Physio Ex 3- Clinical Cases Flashcards
21-Hydroxylase Deficiency
“Congenital Adrenal Hyperplasia”
too many precursors -> increased Testosterone levels
Internally female, but Enlarged clitoris and labia (look like empty scrotum)
Low cortisol, low glucose (dangerous for infant)
Secondary Hypo Hypo
Male with no secondary sex characteristics at 17 YO
Pituitary problem, Low LH and Low Testosterone
After GnRH injection, levels of gonadotropins are still low bc Ant Pit is not responding
Steroid use
Hypogonadism
Low sperm count
Elevated testosterone exhibits negative (-) fedback on Pituitary causing decreased release of gonadotropins (LH and FSH)
PCOS
Too many follicles maturing at the same time, but none are dominant
Turn into cysts
Cysts secrete Androgens –> Hirsutism, acne, dark course hair
Early puberty
Gonadotropin (Ant Pit) dependent
Problem with Ant Pit
Increased LH and FSH
Idiopathic or CNS tumor
Tx: long acting GnRH agonist
Early puberty
Gonadotropin Independent
Normal gonadotropin levels (LH and FSH) but high Testosterone of Estrogen
Problem with Gonads
Tumor on Testicle or Ovary
Tx: remove tumor
Delayed puberty
Hypo Hypo
“Kallmans” is example
Pituitary problem Low gonadotropins (LH and FSH)
lack of smell
Tx: Sex steroids first, later GnRH for fertility
Delayed puberty
Hyper Hypo
“Turner” and “Klinefelter”
Gonad problem
Low gonadal hormones (Testosterone and Estrogen) but high LH and FSH d/t lack of (-) feedback
Tx: GH and then supp sex steroids
Complete Androgen Insensitivity
With no Androgen receptors, Both Wolf and Mujer ducts regresss (No internal reproductive tract at all)
Female Externally (blind end vagina)
Testes inside (inguinal mass)
Tx: Remove gonads
Estrogen therapy
5-a-reductase deficiency
Appear to be female externally, but then at puberty all of a sudden Male external genitalia develop
Male internally
5-a-reductase deficiency
Cant convert T–> DHT until puberty
“Male Pseudohemaphtroditism” All of a sudden male develops at puberty
