Repro Endocrinology

Question 1

What is vaginal agenesis?

Answer 1

Defect in formation of the ductal system, paramesonephric bulb fusion defect

Will have an Ovary, absent Internal Ductal System (vagina, uterus, fallopian tube) and will have a normal clitoris

Question 2

Describe what you see in CAH?

When can you RULE out CAH 21-OH deficiency?

Answer 2

21-OH Deficiency

Have XX, Ovary, Uterus/Vagina, and then over-exposure to androgens so will have Masculinized External Genitalia

When you have ambiguous genitalia + palpable testes

Question 3

Inheritance for CAH, 5-alpha reductase, and androgen insensitivity

Answer 3

X - linked- Androgen Insensitivity
5 - alpha reductase (Penis may develop at puberty) - Autosomal recessive
CAH - Autosomal Recessive

Question 4

What do you need to Diagnose PCOS?

Answer 4

Hyperandrogenism and oligoamenorrhea OR amenorrhea

2. Exclusion of other disorders
3. Ultrasound (polycystic ovaries)

Question 5

What is going on in PCOS?

Answer 5

Increased GnRH pulsatility –> Leads to increased LH (increases androgens, acne, hirsutism) and decreased FSH (multiple follicles can’t mature and ovulate)

Question 6

When do you do aneuploidy screening?

Answer 6

During the second trimester

Also AFP in pregnancy is a risk factor for neural tube defect

Question 7

CRH?

Answer 7

Leads to production of fetal cortisol –> which will positively feedback on placental CRH

CRH will increase uterine contractile response to oxytocin

Cortisol will lead to fetal lung maturation and will increase prostaglandins

Question 8

What is Pathophysiology behind Pre-eclampsia?

Answer 8

Some VASOSPASM and placental hypoxia