Ovary

Question 1

Gonadotropin Stimulation of Hormones/Ovulation/Cells

Answer 1

LH acts on theca cells to induce androgen production
FSH stimulates granulosa cells to convert androgen to estradiol
Estradiol surge induces LH surge, which leads to ovulation (beginning of secretory phase)
After ovulation, residual follicle becomes corpus luteum and secretes progesterone

Question 2

Polycystic Ovarian Syndrome (what it is, pathophys/hormones/some symptoms)

Answer 2

Multiple ovarian follicular cysts due to hormone imbalance
Characterized by increase in LH and decrease in FSH (LH:FSH greater than 2)
Increased LH induces excess androgen production from theca cells resulting in hirsutism and acne
Androgen converted to estrone in adipose tissue (so linked to obesity)
Estrone feedback decreases FSH resulting in cystic degeneration of follicles/anovulation

Question 3

PCOS Diagnosis

Answer 3

2/3 of: Androgen excess, ovulatory dysfunction, polycystic ovaries on US

Question 4

PCOS 2 Associated Future Syndromes

Answer 4

Insulin resistance leading to T2DM

Endometrial cancer due to unopposed estrogen

Question 5

PCOS 5 Tx

Answer 5

Weight reduction
OCPs
Clomiphene citrate for fertility (E partial agonist that binds ERs in brain and releases negative feedback)
Ketoconazole
Spironolactone for hair