More endocrine

Question 1

What is the disease with panhypopituitarism after postpartum haemorrhage?

Answer 1

Sheehan’s syndrome

Question 2

Level of serum prolactin in disconnection hyperprolactinaemia and macro-prolactinoma respectively

Answer 2

<2000
>5000

Question 3

Effect of testosterone and estradiol on SHBG

Answer 3

T: ↓
E2: ↑

Question 4

Procedure of progesterone withdrawal test

Answer 4

Give medroxyprogesterone 10mg daily for 10d

1. 🩸withdrawal bleeding ⇒ ovarian disorder
2. ❌ withdrawal bleedingGive ethinyloestradiol then medroxyprogesterone
   1. 🩸withdrawal bleeding ⇒ pre-ovarian disordercheck FSH for hypo-/hypergonadotropic
   2. ❌ withdrawal bleeding ⇒ uterine disorder

Question 5

Test to rule out CAH

Answer 5

17α-hydroxyprogesterone

Question 6

Which steroid is deficient in placental sulphatase deficiency? What is its effect?

Answer 6

oestrogen
delayed onset of labour

Question 7

Which steroid is deficient in respiratory distress syndrome? What is its effect?

Answer 7

glucocorticoid
⨉ surfactant

Question 8

Which steroid is deficient / ineffective in testicular feminisation syndrome? What are the DDx?

Answer 8

testosterone

DDx: androgen insensitivity syndrome, 17α hydroxylase deficiency, 5α-reductase deficiency

Question 9

Hormone level in androgen insensitivity syndrome (FSH, LH, T, E2)

Answer 9

↑ ↑ ↑ ↓

Question 10

MOA and usage of Cyproterone acetate

Answer 10

AR antagonist
chemical castration

Question 11

MOA and usage of Clomiphene

Answer 11

ER antagonist
ovulation induction

Question 12

MOA and usage of Tamoxifen

Answer 12

SERM
CA breast therapy

Question 13

MOA and usage of Mifepristone

Answer 13

PR antagonist
emergency contraception, abortion…