3: Ovulatory disorders + male hypogonadism (Newey) Flashcards Preview

Endocrine Week 5 2017/18 > 3: Ovulatory disorders + male hypogonadism (Newey) > Flashcards

Flashcards in 3: Ovulatory disorders + male hypogonadism (Newey) Deck (44)
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1

Looks like we were given the same lecture twice, most of this is a rehash but there are some male hypogonadism questions at the end, soz

2

What is GnRH?

Gonadotrophin releasing hormone

released by hypothalamus

stimulates release of FSH and LH from anterior pituitary

3

What sort of GnRH pulses stimulate the release of

FSH

LH?

FSH - LOW frequency pulses

LH - HIGH frequency pulses

4

How long does the menstrual cycle last?

28 - 35 days

5

What are the two phases of the menstrual cycle?

Follicular phase

Luteal phase

6

When roughly does ovulation occur?

Around 14 days, midway between follicular and luteal phases

7

Surge of which hormone triggers ovulation?

LH

8

What is the dominant hormone in the luteal phase?

Progesterone

9

Oestradiol peaks when?

Progresterone peaks when?

Oestradiol before ovulation

Progesterone after

10

Which hormone causes thickening of the endometrium?

Oestrogen

11

How does oestrogen affect gonadotrophin release in the follicular phase and luteal phase?

Pos feedback follicular

Neg feedback luteal

12

Which hormone is secreted by the corpus luteum and maintains early pregnancy?

Progesterone

13

A high serum progesterone level one week on Day 21 indicates what?

Woman has ovulated

14

Irregular cycles cause ___.

anovulation

15

Ovulation disorders cause which symptoms?

Oligomenorrhoea (cycles longer than 35 days)

Amenorrhoea (no period)

16

Issues with which glands cause anovulation?

Hypothalamus

Pituitary

17

What are the levels of FSH and LH in hypothalamic pituitary failure?

Low

because no GnRH produced

18

Because no FSH and LH are released in hypothalamic pituitary failure, oestrogen is __.

low

19

How can oestrogen deficiency be investigated?

Progesterone challenge test

Imitates peak in luteal phase, negative if no menstruation occurs afterwards

20

How is hypothalamic-pituitary related anovulation treated?

GnRH injections (pulsatile)

OR

Gonadotrophin (LH/FSH) injections

21

What is the most common endocrine disease in women and causes anovulation with a positive progesterone challenge test?

Polycystic ovary syndrome

22

What are the three diagnostic criteria for polycystic ovary syndrome?

Oligo/amenorrhoea

Polycystic ovaries

Hyperandrogenism (acne, hirsutism due to increased testosterone)

23

How is PCOS treated before ovulation is induced?

Weight loss

Lifestyle modification

Folic acid

Rubella immunisation

24

Why do patients with PCOS take oestrogen tablets e.g Clomid?

Induces ovulation

25

Apart from oestrogen tablets, what other treatments exist for PCOS?

Gonadotrophin injections

Ovarian drilling?!?!?!?!

26

What, normally associated with diabetes, is also seen in the majority of PCOS patients?

Insulin resistance

big long list of reasons why, don't really matter

27

Which drug is used to address insulin resistance in PCOS?

Metformin

28

Why does PCOS cause insulin resistance?

High levels of LH causes hyperinsulinaemia for some reason

Insulin lowers level of transporter which mops up testosterone

> Masculinisation (acne, hirsutism)

29

What are some risks of using drugs like Clomid and gonadotrophin injections to stimulate ovulation?

Ovarian hyperstimulation

Multiple pregnancy (twins are evil)

Ovarian cancer

30

Multiple pregnancy (twins, triplets) tend to be (premature / late) and can have lots of complications.

premature

complications - cardio, resp, disability