Hypothalamo Pituitary Ovarian Axis

True about Hypothalamo Pituitary Ovarian Axis is

A. The short feedback loop exert positive feedback
B. Gonadotropin levels remain at a lower level in fetal life than during neonatal period
C. During pregnancy, there is hypofunction of the axis
D. The pulsatile pattern of GnRH release is obliterated in perimenopausal period

Most common group II ovulatory disorder is

A. Ovarian failure
C. Panhypopituitarism
D. Pituitary adenomas

Most common cause of hypothalamic-pituitary failure (HPF)

A. Idiopathic hypogonadotropic hypogonadism (IHH)
B. Panhypopituitarism
C. Infectious hypophysitis
D. Compression by pituitary adenomas

Most common benign tumor causing primary amenorrhea

B. Langerhans cell histiocytosis
C. Prolactinoma
D. Glial cell tumors

True of Management of Hypothalamic-Pituitary Failure in prepubertal females is

A. Estrogen replacement for one to two years is critical
B. Replacement of sex steroid hormones with estrogen and progesterone is required
C. Human chorionic gonadotropin (hCG) are commonly used
D. Purified human menopausal gonadotropin (hMG) is essential

Not true of Hypothalamic-Pituitary-Ovarian Axis Dysfunction

A. PCOS includes loss of GnRH pulsatility with increased LH secretion
B. In underweight patients, GnRH pulsatility is not affected
C. Obesity leads to loss of normal GnRH pulsatility due to excessive aromatization of androgen precursors
D. Excessive TRH secretion will interfere with GnRH pulsatility

In shorts

  • Langerhans cell histiocytosis is a condition marked by uncontrolled proliferation of dendritic cells associated with the monocyte-macrophage system. When Langerhans cells infiltrate the anterior pituitary, disordered hormone production may lead to hypogonadotropic hypogonadism.
  • Idiopathic hypogonadotropic hypogonadism (IHH) may be due to septo-opto dysplasia (De Morsier syndrome), a congenital disorder characterized by hypoplasia of the optic nerve and pituitary gland. These patients additionally display craniofacial abnormalities thought to occur secondary to vascular insult in the 6th-7th week of embryogenesis.
  • If clinical signs of hyperandrogenism are apparent, 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHEA-S) and total testosterone should be measured to rule out presence of ovarian or adrenal androgen secreting tumors.

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