Tuesday, June 30, 2009

ANSWERS to GUIDE QUESTIONS

1. LH is also known as:

Lutropin

2. Where is LH produced?

Anterior Pituitary Gland

3. Transcribe ICSH.

Interstitial Cell Stimulating Hormone

4. It acts in a negative feedback manner to suppress secretion of LH by the anterior pituitary gonadotrophs and to suppress secretion of GnRH by the hypothalamic neurosecretory cells.

Testosterone

5. It is triggered when there is an acute rise of LH for female.

Ovulation

6-7. Enumerate two interferring factors.

Either of these:
• Recently administered radioisotopes.
• Hemolysis of blood sample.
• Estrogen or oral contraceptives, testosterone.
• Several drugs affect test outcome.
• Pregnancy.


8. Give one abnormal finding for male.

Either:
• Low plasma LH values may indicate secondary gonadal dysfunction (of hypothalamic or pituitary origin).
• High values may indicate testicular failure (primary hypogonadism) or destruction.
• Congenital abscence of testes.

9. Give one abnormal finding for female.

Either:
• Absence of a mid-cycle peak in plasma LH levels may indicate anovulation.
• Decreased or low-normal plasma may indicate hypogonadism.
• High plasma LH levels may indicate congenital absence of ovaries.
• Ovarian failure associated with Stein-Leventhal syndrome.
• Ovarian dysgenesis.
• Menopause or early stage acromegaly

10. Reference value for Female (follicular).
1.37 to 9.9 mIU/L

II. CASES:(5 points each)

11-15.

A 9 year old girl named Lhalha went to the doctor with her mom a few days ago. They were wondering why at her young age, acne has started to appear on her face, neck, and even on her back. And they also noticed some unwanted excess hair growing on her body(e.g. in the face, in the arms and legs, etc.)

What is the probable reason/disease for Lhalha's case? Are the symptoms normal for her age? What are the treatments to be considered?

Disease: POLYCYSTIC OVARY SYNDROME.

The signs that Lhalha had been encountering are not normal at her age. Listed below are some treatments for Polycystic Ovary Syndrome:

•Lowering the levels of insulin by diet or medications.

•Treatment of fertility.
•Treatment of hirsutism and/or acne.
•Restoration of the regular menstruation.

16-20.

Kimo was happily married with her wife Shimie. But as time went by, their life had gone into something they have not expected.

Everytime they were having intercourse, Kimo didn't ejaculate. It even came to a point wherein Shimie really got mad because of Kimo's attitude toward their sex life. Kimo had apparently lost his libido.

What are the probable diseases or conditions associated with the above-mentioned symptoms? Justify your answer.

Disease: HYPOPITUITARISM.

The deficiency of anterior pituitary hormones are more common than the individual hormone deficiency. In this case, Kimo has deficiency in the LH, thus, he experienced the symptoms.

Tuesday, June 16, 2009

POST QUIZ!

GOODLUCK and GIVE YOUR BEST SHOT!Ü

I. Identification:

________1. LH is also known as?

________2. Where does LH produced?
________3. Transcribe ICSH.

________4. It acts in a negative feedback manner to suppress secretion of LH by anterior pituitary gonadotrophs to suppress secretion of GnRH
by hypothalamic neurosecretory cells.

________5. It is triggered when there is an acute rise of LH for female.

________6. Enumerate two
________7. interferring factors.

________8. Give one abnormal condition for male.

________9. Give one abnormal condition for female.

_______10. Reference value for Female (follicular).

II. CASES:(5 points each)

11-15.

A 9 year old girl named Lhalha went to the doctor with her mom a few days ago. They were wondering why at her young age, acne has started to appear on her face, neck, and even on her back. They also noticed some unwanted excess hair growth on her face, arms and legs.

What is the probable reason/disease for Lhalha's case? Are the physical symptoms normal for her age? What treatment options will you recommend?

16-20.

Kimo was happily married with her wife Shimie. But as time went by, their life went to something they have not expected.

Everytime they had an intercourse, Kimo wasn't able to perform as expected. He could not even ejaculate. It came to a point wherein Shimie really got mad because of Kimo's inability to satisfy her sexual needs. Kimo apparently lost his sexual libido.

What is the probable disease or condition Kimo has? Justify your answer.

Monday, June 1, 2009

Luteinizing Hormone

Luteinizing Hormone a.k.a. Lutropin. It is a hormone that is produced by the anterior pituitary gland. They are under complex regulation by hypothalamic gonadotropin-releasing hormone and by gonadal sex hormones (estrogen and progesterone in females and testosterone in males). Luteinizing hormone acts on Leydig's (interstitial) cells of the gonads. For females, an acute rise of LH will trigger the ovulation, while for males, where LH had also been called Interstitial Cell Stimulating Hormone (ICSH), wherein it stimulates Leydig cell the production of testosterone which stimulates and maintains spermatogenesis. This steroid hormone is synthesized from cholesterol in the testes and is the principal androgen. It is lipid soluble and readily diffuses out of Leydig cell into the interstitial fluid and then into the blood. Testosterone acts in a negative feedback manner to suppress secretion of LH by anterior pituitary gonadotrophs and to suppress secretion of GnRH by hypothalamic neurosecretory cells. In some target cells, such as those in the prostate and seminal vesicles, the enzyme 5 alpha-reductase converts testosterone to another androgen called dihydrotestosterone (DHT).

Purpose for testing
○ To detect ovulation
○ To assess male or female infertility
○ To evaluate amenorrhea
○ To monitor therapy designed to induced ovulation



Reference values for LH:
♀Female
Follicular ------------------------- 1.37 to 9.9 mIU/L
Ovulatory peak ------------------ 6.17 to 17.2 mIU/L
Luteal ---------------------------- 1.09 to 9.2 mIU/L

Postmenopausal ----------------- 19.3 to 100.6 mIU/L
♂Male -------------------------- 1.42 to 15.4 mIU/L



Procedure and posttest care
♦ Perform a venipuncture, and collect the sample in a 7-ml clot-activator tube.
♦ Apply direct pressure to the venipuncture site until bleeding stops.
♦ If a hematoma develops at the venipuncture site, apply warm soaks.
♦ Instruct the patient that he/she may resume medications discontinued before tests as ordered.



Precautions
• Handle the sample gently to prevent hemolysis.
• If the patient is a female, indicate the phase of her menstrual cycle on the laboratory request. Make a note if the patient is menopausal.



Abnormal Findings
In women, absence of a mid-cycle peak in plasma LH levels may indicate anovulation. Decreased or low-normal plasma may indicate hypogonadism; these findings are commonly associated with amenorrhea. High plasma LH levels may indicate congenital absence of ovaries or ovarian failure associated with Stein-Leventhal syndrome (polycystic ovary syndrome), Turner's syndrome (ovarian dysgenesis), menopause or early stage acromegaly. Infertility can result from primary or secondary gonadal dysfunction.
In men, low plasma LH values may indicate secondary gonadal dysfunction (of hypothalamic or pituitary origin); high values may indicate testicular failure (primary hypogonadism) or destruction or congenital abscence of testes.


Interfering factors
◘ Recently administered radioisotopes.
◘ Hemolysis of blood sample.
◘ Estrogen or oral contraceptives, testosterone.
◘ Several drugs affect test outcome.
◘ Pregnancy.






References:

☺A Manual of Laboratory and Diagnostic Tests 7th Edition
by Frances Fischbach

☺Professional Guide to Diagnostic Tests

☺Clinical Chemistry Principles, Procedures, Correlations 5th Edition
by Michael L. Bishop, Edward P. Fody, Larry E. Schoeff

☺Principles of Anatomy and Physiology 10th Edition
by Gerard Tortora, Sandra Reynolds Grabowski

☺http://en.wikipedia.org