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Duke PA Physiology

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If the breast is not expressing estrogen, but only progesterone, would you put someone on tamoxifen?   no  
What happens are 5 years of tamoxifen?   tamoxifen switches and becomes a promoter for the estrogen receptor - acts as an agonist  
What do you put patients on after tamoxifen?   aromatase inhibitors - prevents conversion of androgen to estrogen  
Describe the path from the ovary to the uterus   fimbria, infundibulum, isthmus, ampulla, uterus  
What are you trying to block with oral contraceptives?   LH surge, prevent release of egg  
Polycystic ovaries   No LH surge - follicles all over ovary, high androgen level (from the adrenal)  
DHEA from the adrenal   high levels of DHEA (weak androgen) erase pulsatility of GnRH, critical for timing in cycles  
How do you treat polycystic ovaries?   hormone control of cycles  
What will the level of FSH be in the post-menopausal female?   increased - negative feedback from estrogen is gone  
In a young boy diagnosed with precocious puberty, puberty is best delayed by administration of a long-lasting what?   GnRH receptor agonist  
Why give GnRH for precocious puberty?   shuts down the male axis through giving high endogenous ligand, non-pulsatile - downregulat receptor  


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