none of these
liothyronine
52
If the following condition is present in a patient with hypothyroidism, appropriate treatment for this condition MUST be instituted before any thyroid hormone replacement is given in order to prevent potentially lethal circulatory collapse - what condition is this?
Addison's disease (adrenal insufficiency)
- adrenal insufficiency often causes TSH to be elevated thereby mimicking hypothyroidism
53
45 y/o F ptc with feelings of fatigue, increased appetite, increased sweating and palpitations. Her doc also notes that her eyes appear unusual: her lids appear retracted and it appears the eyeball is protruding further than in normal. She receives pharmacologic treatment for her condition, but soon develops a fever and multiple infections in her throat and GI tract. Her doctor quickly discontinues the medication. Which medication was she prescribed?
Propylthiouracil (PTU)
she has Graves and was prescribed PTU which is associated with agranulocytosis in a small number of patients (< 0.5%)
54
Follicular hyperkeratosis often seen in patients with untreated hypothyroidism is directly related to decreased serum levels of what?
Vitamin A
- poor conversion of beta-carotene into vitamin A due to low thyroid levels.
55
Parathyroid hormone (PTH) is responsible for what in the bones?
increases osteoclast activity
56
Aside from adjusting calcium levels, what other ions (2) does the parathyroid control?
Phosphate
| Magnesium
57
Hypocalcium (in non-pregnant adult females and males) occurs when serum calcium falls below what?
8.5 mg/dL
58
how many parathyroid glands do most people have?
4
59
True or false
| The parathyroid glands are found between the thyroid follicles, embedded with thyroid gland
FALSE
they are located on the posterior surface of the thyroid within the capsule
common ectopic locations:
retroesophageal
thymus
60
The two types of cells found in the parathyroid gland are?
Chief cells
| oxyphil cells
61
Hypocalcemia is typically associated with all of the following except
- tetany
- shorted QT interval on ECG
- anxiety
- muscle cramps
- seizures
Shortened QT-interval on ECG
62
Which hormone is a natural antagonist to parathyroid hormone?
Calcitonin
63
MC cause of hypoparathyroidism
surgical trauma/damage
64
A patient with an elevated serum ionized calcium and high PTH is most likely to have what?
parathyroid adenoma
65
The history and PE of patients presenting with hypercalcemia is most likely to reveal which of the following ssx:
- severe fatigue (pos Chvostek's)
- severe fatigue (pos Trousseau's)
- Bradycardia
- Asx/no pathological signs
Bradycardia
66
42 y/o F ptc with sx of numbness and tingling around her lips and in her extremities. She also complains of frequent muscle spasms, frequent episodes of irritability, HYPOtension and chronic itching over most of her body. Six months ago, she underwent thyroidectomy for papillary thyroid carcinoma and has been taking levothyroxine 200mcg/day. Her current TSH and fT4 levels are WNL. You run a CMP, her serum calcium is 8.0 mg/dL. Which condition is most likely explained by these findings?
Hypoparathyroidism
67
A two year old PTC with noted knobby rib appearances on both sides of midline, her legs - slightly bowed. With a lifestyle consisting of inner city dwelling, a little time outside - it's obvious the girl has rickets. Her mother still breastfeeds - you draw labs - what would you expect to see (an increase or decrease) for the following values:
- calcium
- phosphate
- PTH
- calcium - decreased
- phosphate - decreased
- PTH - increase
vitamin D plays a key role in regulating uptake of both calcium and phosphate
with low calcium, PTH secretion is increased
68
which of the following medications would you give a patient suffering from hypercalcemia to increase Ca excretion in the urine - they've already been vigorously re-hydrated
a loop diuretic - furosemide
69
Which ssx would likely NOT be found in a patient with a PTHrP-secreting tumor?
- shortened QT interval on ECG
- nephrocalcinosis
- hyperactive tendon reflex
- band keratopathy
- ataxia
HYPERactive tendon reflexes
70
these are all typical symptoms of cushing's syndrome - except which one?
- weight loss
- delayed wound healing
- bone loss
- hyperglycemia
- suppressed immune function
Weight loss
71
what would you expect after observing the following in a patient:
- during cortisol suppression test with 1 mg dexamethasone, no change in cortisol upon admin
- 8mg of dexamethasone, cortisol level drops
ACTH-secreting pituitary adenoma
ACTH - key function: stimulate production and release of cortisol from adrenal cortex.
dexamethasone determines if cushing's cortisol rise or other cause. IF Cushing's will see no decrease in cortisol bc ACTH is already quite low from neg. feedback
- partial suppression (with higher dose) = pituitary disease
72
what does the cosynthropin test diagnose?
Adrenal insufficiency
- cosyntropin (synthetic ACTH) is injected - blood is drawn before and after - cortisol levels are measured and compared to see how the adrenals respond to increased ACTH
73
which part of the adrenal gland secretes aldosterone?
zona glomerulosa - in the cortex
74
what would you expect to see in Conn's disease for the following lab profile:
- aldosterone
- potassium
- plasma renin
- aldosterone - high
- potassium - low
- plasma renin - decreased
Conn's disease aka primary hyperaldosteronism; cause of high blood pressure*
75
What causes Cushing DISEASE?
Pituitary Adenoma
76
34 y/o F gives birth to a child with ambiguous genitalia. The child is hypotensive. A geneticist tells the mother the child is genotypically gemale, although there seems to be partially virilized external genitalia. Which enzyme is most likely deficient in this child?
21-alpha-hydroxylase
- child has MC form of Congenital Adrenal Hyperplasia (CAH) - causing hypotension with increased androgens
77
This enzyme converts active cortisol to inactive cortisone - it's also inhibited by glycyrrhetinic acid in licorice - what enzyme is this?
11-beta HSD2
78
What is the rate-limiting step in cortisol synthesis?
cholesterol to pregnenolone
79
26 y/o M PTC complaining of intermittent muscle cramping x3 mo, with no other significant complaints. PE reveals BP 190/105 mmHg. His labs reveal sodium at 155mEq/L (N: 135-147mEq/L), potassium at 3.2mEq/L (N: 3.5-5.0mEq/L), and bicarbonate at 33mEq/L (N:22-28mEq/L). His CMP and CBC were otherwise normal.
What is the most likely cause of this patient's findings?
Conn Syndrome
- the fact his CMP is WNL indicates his glucose is N. Glucose would be elevated in CUSHING's syndrome, but not Conn's syndrome*
80
What is the MC cause of primary adrenal insufficiency?
Autoimmune disease
81
40 y/o M with AIDS presents to the ED iwth acute-onset nausea, vomiting and abd. pain. He is febrile and HYPOtensive. He was started recently on a new drug for systemic fungal infection. Lab tests reveal mild hyperkalemia and hyponatremia. Which of the following agents is most likely to have caused this patient's condition?
- dexamethasone
- trimethoprim-sulfamethoxazole (TMP-SMX)
- Amphotericin B
- Ketoconazole
- Propylthiouracil (PTU)
Ketoconazole
- he has adrenal insufficiency
- ketoconazole inhibits production of adrenal steroids
- given in XS doses, may cause acute adrenal insufficiency*
82
54 y/o F PTC with DM, osteoporosis and hypertension. She notes recent weight gain and abdominal striae. Labs reveal decreased ACTH levels. A single mass is noted adjacent to the right kidney on abd. CT. Neither low or high-dose dexamethasone suppressed her cortisol production - what does she likely have?
adrenal adenoma
83
This hormone is released from the adrenal cortex is response to ACTH, it's primary found with a sulphate group attached to it in the plasma, it is the most abundant androgen found in females and in PCOS its levels are often increased - name it!
DHEA-S
- DHEA is converted to androstenedione then by aromatase, androstenedione is converted to ESTRONE - from there estrone can be converted to estradiol.
(therefore DHEA is NOT directly converted by aromatase to estradiol)
84
27 y/o F PTC with 6 month Hx of progressive weakness, fatigue and occasional mild abdominal pain. She has noticed her skin is becoming more tan, esp at the elbows, knees and knuckles - despite her lack of sun exposure. Labs reveal mild hyponatremia, decreased bicarbonate, chloride and glucose; with hyperkalemia. What is her likely DX?
Addison disease
85
exogenous testosterone administration for anabolic purposes such as abuse of steroids results in all of the following except what?
- acne
- increased muscle mass
- increased bone mass
- anemia
anemia
- low levels of testosterone is actually linked to anemia.
86
The following values are consistent with what
- low testosterone
- low FSH
- low LD
- increased GnRH
secondary hypogonadism
primary - disease of testes
secondary - disease of either pituitary or hypothalamus
in this case- the pituitary is not responding to the GnRH
87
where does spermatogenesis occur?
Seminiferous tubules
88
What is the MC genetic cause of secondary hypogonadism (hypogonadotrophic hypogonadism) in males?
Kallmann Syndrome
- characterized by delayed or absent puberty and impaired sense of smell
89
Sertoli cells respond primarily to which pituitary hormone - FSH or LH?
FSH
90
When administering testosterone, which route carries the greatest risk of possible liver damage?
P.O. tablets
91
Aromatase is widely present in both men and women, with levels elevating in men as they age. It is an intercellular cytochrome p450 enzyme that can be inhibited in estrogen(+) breast cancer therapy - what is this lovely enzyme most commonly known for conversion of?
responsible for converting androgen to estrogens
92
5-alpha-reductase inhibitors such as finasteride and dutasteride are useful in the treatment of all of the following except?
- benign prostatic hyperplasia
- androgenic alopecia
- prostate cancer
- erectile dysfunction
erectile dysfunction
93
this medication interrupts the pulsatile rhythm of GnRH, leading to decreased FSH and LH - what is it?
Leuprolide acetate (Lupron)
give SQ or IM
- used to tx prostate cancer, breast cancer, endometriosis, uterine fibroids and early puberty
94
Klinefleter's syndrome is associated with all of the following except?
- accessory X chromosome (47XXY)
- gynecomastia
- azoospermia (no viable sperm)
- reduced testicular volume
- GnRH insensitivity
GnRH insensitivity
Klinefleter's syndrome
- hypogonadism and infertility in men
95
all of the following regarding progesterone are true, except?
- has many important roles in fetal development
- decreases core temperature during ovulation
- elevated in the plasma during the luteal phase of the menstrual cycle
- inhibits lactation during pregnancy
- is considered a neurosteroid
decreases core temp
Progesterone actually INCREASES core temp during ovulation
96
Estrogen receptor beta (ER2) has natural ligands that include flax ligands and isoflavones (soy). It's found in the CNS, bone, heart, endothelial and prostate tissue, and estriol preferentially binds ER2 (beta) as opposed to ER1 (alpha) - is ER1 or ER2 the receptor most expressed in breast cancer tumors?
ER-alpha (ER1) is typically MC in ER+ breast cancers
- usually expressed in 70% of BCs
97
does estradiol increase muscle mass?
No - estrogen tends to decrease muscle mass where androgens are generally responsible for increased muscle mass
98
Decreased LDL, increased HDL, increased sodium and water retention, decreased bone resorption and increased bone formation as well as breast and reproductive tract development are all associated with which hormone?
estradiol
99
These typically decrease sex hormone binding levels (4)
glucocorticoids
obesity
hyperandrogenism
hyperinsulinemia
- with high estrogen states - SHBG is actually increased**
100
all of these describe PCOS except?
- elevated androgens
- amenorrhea or oligomenorrhea
- infertility
- insulin resistance
- hypotension
hypotension
- generally associated with a more metabolic syndrome picture which tends toward hypertension
101
what the 2003 Rotterdam criteria for dx of PCOS?
- presence of oligo-ovulation or anovulation
- polycystic ovaries (obs. in TVUS)
- clinical/biochemical signs of hyperandrogenism
need 2/3 for DX
102
All of these cause secondary amenorrhea except?
- hyperprolactinemia
- mullerian agenesis
- PCOS
- Asherman syndrome
- Functional hypothalamic/pituitary dysregulation of gonadotropins
Mullerian agenesis
- anatomic abnormality of the female genitalia - PRIMARY amenorrhea
103
HRT using oral conjugated equine estrogens (premarin) + a progestin (such as Provera) in post-menopausal women would tend to have all the following benefits except?
- reduced risk of hip fracture & osteoporosis
- reduced risk of thrombosis
- reduced risk of developing colorectal cancer
- reduced LDL and T-cholesterol levels
- reduced hot flashes and vaginal dryness
reduced risk of thrombosis
greatest RISK of therapy.
with HRT
- thrombosis
- breast, ovarian, endometrial cancers
104
Menstruation occurring in intervals greater than 35 days, with only 4-9 periods in one year is termed?
oligomenorrhea
