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Q5 GNMD > Infertility: lasku > Flashcards

Infertility: lasku Flashcards

1
Q

what is estrogen fraction used to evaluate

A

sexual maturity, menstrual problems, fertility, fetal-placental health, estronge-producing tumors in females

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2
Q

when does E2 peak?

A

peaks during the ovulatory phase

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3
Q

estrodil E3

A

produced in placenta

major in pregnancy

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4
Q

estrone E1

A

from androstenedione peripheral tissues

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5
Q

drugs that elevate and decrease estrogen

A

increase: steroids, ampicillin, estrogen containing drugs

decrease: clomiphene (used to treat infertility)

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6
Q

Clinical sig of increased estrogen levels

A

feminization syndrome, precocious puberty
ovarian, testicular adrenal tumors
normal preg
hepatic cirrhosis
hyperthyroidism

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7
Q

clinical sig od decreased estrogen levels

A

failing pregnanxy
turners
hypopituitarism
primary and secondary hypogonadism
menopause: low estrogen/progesterone: high LH/FSH
anorexia nervosa

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8
Q

what is progesterone assay used for

A

infertility
problems maintaining the pregnancy

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9
Q

when should progesterone assay be done

A

check day 21 bc its at its highest levels

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10
Q

where is progesterone secreated

A

secreted by corpus luteum after ovulation

initiates the secretory phase of endometrium

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11
Q

clinical sign of increased progesterone levels

A

ovulation, pregnancy, luteal cysts of ovary, adrenocortical hyperplasia, choriocarcinoma (releases HCG which stimulate the corpus luteum to continue to make progesterone to support preg)

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12
Q

clinical sig of decreased progesterone levels

A

amenorrhea, ovarian hypofunction, preeclampsia, eclampsia, threatened abortion, placental failure, fetal death, ovarian neoplasm

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13
Q

complications during pregnancy of low progesterone:

A

preclampsia: high BP and protein in urine

eclampsia: develops seizures

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14
Q

what is serum testosterone used to evaluate

A

ambiguous sex characteristics
precocious puberty
virilizing syndromes in females
infertility in males

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15
Q

where is testosterone secreted?

A

leydig cells of the testicles

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16
Q

where are DHEA and androstenedione produced

A

in the adrenals

17
Q

what does LH stimulate in males
FSH?

A

LH: stimulates the production of testosterone
FSH: stimulates spermatogenesis

18
Q

clinical sig of increased testosterone levels males vs females

A

males: sexual precocity, congenital adrenal hyperplasia, leydig cell tumors, hyperthyroidism, adrenocortical tumor

females: pcos, congenital adrenal hyperplasia, trophoblastic tumor (during pregnancy)

19
Q

what is LH/FSH assay used to evaluate

A

infertility, menopause, gonadal failure

20
Q
A
21
Q
A
22
Q
A
23
Q
A
24
Q

interfering factors in LH/FSH assay

A

drugs that increase: cimetidine, digitalis, levodopa, clomiphene

drugs that decrease: estrogen, progesterone, testosterone, steroids

24
Q

clinical sig of increased LH/FSH

A

gonadal failure
precocious puberty
pituitary adenoma
PCOS

24
Q

clinical sig of decreased LH/FSH

A

pituitary failure
hypothalamic failure
stress
anorexia nervosa, malnutrition

25
Q

what is semen evaluation used to evaluate

A

quality of sperm, infertile couple, to document the adequacy of operative vasectomy

performed 2-3 days of sexual abstinence

26
Q

sperm count

A

50-200 millin/ml

27
Q

anti spermatozoal antibody

A

in an infertility screening to detect the presence of sperm antibodies

28
Q

IgA anti-sperm antibodies

A

decrease sperm mobility

29
Q

igG anti-sperm antibodies

A

decrease their ability to penetrate the ovum

30
Q

when are antispermatozoal antibodies present in men

A

positive in men with blocked efferent ducts of testes and in 30-70% of them who have had a vasectomy

31
Q

postcoital test (sims-huhner test)

A

from cervical mucus
measures the ability of sperm to penetrate the mucus and maintain motitlity

32
Q

when is the postcoital test (sims-huhner test) performed

A

done midcycle when estradiol levels are highest

a specimen of endocervical mucus is obtained between 2-8 hours after intercourse

33
Q

normal postcoital test (sims-huhner test) findings

A

mucus is clear
stretchable for more than 4cm (spinnbarkeit)
exhibits a ferning pattern
contains more than 5 motile spem

34
Q

abnormal postcoital test (sims-huhner test) findings

A

increased viscosity
absence of sperm
more than 3 WBC suggest antisperm antibodies and cervicitis or prostatitis

35
Q
A

Q5 GNMD (15 decks)

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