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Endocrinology > Gonadal disease > Flashcards

Gonadal disease Flashcards

1
Q

What is PCOS?

A

Complex condition of ovarian dysfunction characterised by hyperandrogenism, insulin resistance, and high LH

Overlap with metabolic syndrome

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2
Q

What are Sx of PCOS?

A 
Hirsutism 
Acne and alopecia
Oligo/amenorrhoea 
Weight gain
Acanthosis nigrans 
Infertility
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3
Q

What Ix in PCOS?

A

Can be a clinical diagnosis if hirsutism with abnormal periods.

LH:FSH ratio >2:1 can also be helpful

Measure androgen levels e.g. testosterone, SHBG (elevated)

Luteal phase progesterone: can see if patients are ovulating.

TV US of uterus: polycystic ovaries

All patients should have TSH, prolactin, 17OHprogesterone, to exclude other causes of Sx.

OGT and fasting lipids can establish metabolic risk

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4
Q

What are DDx for PCOS?

A 
21OH deficiency 
Thyroid dysfunction
hyperprolactinaemia
cushing's
Diabetes
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5
Q

What is Rx of PCOS?

A

Weight loss can restore ovulation

COCP can help regulate cycles and hirsutism too (if not wanting pregnancy)

Metformin
Clomifene is good in patients who want to get pregnant

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6
Q

What are complications of PCOs?

A

Infertility
T2DM
NAFLD
metabolic syndrome

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7
Q

What are causes of primary hypogonadism in men?

A

Klinefelter’s syndrome (XXY)
Cryptorchidism
Alkylating agents (chemo), steroids
Untreated testicular torsion

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8
Q

What are causes of primary hypogonadism in women?

A 
PCOS
Turner
Fragile X
Menopause
CAH
Alkylating agents
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9
Q

What are Sx of primary gonadal failure in males?

A 
Decreased libido
loss of morning erection
ED
gynaecomastia
infertility 
micropenis, small testes
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10
Q

what are Sx of primary gonadal failure in females?

A 
irregular periods
infertility 
hot flushes and night sweats 
vaginal dryness
decreased libido
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11
Q

What Ix in primary gonadal failure?

A

Males: testosterone, SHBG, LH/FSH, prolactin, semen analysis, genetic testing

Females: FSH/LH (high), oestrogen (low), TSH, prolactin, pelvic US, karyotype

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12
Q

What Rx in primary gonadal failure?

A

Men: testosterone

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13
Q

What is Klinefelter’s syndrome?

A

Men with extra X chromosome (47XXY) - most common genetic cause of male hypogonadism

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14
Q

What are Sx of Klinefelter’s

A

Manifests @ puberty. Delayed puberty, small penis/testes, reduced secondary sexual characteristics, gynaecomastia, learning difficulties

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15
Q

What Ix in Klinefelter’s

A

FH and LSH high

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