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28 Cards in this Set
- Front
- Back
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The presence of insulin resistance in PCOS places affected women at high risk for what 2 diseases?
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DM Type 2
Heart disease |
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Diazoxide: what does it do in PCOS?
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Suppresses insulin and therefore lowers serum testosterone in women with PCOS
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Metformin: role in PCOS
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Increases insulin sensitivity and increases ovulatory frequency
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PCOS : defn
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<8 menstrual cycles/year
Hyperandrogenism |
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T/F Hyperinsulinemic insulin resistance appears to be a universal feature of women with PCOS
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T
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What conributes to the hyperandrogenism and anovulation of PCOS?
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Hyperinsulinemia.
Insulin stimulates androgen production, decreases sex-hormone binding globulin concentration |
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T/F in normal women, hyperinsulemina causes ovarian androgen increase
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F. There is a lack of effect of insulin on ovarian androgens in normal women.
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Goals of PCOS therapy
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1) Reduce circulating androgens
2) Improve reproductive function and fertility 3) Ameliorate PCOS-associated complications due to hyperinsulinemic insulin resistance (Glucose tolerance, dyslipidemia, hypertension, etc) 4) Enhance weight loss |
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Two mechanisms by which excessive insulin produces hyperandrogenism in PCOS:
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1) Stimulates ovarian androgen production
2) Directly and independently reducing serum sex hormone binding globulins |
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Pathophys of PCOS
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1) INsulin sensitivity decreases
2) Insulin output by pancreas increases 3) Normal glucose tolerance 4) COMPENSATORY HYPERINSULINEMIC INSULIN RESISTANCE 5) Increase androgen production, decrease sex hormone binding globulin (SHBG); disordered FSH/LH release 6) Anovulation --> PCOS |
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T/F SHBG Levels in PCOS Are Directly Suppressed by Hyperinsulinemia
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T
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What are Effects of Insulin Sensitizing Drugs (metformin, thiazolidinediones) on Androgens and Ovulation in PCOS?
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Decrease androgens
Increase rate of spontaneous ovulation |
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Clinical syndrome resulting from failure of testis to produce physiological levels of T (androgen deficiency) and normal numbers of spermatozoa d/t disruption of one or more levels of the hypothalamic-pituitary-gonadal axis
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hypogonadism
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What is testosterone responsible for?
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Muscle mass/strength
Bone mass Libido Hematocrit Male hair pattern |
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Symptoms of hypogonadism
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Erectile dysfunction
Decreased strength/energy Diminished facial/body hair Decreased hematocrit |
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What is secondary hypogonadism?
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Due to hypothalamic-pituitary disorders.
Can be genetic or acquired |
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Testosterone levels are inversely associated with _____
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insulin, glucose, TGs.
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What is Kallman's syndrome?
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Cause of 2ndary hypogonadism
Defect in migration of GnRH neurons from olfactory placode to hypothalamus. |
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Klinefelter's is a cause of (primary, secondary) hypogonadism
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primary. It's a testicular disorder.
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Presentation of Klinefelter's d/o
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Gynecomastia
Small firm testes Eunuchoidal Infertility |
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Cryptorchidism is aka
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undescended testicle
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Symptoms of Kallman's syndrome
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Small rubbery testes
Micropenis Eunuchoidal Anosmia/hyposmia |
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Low T, High LH
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primary hypogonadism
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Why Does Testosterone
Decrease With Aging? |
There is decreased secretion of GnRH.
In the testis, there is a decreased number of Leydig cells, and decreased testosterone production/cell. |
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T/F In Androgen Decline in Aging Male, there are hot flashes similar to menopause
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F
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Adverse effects of oral testosterone
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Associated with hepatotoxicity
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Testosterone: Adverse Effects
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Testosterone being converted to DHT causes sx like hair loss
For BPH: T stimulates prostate growth and worsens sx Blood: Increases hematocrit with increased risk of clotting Sleep Apnea Effects on lipids is mixed, overall neutral Causes aggression |
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T/F Testosterone decreases adverse CV events
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F
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