Reproduction

Question 1

Where is glandular oestrogen synthesised?

Answer 1

Granulosa and theca cells of the ovaries

And the corpus luteum

Question 2

What are granulosa cells stimulated by?

Answer 2

LH to produce pregnenolone

Question 3

What is oligomenorrhea?

Answer 3

Reduction in frequency of periods to less than 9 per year

Question 4

What is primary amenorrhea?

Answer 4

Failure of menarche by age 16

Question 5

What is secondary amenorrhea?

Answer 5

Cessation of periods for >6 months

Question 6

What congenital problems can cause amenorrhea?

Answer 6

Turner’s syndrome

Kallman’s syndrome

Question 7

What should you measure in amenorrhea?

Answer 7

LH, FSH, Oestradiol

Thyroid function, prolactin

Question 8

What defines female hypogonadism?

Answer 8

low levels of oestrogen

Question 9

What can cause primary hypogonadism?

Answer 9

Ovary problems
High FH/FSH - Hyper H
e.g. premature ovarian failure

Question 10

What can cause secondary hypogonadism?

Answer 10

Hypothalamus or pituitary problems
Low FH/FSH - hypo H
e.g. high PRL, hypopituitarism

Question 11

What characterises hypogonadism?

Answer 11

Low oestradiol with low/normal LH/FSH

Question 12

What rarer things can cause secondary hypogonadism?

Answer 12

Prader-willi

Haemachromatosis

Question 13

What is idiopathic HH?

Answer 13

Delayed/absent sexual development with low gonadotrophin + sex hormones without anatomical/functional abnormalities of hypothalamic-pituitary gonadal axis

Question 14

What is Kallman’s syndrome

Answer 14

Absence of olfactory bulbs

Genetic

Question 15

What is Pituitary dysfunction?

Answer 15

Loss of FH/FSH stimulation due to non-functioning pituitary macroadenoma
Hyperprolactinemia

Question 16

What can cause hyperprolactinanemia?

Answer 16

Prolactinomas
Drugs e.g. anti-psychotics
hypothyroidism
Idiopathic
Macroprolactin

Question 17

What can high gonadotrophins be a sign of?

Answer 17

Ovarian failure

Question 18

What is hirsutism?

Answer 18

Excess hair

Question 19

What can cause hirsutism?

Answer 19

Androgen excess at the hair follicle by an adrenal or ovarian tumour, idiopathic, PCOS or familial

Question 20

What is Congenital Adrenal Hyperplasia (CAH)

Answer 20

Inherited deficiency of the enzymes needed for cortisol synthesis

Question 21

What are signs of an Androgen-secreting tumour?

Answer 21

Rapid onset of symptoms
Assoc. with virilisation
High testosterone (>5nmol/l)
MRI adrenal and ovaries will have tumour over 1cm

Question 22

What is Turner’s syndrome?

Answer 22

Absence of an X chromosome

Question 23

What are 4 main features of Turner’s?

Answer 23

Short stature
Webbed neck
Shield chest with widespread nipples
Cabitus valgus

Question 24

What is a sign of Turner’s?

Answer 24

failure to progress through puberty
Infertility
Primary/secondary amenorrhea

Question 25

What is Klinefelter’s Syndrome?

Answer 25

Primary hypogonadism in men
reduced testicular volume 
Gynaecomastia 
Eunochoidism 
Intellectual dysfunction
Azoospermia

Question 26

What are test results for Klinefelter’s?

Answer 26

Low testosterone
High FH/FSH
elevated SHBG/oestradiol

Question 27

What are signs of hypogonadism due to hypothalamic or pituitary dysfunction?

Answer 27

Low 9am testosterone

Low/mormal LH/FSH

Question 28

Can testosterone therapy restore fertility?

Answer 28

No, it may actually make it worse

Question 29

What causes gynaecomastia?

Answer 29

Increased oestrogen action on breast tissue
Spironolactone, digoxin etc
Cushings, thyrotoxicosis

Question 30

What can treat gynavcomastia?

Answer 30

anti-oestrogens

surgery