Chapter 050 Hirsutism and Virilization (Part 4) ppsx

... particularly SHBG; (3) impairment of the peripheral conversion of androgen precursors to active androgen; and (4) inhibition of androgen action at the target tissue level. Attenuation of hair ... the steps in the pathway of androgen synthesis and action: (1) suppression of adrenal and/ or ovarian androgen production; (2) enhancement of androgen-binding to plasma- binding proteins,...

Ngày tải lên: 06/07/2014, 20:20

... presenting with hirsutism. This assessment permits the distinction between hirsutism and hypertrichosis and provides a baseline reference point to gauge the response to treatment. A simple and commonly ... eyelashes, and vellus hairs are androgen- insensitive, whereas the axillary and pubic areas are sensitive to low levels of androgens. Hair growth on the face, chest, upper...

Ngày tải lên: 06/07/2014, 20:20

... after menopause. Figure 50-2 Chapter 050. Hirsutism and Virilization (Part 3) Hormonal Evaluation Androgens are secreted by the ovaries and adrenal glands in response to their respective ... (LH) and adrenocorticotropic hormone (ACTH). The principal circulating steroids involved in the etiology of hirsutism are testosterone, androstenedione, and dehydroepiand...

Ngày tải lên: 06/07/2014, 20:20

... on hirsutism have been reported, but the predominance of 5α- reductase type 1 in the PSU appears to account for its limited efficacy. Finasteride Chapter 050. Hirsutism and Virilization (Part ... SHBG levels and in their androgenic potential. Ethynodiol diacetate has relatively low androgenic potential, whereas progestins such as norgestrel and levonorgestrel are particu...

Ngày tải lên: 06/07/2014, 20:20

... clitoromegaly, and increased libido; virilization is an ominous sign that suggests the possibility of an ovarian or adrenal neoplasm. Table 50-1 Causes of Hirsutism Gonadal hyperandrogenism ... Diazoxide Cyclosporine True hermaphroditism Virilization refers to a condition in which androgen levels are sufficiently high to cause additional signs and symptoms such as deepeni...

Ngày tải lên: 06/07/2014, 20:20

... syndrome); (4) a decrease in the effective anionic charge on albumin by acidosis; or (5) hyperviscosity and severe hyperlipidemia, which can lead to an underestimation of sodium and chloride ... Steps in Acid-Base Diagnosis 1. Obtain arterial blood gas (ABG) and electrolytes simultaneously. 2. Compare [HCO 3 - ] on ABG and electrolytes to verify accuracy. 3. Calculate anion ga...

Ngày tải lên: 06/07/2014, 15:21

... prostate, lung, breast, and colon cancer cells in vitro. Clinical trials of telomerase vaccines are underway. Chapter 080. Cancer Cell Biology and Angiogenesis (Part 4) Telomerase DNA polymerase ... these processes include transcription factors (e.g., Myc, AP-1, and serum response factor) and the cell cycle machinery (CDKs and cyclins). Inhibitors of many of these path...

Ngày tải lên: 07/07/2014, 01:20

... Chapter 017. Fever and Hyperthermia (Part 4) Chronology of events required for the induction of fever. AMP, adenosine ... 5'-monophosphate; IFN, interferon; IL, interleukin; PGE 2 , prostaglandin E 2 ; TNF, tumor necrosis factor.There are four receptors for PGE 2 , and each signals the cell in different ways. Of the four ... with an instrument sensitive to the identific...

Ngày tải lên: 06/07/2014, 12:20

... BP, blood pressure; CV, central venous; ROR, rate of rewarming.[newpage] Chapter 020. Hypothermia and Frostbite (Part 4) Rewarming Strategies The key initial decision is whether to rewarm ... (CPB) Circuit—full circulatory support with pump and oxygenator Perfusate-temperature gradient (5°–10°C) Flow rates 2–7 L/min (ave. 3 4) ROR up to 9.5°C/h Note: BP, blood press...

Ngày tải lên: 06/07/2014, 12:21

... Chapter 022. Dizziness and Vertigo (Part 4) a In Ménière's disease, the direction of the fast phase is variableVertigo ... decreases cerebral blood flow and should reproduce ischemic symptoms. Hyperventilation is the cause of dizziness in many anxious individuals; tingling of the hands and face may be absent. Forced ... hyperventilation syndrome, hypoglycemia, and...

Ngày tải lên: 06/07/2014, 12:21