Endocrine B Flashcards
(23 cards)
What is HCG?
Pregnancy hormone produced by the placenta which stimulates the ovary to produce progesterone.
When is the best time to measure HCG levels?
12 weeks into pregnancy, may not detect early in pregnancy.
What sample should be used to measure HCG levels?
Early morning mid-stream urine due to it being the most concentrated and avoids bacterial contamination.
What would cause false positive HCG levels?
Malignant tumour containing tissue from placenta
Pituitary hCG production in post menopausal women
Pituitary hCG in hypogonadal men
Molar pregnancy
What is a molar pregnancy?
A benign tumour formed by the cells that make up the placenta.
What are equivocal results?
Results that may give a positive test or may not.
What can cause equivocal results?
Miscarriage
Ectopic pregnancy
Early samples
Interference
What is the first step of fertility testing?
HCG levels, if the patient is pregnant or not.
Why do you test HCG levels in fertility testing?
A lot of testing will look like infertility if the person is pregnant so always start with HCG.
How do you test for ovulation?
Progesterone at day 22 because if ovulation has occurred you will get a strong broad peak.
Why is LH not measured when testing for ovulation?
Because it has a very narrow window so it can be easy to miss.
How does the hypothalamus control hormone release?
Hypothalamus releases GnRH which acts on the pituitary to release FSH and LH. FSH acts on the follicle and LH acts on the ovary.
How does high levels of prolactin cause infertility?
Women who are not pregnant and not breast feeding should have low levels of prolactin. It affects the LH and FSH surges coming from the pituitary which leads to the loss of ovarian stimulation.
What are the causes of high prolactin levels?
Drugs
Anti-depressants
Anti-hypertensives
Tumours in pituitary
If you got a high prolactin level what would you do next?
Rule out drug induced hyperprolactinaemia then MRI to image the pituitary if positive would be caused by pituitary tumour.
What are the causes of ovarian failure?
Premature menopause Idiopathic Turner's syndrome Chemotherapy Pelvic surgery Galactosaemia Pelvic irradiation
What is PCOS?
Poly cystic ovarian syndrome. Is a hormone disorder where you have enlarged ovaries with small cysts it is not well understood.
What is the leading cause of infertility?
PCOS
When does PCOS occur?
Can occur at any age before menopause so the most common endocrine disorder in women.
How is PCOS diagnosed?
No ovulation
High androgen levels (testosterone)
Ovarian cysts
What are symptoms of PCOS?
Hirsutism (excess facial hair)
Amenorrhea (no menstruation)
Oligomenorrhea (infrequent menstruation)
What characteristics would you see in someone with PCOS?
Overweight
Insulin resistance
Obstructive sleep apnoea
Mood disorders
How does PCOS cause issues in ovulation?
High levels of testosterone affects a lot of correct surges so LH is produced but not the correct surge so ovulation wont occur or is less likely to occur.
