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Flashcards in Gonad conditions Deck (50):
1

What are the symptoms of oestrogen deficiency

flushing
libido
dyspareunia

2

What are the features of PCOS/androgen excess

hirsutism
acne

3

How is female hypogonadism identified

decreased oestrogen

4

What are the primary causes of female hypogonadism

problem with the ovaries
e.g. premature ovarian failure

5

What are the secondary causes of female hypogonadism

problem with the hypothalamus/pituitary
e.g. increased PRL
hypopituitarism

6

What are FSH and LH likely to look like in primary causes of female hypogonadism

increased

7

What are FSH and LH likely to look in secondary causes of female hypogonadism

decreased

8

What will a patient present with if they have premature ovarian failure

<40yrs
amenorrhoea
oestrogen deficiency
increased gonadotrophins (FSH and LH)

9

How was premature ovarian failure occur

due to a loss of ovarian function

10

What is diagnostic of premature ovarian failure

FSH >30 on 2 separate occasions, 1 month apart

11

What are the causes of premature ovarian failure

chromosomal abnormalities
gene mutations
autoimmune
iatrogenic (radio/chemo)

12

what is the treatment for premature ovarian failure

hormone replacement
egg/embryo donation
egg/ovary cryopreservation
support

13

What is secondary hypogonadism of a female characterised by

decreased estradiol and decreased FSH/LH

14

What are the causes of secondary female hypogonadism

hypothalamic - functional
- Kallman's syndrome
- idiopathic

pituitary
-Prader-willi
-haemachromatosis

15

What are examples of functional hypothalamic amenorrhoea

weight change
stress
exercise
sarcoidosis
anabolic steroids
systemic illness
iatrogenic
recreational drugs
head trauma

16

How is idiopathic hypogonadotrophic hypogonadism identified

identified by absent or delayed sexual development

17

What is idiopathic hypogonadotrophic hypogonadism associated with

decreased gonadotrophins and sex hormones in absence of anatomical/functional defects of hypothalamus/pituitary

18

What is idiopathic hypogonadotrophic hypogonadism

patient cannot activate pulsatile GnRH secretion during puberty

19

What might be the cause of idiopathic hypogonadotrophic hypogonadism

mutation in Kisseptin

20

What is Kallman's syndrome

loss of GnRH secretion and anosmia/hyposmia (lack of sense of smell)

21

What is there absence of in Kallman's syndrome

olfactory bulbs

22

Loss of FSH/LH production can be caused by what happening to the pituitary

non-functioning macroadenoma
empty sella
pituitary infarction

23

hyperprolactinaemia can be caused by

micro/macro prolactinoma
dopamine antagonists

24

What are the ovarian causes of amenorrhoea

PCOS
ovarian failure
congenital - Turner, testicular feminisation, congenital adrenal hyperplasia

25

What criteria does PCOS follow

rotterdam

26

what is the rotterdam criteria

menstrual irregularity
hyperandrogenism (hirsutism, increased free testosterone)
polycystic ovaries

27

What oestrogen level does PCOS have

normal

28

what is PCOS

genetic disposition to excess androgen secretion causing polycystic ovaries and increased testosterone levels (hirsutism)

29

In what percentage of patients with PCOS is insulin resistance seen

50-80%

30

What is the treatment for insulin resistance in PCOS

metformin

31

Androgen secreting tumours would present with

virilisation
increased testosterone >5

32

What is the treatment for PCOS

oral pill - decreased androgens
anti-androgens - cyproterone acetate

33

Who does turners affect

women only
they only have one X chromosome

34

What are the features of Turners

short stature
low hairline
webbed neck
underdeveloped breasts
wide spread nipples
elbow deformity
no menstruation -> infertility
short 4th MCP
neavi on skin

35

Which part of puberty still occurs in people with turners

adrenarche (pubic hair growth)

36

What else is likely to occur in turners

coarctation of aorta
bicuspid aortic valve
hypoplastic left heart
GI bleed
increased risk of Crohns/UC

37

What is the most common congenital form of primary hypogonadism

Kleinfelters

38

What are the features of Kleinfelters

decreased testicular vol
gynaecomastia
eunochoidism
intellectual dysfunction in 40%

39

What is the problem in Kleinfelters

47 XXY

40

What is the treatment for Kleinfelters

testosterone replacement (WILL NOT RESTORE FERTILITY)

41

Gynaecomastia can be caused by what

androgen secreting tumours
hCG secreting tumours
thyrotoxicosis
cushings
hypogonadism
spironolactone
digoxin
oestrogen
testosterone

42

sperm count =

oligozoospermia

43

sperm motility =

asthenozoospermia

44

sperm morphology =

teratozoospermia

45

no sperm =

azoospermia

46

what is endometriosis

presence of endometrial glands outside uterine cavity

47

what is the most common cause of anovulatory infertility

PCOS

48

What are the features of PCOS

central obesity
hirsutism
acne/oily skin

49

Name 2 anti-oestrogens used in PCOS

clomifene citrate
tamoxifen

50

What is the most common cause of male infertility

idiopathic (60%)