Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
43 Cards in this Set
- Front
- Back
|
What are the 4 reproductive hormones to remember?
|
GnRH
FSH LH Testosterone |
|
|
What is GnRH used for diagnosing?
|
LH deficiency
|
|
|
What is GnRH used for in treating?
|
Medical hypogonadotropic hypogonadism
|
|
|
What are 2 things gonadotropins are used for treating?
|
-Ovulation (induce it)
-Low sperm counts |
|
|
Where is GnRH released from and in what manner?
|
From the hypothalamus in PULSES every 90 minutes
|
|
|
What effect does GnRH have on the pituitary?
|
Stimulates LH/FSH release
|
|
|
What effect do LH/FSH have in men and where?
|
-LH stimulates Leydig cells to produce testosterone
-FSH stimulates Sertoli cells to undergo spermatogenesis |
|
|
What does the testosterone produced from Leydig cells do?
|
Also stimulates Sertoli cells to undergo spermatogenesis
|
|
|
From what nucleus in the hypothalamus is GnRH released?
|
Arcuate nucleus
|
|
|
What inhibits the arcuate nucleus from releasing GnRH?
|
Negative feedback from testosterone
|
|
|
What inhibits the Ant pituitary from releasing LH/FSH? What is the source?
|
Inhibin from Sertoli cells
Testosterone from Leydig cells |
|
|
What test is done for the diagnosis of pituitary LH deficiency?
|
GnRH test - inject it to see if it stimulates the pituitary to release LH
|
|
|
What is 2ndary Hypogonadotropic hypogonadism?
|
A problem with the pituitary causing low LH
|
|
|
What is Tertiary Hypogonadotropic hypogonadism?
|
A problem with the hypothalamus so GnRH is low so LH release is not stimulated adequetely
|
|
|
What will basal levels of LH be in 2ndary vs Tertiary Hypogonadotropic hypogonadism?
|
Both will show low basal LH
|
|
|
How will LH levels respond to GnRH injection in 2ndry vs Tertiary Hypogonadotropic hypogonadism?
|
Both will show attenuated responses to GnRH
|
|
|
So how can you differentiate between 2ndry and Tertiary Hypogonadotropic hypogonadism?
|
By treating with GnRH and seeing LH levels normalize in tertiary Hypogonadotropic hypogonadism, but not in secondary.
|
|
|
What KIND of GnRH administration is necessary for it to actually have a therapeutic effect on LH secretion from the pituitary?
|
Pulsatile administration
|
|
|
What will continuous administration of GnRH do to LH levels?
|
Inhibit LH release so it will be low - regardless of how high the GnRH levels are.
|
|
|
What is a possible USE of continuous GnRH administration?
|
Inducing a medical hypogonadism
|
|
|
So what does pulsatile GnRH do?
|
Stimulates LH release
|
|
|
What does continuous GnRH do?
|
Inhibits LH release
|
|
|
What is the shot that induces longterm continuous GnRH levels called?
|
Lupron
|
|
|
What is Lupron used for treating?
|
Prostate cancer
|
|
|
What is another possible use of inducing medical hypogonadism?
|
Male contraception
|
|
|
What are 2 types of drugs that you can give to treat Anovulation (induce ovulation)?
|
-Gonadotropins
-Dopamine agonists |
|
|
What are 4 gonadotropins that can be used for treating anovulation?
|
-hCG
-hMG -LH -FSH |
|
|
What are 2 DA agonists that can be used for treating anovulation?
|
-Bromocriptine
-Cabergoline |
|
|
What exactly is hMG?
|
Human menopausal gonadotropin from a bunch of old women's pee
|
|
|
What exactly is hCG?
|
Human chorionic gonadotropin - surrogate LH from placenta; much cheaper
|
|
|
What % of women treated with hMG will get pregnant within 10 cycles?
|
80%!!
|
|
|
When is it easiest to treat decreased sperm counts?
|
When the sperm count decreases after puberty
|
|
|
What is sufficient for increasing the sperm count if it begins to be decreased after puberty?
|
hCG
|
|
|
What is required for increasing the sperm count if it is decreased before puberty?
|
Both hCG + hMG
|
|
|
What is the MOST COMMON pituitary disorder?
|
Hyperprolactinemia due to a pituitary adenoma
|
|
|
How is a hyperprolactinemia treated?
|
Medically - with Dopamine agonists
|
|
|
How does dopamine agonism induce ovulation by the way?
|
Prolactin normally inhibits FSH/LH release; Dopamine inhibits Prl release, thus releasing FSH/LH from Prl inhibition.
|
|
|
So does it make sense that giving a Dopamine agonist would both induce ovulation and treat a prolactin-secreting pituitary adenoma?
|
Yes.
|
|
|
What is Prolactin release from the pituitary stimulated by?
|
It is always on!
|
|
|
What is Prolactin release from the pituitary inhibited by?
|
Dopamine
|
|
|
What are the 2 dopamine agonists used for treating hyperprolactinemia?
|
-Bromocriptine
-Cabergoline |
|
|
What is a good thing about Bromocriptine?
|
It is safe for use in pregnancy
|
|
|
What is good about Cabergoline?
|
Fewer side effects, lower doses
|
