Repeoductive

Question 1

Adrenal glands

Answer 1

DHEAS

Question 2

Work up for hirsutism

Answer 2

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

Question 3

Work up for nonclassic adrenal hyperplasia

Answer 3

17-OHP

21 hydroxylase deficiency

Question 4

Treatment of hirsutism

Answer 4

OCPs
Spirinolactone
Cyproterone acetate
Finasteride 
Flutamide
Metformin and thiazolinediones

Question 5

Action of finasteride

Answer 5

Inhibits 5alpha reductase activty

Question 6

Flutamide reduction in ferriman gallwet score

Answer 6

41.3%

Question 7

Spirinolactone teduction in ferriman gallwet score

Answer 7

38.4%

Question 8

Most direct evidence of androgen excess

Answer 8

Total testosterone more than 2 ng/mL

Question 9

Measurement of estradiol in serum

Answer 9

Picograms per mL

Question 10

Measuremenr if testosterone

Answer 10

Nanograms per mL

Question 11

Most strikingly elevated steroid in PCOS

Answer 11

Androstenedione of ovarian

Question 12

PCOS dose of metformin

Answer 12

Metformin 500 1-1-1

Question 13

Post menopausal FSH levels

Answer 13

> 100 IU/L

Question 14

Define amenorrhea

Answer 14

Absence of menses by age 15

Failure to menstruate 3 yrs after peak growth velocity

Question 15

How does high insulin cause pcos?

Answer 15

Highinsulin

Question 16

Enumerate the different criteria for pcos

Answer 16

• rotterdam
• NIH
• androgen council

Question 17

Defective neuronal proteins in Kallmann syndrome

Answer 17

Anosmin1 (encoded by KAL1 gene)

FGF Type I (encoded by FGFR)

Question 18

Neurotransmitter effect on GnRG

Answer 18

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

Question 19

What is the role of kisspeptin

—- makes mutations of, cause hypogonadotropic hypogonadism

Answer 19

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

Question 20

Mechanism of action of Gonadotropin releasing hormone agonists

Answer 20

Initial flare

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

Question 21

% of thw anterior pit cells that are gonadotrophs

Answer 21

7-15%

Question 22

Inhibin secreted by the ovarian granulosa cells during the folliculae phase

Answer 22

Inhibin B

Question 23

Inhibin secreted by the corpus puteum during the luteal phase

Answer 23

Inhibin B

Question 24

Negatively regulates function of activin

Answer 24

Follistatin

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

Question 25

Responsible for the slower clearance of FSH

Answer 25

Sialic acid more in FSH

Question 26

Gene mutation of this causes ovarian dysgenesis | A growth and differentiation cactor expressed in oocyre stimulated folliculogenesis

Answer 26

Bone morphogenetic protein | BMP15 gene

Question 27

Mutation causes familial ovarian dysgenesis

Answer 27

Bmp15

Question 28

Germ cells present at birth

Answer 28

1-2 x 10^6

Question 29

of germ cells at puberty

Answer 29

300,000

Question 30

Stage of promary oocyte until ovulation

Answer 30

Prophase of twb forst meiotic division

Question 31

Marks transition primordial ro prkmary follicle

Answer 31

Morphologic change in granulosa cells from squamous to cuboidal

Question 32

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

Answer 32

Anti mullerian hormone

Question 33

A useful marker of ovarian reserve

Answer 33

Serum AMH

Question 34

In ovary produces the C19 steroid

Answer 34

Theca interna Theca externa- macrophages

Question 35

Folliculae rupture after LH surge

Answer 35

34-36 hrs after LH surge

Question 36

Major steroid product of the ovary which is not biologically active

Answer 36

Andostenedione

Question 37

Biologically active ovarian seroida

Answer 37

Estradiol | Progesterone

Question 38

Major estrogen products of thw corpus luteum

Answer 38

Progest | 17OHP

Question 39

Most potent anti HIV drug to cause gynecomastia

Answer 39

Efavirenz

Question 40

How does thyrotoxicosis affect repro hormones

Answer 40

Increases SHBG which binds more to testosterone than estradiol

Question 41

Gunecomastia with Normal FSH High testosterone and LH

Answer 41

Androgen resistance

Question 42

Gynocomastia Decrease testosterone High FSH than LH

Answer 42

Primary hypogonadism

Question 43

Hormones that regulate spermiogenesis

Answer 43

AMH Inhibit B Both secrered by sertoli

Question 44

Amle henotypic devt complete by

Answer 44

15 wks age of gestation

Question 45

When to do hematocrit monitoring in patients with testosterone treatment

Answer 45

Baseline, 3-6 mi, then yearly

Question 46

Half life of GnRH

Answer 46

2-4 mins

Question 47

Amplitude and pulsatility of GnRH

Answer 47

60-90 mins

Question 48

Slower gnrh- DAH | Rapid fequency favors

Answer 48

LH

Question 49

% of pituitary cells gonadotrophs

Answer 49

7-15%

Question 50

Most active steroidogenic tissue of humans

Answer 50

Corpus luteum

Question 51

Rate limiting step of prigesterone

Answer 51

Entry of LDL into mitochondria regulated by star protein

Question 52

Define primay amenorrhea

Answer 52

Ansence of menses by age 15

Question 53

Surrogate market of GnRH

Answer 53

LH

Question 54

Most common primary amenorrhea

Answer 54

Ovarian dysgenesis

Question 55

Complete androgen insensitivity syndrome

Answer 55

46 XY | Female ohenotype

Question 56

Rx of turner

Answer 56

Recombinant GH Oxandrolone height Estrogen at 14 yrs

Question 57

Secondary amenorrhea

Answer 57

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

Question 58

Signs fetal androgen deficiency

Answer 58

``` Ambiguous genitalia Notmal female Microphallus Hypospadias Bifid scrotum Cryptorchidism ```

Question 59

Eunochoidiam

Answer 59

Arm span longer than height by 5 cm

Question 60

HIV most potent drig to cause gynecomastia

Answer 60

Efavirenz