Nonneoplastic Ovary Disorders Flashcards
Explain big picture the normal anatomy of the functional unit of the ovary and normal physiology to mature the egg?
The functional unit of the ovary is the follicle. Inside the follicle you have an oocyte surrounded by granulosa and outside of the g cells we have theca cells. LH hits the theca cells to make androgen. Androgen moves over into the granulosa cells, and under the influence of FSH, produces estradiol (estrogen) to mature the egg.
What else does the estrogen also do in addition to maturing the egg?
Goes out and induces the proliferative phase of the endometrium
What happens after ovulation of the egg?
The residual follicle, granulosa and theca, make up the corpus luteum and secrete progesterone for the secretory phase.
What is the most common cause of an ovarian mass in a reproductive age female?
Follicular cyst
How do we define polycystic ovarian syndrome?
Multiple ovarian follicular cysts due to a hormonal imbalance
What is the specific hormonal imbalance?
2:1 ratio of LH to FSH, so increased LH and decreased FSH
Explain the patho of high LH and low FSH?
Because there is high LH, the theca cells are over stimulated to make tons of androgen. A lot of the androgen spills out into the blood and goes to fat. Androgen is converted to estrone by fat. The high amounts of estrone goes to the pituitary gland and shuts down production of FSH.
What is the effect of low FSH?
Need FSH to converted androgen in granulosa cells to estradiol to mature the oocyte. Well no FSH, so the follicles degenerate and become cystic.
Classic clinical presentation of PCOS?
High androgen with hirsutism, menstrual irregularities, chronic anovulation, and infertility
What are the 3 health conditions highly associated with PCOS?
Obesity, diabetes, and atherosclerosis
Why hirsutism and what is hirsutism?
Androgen dependent male pattern hair growth
LH increase gets the theca cells to spit out ones of androgen
Good definition of virilization?
Androgen levels are so high that they are causing other man things like deep voice, muscle bulk, etc.
