B6 Endo GU Pharmacology Final Exam

B6 Endo/GU Pharmacology Final Exam Definition & General Causes of Infertility - fail conceive after specif time w/ reg interc w/o contrac (ie. 12 mts if 35y/o & 6mts if 35 or PCOS) - 1/3 causes each fem orig, male orig, unk/combo of both partners - conceiv prob decr 3-5%/yr after 30-32, faster after 37-40y/o by dim oocyte qual+quant Pathophysiology, Sx, Labs, Causes, Solution for WHO Group I Infertility - - Pathophys = hypogonadotr hypogon by hypoth-pit fail - Sx/labs = amen, low FSH/LH, low estrad, +/- elev prolactin - Causes = eating disords, wt/exerc extremes, hyperprol - Soln = correct cause (ie. gain wt, thyr med, dopa ag); reg Gn & ind ovul Pathophysiology, Sx, Labs, Causes, Solution for WHO Group II Infertility - - Pathophys = normogonadotr anov by hypoth-pit-ovar fail **MOST COMMON** - Sx/labs = nl FSH, nl-elev LH, nl estrad, elev PRL, galactorr - Causes = PCOS, ovul-rel dysfunc, hyperPRL - Soln = meds ind ovul, Gn to reg ovul, decr PRL by Dopa ag Pathophysiology, Sx, Labs, Causes, Solution for WHO Group III Infertility - - Pathophys = hypergonadotr hypogon by ovar fail - Sx/labs = elev FSH, low estrad - Causes = adv age - Soln = oocyte don, IVF Other causes of Infertility - ut/outfl tract abnorms, tub dis by PID - Treat w/ meds/IVF Pathophysiology, Sx, Labs, Causes, Solution for Male Factor Infertility - - Pathophys = anat vars, chrom abnorms, erec/ejac dysf - Sx/labs = abnl FSH/LH, testost, semen analysis - Causes = inf, inj, tox expos, syst dis, sperm ABs, hypogon, testic dis, sperm transp defs - Soln = IVF, intraut insem, don sperm **MOST COMMON CAUSE is cryptorch** Overview of Repro Endocrinology - hypoth secr GnRH stim ant pit gonadotropins LH+FSH stim ovars+testes - -reg by inhibin (-FSH) & elev estrog/progest/testost (-GnRH+LH/FSH) - +reg by activin (+FSH) & estrog (+LH/FSH mid-cyc) Role of Gonadotropins in Menstrual Cycle - - Follic ph (prolif ph) = low estrog/inhib -- elev LH/FSH stim follic dev for dom foll form; high sust estrog, mid-cyc LH/FSH surge for ovul - Luteal ph (secr ph) = corp lut secr estrog+progest, endom prep for implant by progest incr blood supp spir arts **ovar dysf accounts for most infert cases**