Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Endocrinology > Reproductive Treatments > Flashcards

Reproductive Treatments Flashcards

1
Q

is primary hypogonadism easy or difficult to treat?

A

difficult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how to treat secondary hypogonadism in males?

A

treat with gonadotrophins (ie LH and FSH) to induce spermatogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how does LH work to induce sperm?

A

LH > stimulates Leydig cells > ^ intra testicular testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how does FSH work to induce sperm?

A

FSH > stimulates seminiferous tubule development + spermatogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

when treating secondary hypogonadism, how much does LH increase testosterone?

A

to much higher levels than in circulation (x100)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

give an example of a cause of acquired hypogonadism

A

opioid abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

should testosterone be given to men desiring fertility?

A

no, avoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

why should giving testosterone be avoided in men that desire fertility?

A

treatment will lower LH / FSH further and further reduce spermatogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the preferred reproductive treatment for men with secondary hypogonadism desiring fertility?

A

Give hCG injections (which act on LH-receptors)

If no response after 6 months, then add FSH injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is Kallmann syndrome?

A

Congenital Hypogonadotrophic Hypogonadism

due to deficiency of gonadotropin-releasing hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Kallmann syndrome presents as?

A

anosmia

lack of/delayed puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

have people with congenital hypogonadotrophic hypogonadism had mini-puberty?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

why is FSH important during mini puberty?

A

for growing the pool of immature spermatogonia and germ cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

reproductive treatment for congenital hypogonadotrophic hypogonadism?

A

2-4 months pretreatment with FSH before hCG treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what gives the indication a better prognosis in those with congenital hypogonadotrophic hypogonadism?

A

Pretreatment Testicular size (Seminiferous tubules)

ie testicular volume >6ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

symptoms for loss of testosterone

A

loss of early morning erections
decreased libido
decreased energy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how to confirm low testosterone?

A

At least 2 low measurements of serum testosterone before 11am

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

testosterone replacement

A 
Daily Gel eg Tostran. Care not to contaminate partner.
3 weekly intramuscular injection (eg Sustanon)
3 monthly intramuscular injection (eg Nebido)
Less Common (Implants, oral preparations)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the risks that come with testosterone replacement?

A

increased haematocrit > risk of hyperviscosity + stroke

increased PSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

aim of ovulation induction?

A

to develop one ovarian follicle

to increase FSH by a small amount

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what can happen if >1 follicle develops?

A

this risks multiple pregnancy (ie Twin / Triplet)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what does PCOS stand for?

A

polycystics ovarian syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

PCOS usually presents as?

A

amenorrhoea (missed periods) or irregular periods, weight gain, fatigue, hirsutism, acne, mood changes, sleep problems, infertility, depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how to restore ovulation?

A

Lifestyle / Weight Loss / Metformin
Letrozole (Aromatase inhibitor)
Clomiphene (Oestradiol receptor antagonist)
FSH stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
oestradiol causes negative feedback to?
hypothalamus | pituitary
26
how does letrozole work?
inhibits aromatase > prevents conversion of testosterone to oestradiol > decreases -ve feedback > increases LH/FSH > stimulates follicle growth
27
how does clomiphene work?
oestradiol receptor antagonist > decreases ve feedback > increases LH/FSH > stimulates follicle growth
28
outline the steps to in vitro fertilisation
FSH stimulation > oocyte retrieval > fertilisation in vitro > embryo incubation > embryo transfer
29
how to prevent premature ovulation in IVF?
prevent premature LH surge either GnRH antagonist/agonist protocol
30
how can both a GnRH agonist or a GnRH antagonist be used to block an LH surge?
depends on if GnRH given is pulsatile (causing LH peaks) or non-pulsatile (initial flare then inhibited)
31
how to mature eggs in IVF?
exposure to LH via hCG
32
exposure to hCG has the side effect of?
excessive ovarian stimulation > ovarian hyper-stimulation syndrome
33
ovarian hyper-stimulation syndrome can lead to?
``` pleural effusion shortness of breath ascites kidney failure ovarian torsion ```
34
list permanent methods of contraception
vasectomy | female sterilisation
35
list non-permanent methods of contraception
``` barrier (male/female condom/diaphragm) combined oral contraceptive pill progestogen only pill long acting reversible contraception emergency contraception ```
36
positives to barrier conception (condoms)
Easy to obtain – free from clinics No need to see a healthcare professional Protect against STI’s No contra-indications as with some hormonal methods
37
negatives to barrier conception (condoms)
Can interrupt sex Can reduce sensation Can interfere with erections Some skill to use properly eg ensure no air, not too large or small
38
what effect does the oral contraceptive pill have on the HPG axis?
oestrogen + progesterone -vely feedback to hypothalamus and pituitary > decreased LH/FSH thickening of cervical mucus thinning of endometrial lining to reduce implantation
39
positives to the combined oral contraceptive pill
``` Easy to take (one pill any time of day) Effective Doesn’t interrupt sex Can take several packets back to back and avoid withdrawal bleeds Reduce endometrial and ovarian cancer Weight Neutral in 80% ```
40
negatives to the combined oral contraceptive pill
It can be difficult to remember No protection against STIs P450 Enzyme Inducers may reduce efficacy Not the best choice during breast feeding
41
possible side effects to the combined oral contraceptive pill
``` Spotting (bleeding in between periods) Nausea Sore breasts Changes in mood or libido Feeling more hungry ```
42
extremely rare side effects to combined oral contraceptive pill
Blood clots in the legs or lungs
43
non-contraceptive uses of the combined oral contraceptive pill
Helps make periods lighter and less painful Withdrawal bleeds will usually be very regular PCOS: help reduce LH and hyperandrogenism
44
positives to the progesterone only pill
Works as OCP but less reliably inhibits ovulation, often suitable if can't take oestrogen, easy to take – one pill a day, every day with no break, doesn’t interrupt sex, helps heavy or painful periods, periods may stop (temporarily), can be used when breastfeeding
45
negatives to the progesterone only pill
Can be difficult to remember No protection against STIs Shorter acting – needs to be taken at the same time each day
46
possible side effects to the progesterone only pill
``` Irregular bleeding Headaches Sore breasts Changes in mood Changes in sex drive ```
47
list examples of long acting reversible contraceptives
intra uterine device (IUD) intra uterine systems (IUS) Progestogen-only injectable contraceptives or subdermal implants
48
list examples of emergency contraception
IUD Emergency contraceptive pill, ulipristal acetate 30 mg (ellaOne) Emergency contraceptive pill, levonorgestrel 1.5 mg (Levonelle)
49
side effects of the emergency contraceptive pill
headache, abdominal pain, nausea
50
avoid OCP if you have these comorbidities:
``` Migraine with aura (risk of stroke) Smoking (>15/day) + age >35yrs Stroke or CVD history Current Breast cancer Liver Cirrhosis Diabetes with retinopathy/nephropathy/neuropathy ```
51
oral contraceptive pill has risk of?
risk of venous thromboembolism
52
conditions that may benefit from OCP
menorrhagia endometriosis fibroids
53
what concurrent medication needs to be considered when choosing contraception?
``` P450 liver enzyme-inducing drugs (eg anti-epileptics, some antibiotics) Teratogenic drugs (eg lithium or warfarin) ```
54
list types of contraception by increasing efficacy (in brackets are user dependent)
none > withdrawal > fertility awareness > [diaphragm > male condoms > vaginal ring > POP > OCP > female condoms] > depot progesterone > IUD > IUS > implant
55
peri-menopausal
Within 12 months of last menstrual period
56
post-menopausal
After 12 months of last menstrual period
57
risks of HRT
venous thrombo-embolism hormone sensitive cancers concern for increased risk of cardiovascular disease risk of stroke
58
which are safer for VTE: oral or transdermal oestrogens?
transdermal
59
avoid oral oestrogens in what population?
BMI > 30 kg/m2
60
what cancers are women at a higher risk of on HRT?
breast ovarian endometrial
61
when giving HRT, '.........' must be prescribed to all women with an endometrium
progestogens
62
benefits of HRT
Relief of symptoms of low oestrogen | Less osteoporosis related fractures
63
hormone treatment for transgender / gender non binary pre-pubertal young people
GnRH agonist for pubertal suppression and then sex steroids
64
masculinising hormones for transgender men
testosterone
65
side effects of masculinising hormones for transgender men
Polycythaemia lower HDL Obstructive Sleep Apnoea
66
feminising hormones for transgender women
estrogen | reduce testosterone

Endocrinology (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions