Pgo - 61: Endocrine Syndromes In Gynecology

Front 1

interval between bleeding

Back 1

21 – 36 days

Front 2

duration of bleeding

Back 2

2-8 days

Front 3

max blood loss

Back 3

80 mL

Front 4

factors influencing age of menarche

Back 4

• under control of the CNS
• genetically determined
• socioeconomical influence
• affected by body mass

Front 5

structures controlling menstrual cycle

Back 5

- brain cortex
- hypothalamus
- pituitary gland
- ovary

Front 6

FSH & LH IS released from

Back 6

anterior pituitary

Front 7

gonadotropin-releasing factor (gonadoliberin) is released from

Back 7

hypothalamus
• Decapeptide produced pulsatively in hypothalamus
• Produced in the area of nucleus arcuatus with terminals axons in the eminentia mediana

Front 8

Ovaries produce

Back 8

estrogens, progesteron, androgens

Front 9

is it possible to synthesize gonadoliberins

Back 9

yes

Front 10

estradiol peaks

Back 10

preovulatory & lutheal phase

Front 11

habitual abortion can be seen if

Back 11

progesteron production is low in second phase

Front 12

prolactin is produced by

Back 12

lactotropic cells in anterior pituitary lobe

Front 13

Hyperprolactinemia - influence on hypothalamus

Back 13

influence hypthalamus by suppression → no ovulation, amenorrhea

Front 14

Breastfeeding - action on hypothalamus

Back 14

Breastfeeding block the hypothalamo-hypophyseal axis (when breastfeeding is at least 6 times a day, lasting at least 60 min together)

Front 15

Ovary – function (2)

Back 15

• Endocrine: production of estrogens, progesteron, androgens
• Oogenesis: production of oocytes

Front 16

Theca cells produce

Back 16

androgens and progesterone

Front 17

Granulosa cells produce

Back 17

aromatase + estrogen

Front 18

role of aromatase

Back 18

aromatase convert androgens to estrogen. Present in adipose tissue, ovaries, breast. Pathology of aromathase function → increased production of estrogen, and an estrogen-dependent disease can occur

Front 19

steroid hormones: estrogens (C18) - levels during menstrual cycle

Back 19

• Low in the early follicular phase
• Increase 1 week before gonadotropin release
• Second increase during formation of corpus luteum

Front 20

Steroid hormones: gestagens (C–21) - levels during menstrual cycle

Back 20

• During follicular phase on low level
• Production of progesterone
• Proliferative phase 2,5-5,4 mg/24 hour.,
• Luteal phase 22-43 mg/24 hour.

Front 21

is corpus luteum an endocrine tissue

Back 21

yes

Front 22

hormones secreted by corpus luteum

Back 22

progesterone and oestradiol

Front 23

essential for keeping corpus luteum in function is

Back 23

• Luteinization - granulosa lutein cells
• LH essential for keeping CL in function

Front 24

when is the max production of progesterone

Back 24

the 10th day after ovulation

Front 25

androgens

Back 25

DHEAS, androstendione, testosterone

Front 26

Daily plasmatic production of testosterone

Back 26

0,23-0,34 mg/24 hour.

Front 27

% of hormones produces by ovaries
• Testosterone
• Androstendione
• Dehydroepinadrosterone

Back 27

• Testosterone – 50% ovarial
• Androstendione – 60% ovarial
• Dehydroepinadrosterone – 20%

Front 28

Virilism

Back 28

women with high androgen production → hirsutism, acne, hypertrophy of clitoris etc.

Front 29

amenorrhea - progesteron positive vs Progesteron negative: clinical test

Back 29

Clinical test (after excluding pregnancy): inject some amount of progesterone → if women is bleeding in 5 days, the amenorrhea is progesterone negative

Front 30

Shean amenorrhea

Back 30

nacrosis lead to hypofunction of pituitary gland (usually in developing countries)

Front 31

anovulation - causes

Back 31

• Hyper PRL
• PCO sy (quite frequent!!)
• Hypothalamus ( CNS )

Front 32

PCO (polycystic ovaries = Stein-Leventhal syndrome)
1) clinical signs
2) treatment
3) mechanism

Back 32

1) Typically conected with hyperandrogenism, oligomenorrhea
2) Treatment: antiestrogens , antiandrogens
3) Machanism: disturbance of FSH & LH production (normally, the ration is higher FSH → in PCO the LH is 2 times higher than FSH)

Front 33

Adrenogenital syndrome

Back 33

congenital syndrome with elevated production of androgens

Front 34

morbus Cushing

Back 34

• 80% hirsutism
• hypertrophy of clitoris
• 77% amenorrhea

Front 35

Test which can contraindicate contraception use

Back 35

• Protein C, protein S (clotting factors)
• Leiden mutation (clotting factor V)

Front 36

menopause - influencing factors

Back 36

genetically determined
socioeconomical influence

Front 37

production of progesterone in
1) proliferative phase
2) lutheal phase

Back 37

1) Proliferative phase 2,5-5,4 mg/24 hour.,
2) Luteal phase 22-43 mg/24 hour.

Front 38

classification of amenorrhea

Back 38

Primary
Secondary

Physiological
Pathological

Progesteron positive
Progesteron negative

Front 39

causes of hypothalamic dysfunction

Back 39

GnRH dysregulation
GnRH supression

Front 40

causes of pituitary dysfunction

Back 40

Tumor
Necrosis
Dysregulation ( hypothalamic pituitary )

Front 41

causes of ovarian dysfunction

Back 41

Ovarian failure
Ovarian tumor
Ovarian dysgenesis