Created by Bhavi Mistry
over 11 years ago
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Question | Answer |
Hyperprolactinaemia pathology | Depresses GnRH, therefore decreasing FSH and estrogen, thus cessation of Follicle stimulation, and a decrease in bonestrength |
Hyperprolactinaemia treatment: | DA agonist (bromocriptine, prevergroline) |
Hypothyroidism and infertility | -->Increase in TSH --> decrease in T4/3 --> Increase in TRH --> Increase in prolactin --> -GnRH and FSH |
Hypothyroidism treatment | Thyroxine replacement |
Estrodiol | 2-OH Dominant estrogen in pre-menopausal women |
Estrotriol | 3-OH Found in pregnancy produced by the placenta |
Estrone | Ketone Post menopausal |
Endometrial glands | Eventually produce glycogen for endometrial noursihment Mucin - glue for embryo implantation |
PCOS Features | Black pearl necklace (US) Follicles appear in the periphery of the ovary (cortex) Maturing follicles are larger than normal and ovaries enlarged |
PCOS symptoms and signs | Amenorrhea, oligomenorrhea, mennorhagia, overweight, acne, hisutism, insulin resistance, non-insulin dependent DM |
Theca cells | Responsible for androgen and progesterone production |
Granulosa cells | Convert androgens to oestrogens with aromatase |
PCOS pathology | Rate limiting step is conversion from androgens to oestrogens Too much androgen sitting around will move into the circulation as it is not being converted to oestrogen by the follicle |
PCOS pathology | Sexhormone binding protein carries androgens and oestrogen, and is suppressed by androgens, which increases free androgens in the circulation |
PCOS (III) Infertility | Androgens --> + pituitary --> LH above normal levels, they're normally released in a pulsatile fashion, but they become tonic. If LH is tonically released, there is no ovulation and therefore no progesterone and no FSH therefore no stimulus for the follicles to grow |
PCOS (IV) menorrhagia | Normal estrogen levels, and no progesterone --> endometrial lining grows infinitely --> heavy bleed when it can grow no more Predisposition to cancer |
PCOS treatment: Hormonal injection | Needs to be super physiological to overcome infertility |
PCOS treatment clomiphene citrate | Induces withdrawal bleed to decrease chances of endometrial hyperplasia |
PCOS treatment: Ovarian diathermy | Burning ovary androgen producing tissue Allows normal function for 5 - 6 months - buys time for conception |
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