PROLOG: Reproductive Endocrinology and Infertility

Question 1

Pathophysiology of CAH

Question 2

Clinical manifestations of CAH

Question 3

Diagnosis of CAH

Question 4

35 yo G2P1 has hx of bilateral tubal blockage. Underwent IVF 2 years ago and had a severely virilized female infant with 21-hydroxylase deficiency. She wishes to avoid pregnancy termination. What is the best way to prevent virilization in next pregnancy?

Question 5

What causes Androgen Insensitivity Syndrome?

Question 6

Turner syndrome - 45, XO

Clinical features

Question 7

16 yo presents for eval of primary amenorrhea. On exam, Tannger stage IV breast development, scan pubic hair, and 2 cm vaginal pouch without visible cervix. Labs reveal FSH 8 mIU/ml, testosterone 811 and karyotype 46 XY. Next best step?

Answer 7

AIS: psychological counseling

Question 8

Stage 1 Tanner stage breast development

Question 9

What is precocious puberty?

Question 10

McCune Albright Syndrome

Answer 10

Triad of precocious puberty, cafe au lait spots, skeletal abnormalities

Question 11

Treatment of central PP

Answer 11

Long-acting GnRH agonist

Question 12

Delayed puberty: absence of signs of puberty by an age 2-3 SD above the mean age. In the US, age 12.

Causes