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ENDOCRINE > Repeoductive > Flashcards

Repeoductive Flashcards

1
Q

Adrenal glands

A

DHEAS

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2
Q

Work up for hirsutism

A

Shea’s - adrenals
Testosterone- ovaries
17 OH P - CAH

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3
Q

Work up for nonclassic adrenal hyperplasia

A

17-OHP

21 hydroxylase deficiency

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4
Q

Treatment of hirsutism

A 
OCPs
Spirinolactone
Cyproterone acetate
Finasteride 
Flutamide
Metformin and thiazolinediones
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5
Q

Action of finasteride

A

Inhibits 5alpha reductase activty

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6
Q

Flutamide reduction in ferriman gallwet score

A

41.3%

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7
Q

Spirinolactone teduction in ferriman gallwet score

A

38.4%

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8
Q

Most direct evidence of androgen excess

A

Total testosterone more than 2 ng/mL

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9
Q

Measurement of estradiol in serum

A

Picograms per mL

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10
Q

Measuremenr if testosterone

A

Nanograms per mL

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11
Q

Most strikingly elevated steroid in PCOS

A

Androstenedione of ovarian

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12
Q

PCOS dose of metformin

A

Metformin 500 1-1-1

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13
Q

Post menopausal FSH levels

A

> 100 IU/L

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14
Q

Define amenorrhea

A

Absence of menses by age 15

Failure to menstruate 3 yrs after peak growth velocity

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15
Q

How does high insulin cause pcos?

A

Highinsulin

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16
Q

Enumerate the different criteria for pcos

A
  • rotterdam
  • NIH
  • androgen council
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17
Q

Defective neuronal proteins in Kallmann syndrome

A

Anosmin1 (encoded by KAL1 gene)

FGF Type I (encoded by FGFR)

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18
Q

Neurotransmitter effect on GnRG

A

NE- stimulates
Dopa- inhibitory
Endorphins- inh
Opioids- inhibitory

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19
Q

What is the role of kisspeptin

—- makes mutations of, cause hypogonadotropic hypogonadism

A

Binding of kisspeptin to G protein coupled Kiss1R Stimulates gnRH release in the hypothalamus

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20
Q

Mechanism of action of Gonadotropin releasing hormone agonists

A

Initial flare

Downregularion of axis in 1-3 weeks due to 1) desensitization 2) loss of receptors

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21
Q

% of thw anterior pit cells that are gonadotrophs

A

7-15%

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22
Q

Inhibin secreted by the ovarian granulosa cells during the folliculae phase

A

Inhibin B

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23
Q

Inhibin secreted by the corpus puteum during the luteal phase

A

Inhibin B

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24
Q

Negatively regulates function of activin

A

Follistatin

Activin- stimulate FSH
Inhibin- inhibit FSH (along with estrogen)

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25
Q

Responsible for the slower clearance of FSH

A

Sialic acid more in FSH

26
Q

Gene mutation of this causes ovarian dysgenesis

A growth and differentiation cactor expressed in oocyre stimulated folliculogenesis

A

Bone morphogenetic protein

BMP15 gene

27
Q

Mutation causes familial ovarian dysgenesis

A

Bmp15

28
Q

Germ cells present at birth

A

1-2 x 10^6

29
Q

of germ cells at puberty

A

300,000

30
Q

Stage of promary oocyte until ovulation

A

Prophase of twb forst meiotic division

31
Q

Marks transition primordial ro prkmary follicle

A

Morphologic change in granulosa cells from squamous to cuboidal

32
Q

Produced by the granulosa cells of growing follicles
Inhibits the growth of primordial follicles
Faster depletion if it is absent

A

Anti mullerian hormone

33
Q

A useful marker of ovarian reserve

A

Serum AMH

34
Q

In ovary produces the C19 steroid

A

Theca interna

Theca externa- macrophages

35
Q

Folliculae rupture after LH surge

A

34-36 hrs after LH surge

36
Q

Major steroid product of the ovary which is not biologically active

A

Andostenedione

37
Q

Biologically active ovarian seroida

A

Estradiol

Progesterone

38
Q

Major estrogen products of thw corpus luteum

A

Progest

17OHP

39
Q

Most potent anti HIV drug to cause gynecomastia

A

Efavirenz

40
Q

How does thyrotoxicosis affect repro hormones

A

Increases SHBG which binds more to testosterone than estradiol

41
Q

Gunecomastia with
Normal FSH
High testosterone and LH

A

Androgen resistance

42
Q

Gynocomastia
Decrease testosterone
High FSH than LH

A

Primary hypogonadism

43
Q

Hormones that regulate spermiogenesis

A

AMH
Inhibit B
Both secrered by sertoli

44
Q

Amle henotypic devt complete by

A

15 wks age of gestation

45
Q

When to do hematocrit monitoring in patients with testosterone treatment

A

Baseline, 3-6 mi, then yearly

46
Q

Half life of GnRH

A

2-4 mins

47
Q

Amplitude and pulsatility of GnRH

A

60-90 mins

48
Q

Slower gnrh- DAH

Rapid fequency favors

A

LH

49
Q

% of pituitary cells gonadotrophs

A

7-15%

50
Q

Most active steroidogenic tissue of humans

A

Corpus luteum

51
Q

Rate limiting step of prigesterone

A

Entry of LDL into mitochondria regulated by star protein

52
Q

Define primay amenorrhea

A

Ansence of menses by age 15

53
Q

Surrogate market of GnRH

A

LH

54
Q

Most common primary amenorrhea

A

Ovarian dysgenesis

55
Q

Complete androgen insensitivity syndrome

A

46 XY

Female ohenotype

56
Q

Rx of turner

A

Recombinant GH
Oxandrolone height
Estrogen at 14 yrs

57
Q

Secondary amenorrhea

A

Absence of menses more than 3 mos in women who had normal menses

58
Q

Signs fetal androgen deficiency

A 
Ambiguous genitalia 
Notmal female 
Microphallus 
Hypospadias 
Bifid scrotum 
Cryptorchidism
59
Q

Eunochoidiam

A

Arm span longer than height by 5 cm

60
Q

HIV most potent drig to cause gynecomastia

A

Efavirenz

ENDOCRINE (12 decks)

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