Endocrine B

Question 1

What is HCG?

Answer 1

Pregnancy hormone produced by the placenta which stimulates the ovary to produce progesterone.

Question 2

When is the best time to measure HCG levels?

Answer 2

12 weeks into pregnancy, may not detect early in pregnancy.

Question 3

What sample should be used to measure HCG levels?

Answer 3

Early morning mid-stream urine due to it being the most concentrated and avoids bacterial contamination.

Question 4

What would cause false positive HCG levels?

Answer 4

Malignant tumour containing tissue from placenta
Pituitary hCG production in post menopausal women
Pituitary hCG in hypogonadal men
Molar pregnancy

Question 5

What is a molar pregnancy?

Answer 5

A benign tumour formed by the cells that make up the placenta.

Question 6

What are equivocal results?

Answer 6

Results that may give a positive test or may not.

Question 7

What can cause equivocal results?

Answer 7

Miscarriage
Ectopic pregnancy
Early samples
Interference

Question 8

What is the first step of fertility testing?

Answer 8

HCG levels, if the patient is pregnant or not.

Question 9

Why do you test HCG levels in fertility testing?

Answer 9

A lot of testing will look like infertility if the person is pregnant so always start with HCG.

Question 10

How do you test for ovulation?

Answer 10

Progesterone at day 22 because if ovulation has occurred you will get a strong broad peak.

Question 11

Why is LH not measured when testing for ovulation?

Answer 11

Because it has a very narrow window so it can be easy to miss.

Question 12

How does the hypothalamus control hormone release?

Answer 12

Hypothalamus releases GnRH which acts on the pituitary to release FSH and LH. FSH acts on the follicle and LH acts on the ovary.

Question 13

How does high levels of prolactin cause infertility?

Answer 13

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.

Question 14

What are the causes of high prolactin levels?

Answer 14

Drugs
Anti-depressants
Anti-hypertensives
Tumours in pituitary

Question 15

If you got a high prolactin level what would you do next?

Answer 15

Rule out drug induced hyperprolactinaemia then MRI to image the pituitary if positive would be caused by pituitary tumour.

Question 16

What are the causes of ovarian failure?

Answer 16

Premature menopause 
Idiopathic
Turner's syndrome
Chemotherapy
Pelvic surgery
Galactosaemia
Pelvic irradiation

Question 17

What is PCOS?

Answer 17

Poly cystic ovarian syndrome. Is a hormone disorder where you have enlarged ovaries with small cysts it is not well understood.

Question 18

What is the leading cause of infertility?

Answer 18

PCOS

Question 19

When does PCOS occur?

Answer 19

Can occur at any age before menopause so the most common endocrine disorder in women.

Question 20

How is PCOS diagnosed?

Answer 20

No ovulation
High androgen levels (testosterone)
Ovarian cysts

Question 21

What are symptoms of PCOS?

Answer 21

Hirsutism (excess facial hair)
Amenorrhea (no menstruation)
Oligomenorrhea (infrequent menstruation)

Question 22

What characteristics would you see in someone with PCOS?

Answer 22

Overweight
Insulin resistance
Obstructive sleep apnoea
Mood disorders

Question 23

How does PCOS cause issues in ovulation?

Answer 23

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.