Chapter 050 Hirsutism and Virilization (Part 1) pptx

... 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

... 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

... 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, particularly ... hyperandrogenism. Because adrenal androgens are readily suppressed by low doses of glucocorticoids, the dexamethasone androgen-suppression test may broadly distinguish ovarian from...

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

... small-diameter myelinated A- delta (Aδ) and the unmyelinated (C fiber) axons (Fig. 12 -1). These fibers are present in nerves to the skin and to deep somatic and visceral structures. Some tissues, ... sensation and emotion. When acute, pain is characteristically associated with behavioral arousal and a stress response consisting of increased blood pressure, heart rate, pupil dia...

Ngày tải lên: 06/07/2014, 08:20

... Activators of Emesis Chapter 039. Nausea, Vomiting, and Indigestion (Part 1) Harrison's Internal Medicine > Chapter 39. Nausea, Vomiting, and Indigestion Nausea, Vomiting, and Indigestion: ... requires understanding of these pathways. Several brain stem nuclei—including the nucleus tractus solitarius, dorsal vagal and phrenic nuclei, medullary nuclei that re...

Ngày tải lên: 06/07/2014, 15:21

... importance and relevance to all 21 st century organizations. KM is not a simple activity, rather it requires thoughtful and careful evaluation of, and understanding of numerous external and internal ... information, and knowledge systems and thus serves to explain confusions that may exist. Understanding A related construct to knowledge and most relevant in knowledge managem...

Ngày tải lên: 24/12/2013, 14:16

... Association of America), Chapter 3. Kahaner, D., Moler, C., and Nash, S. 1989, Numerical Methods and Software (Englewood Cliffs, NJ: Prentice Hall), Chapter 4. Johnson, L.W., and Riess, R.D. 1982, Numerical ... REFERENCES AND FURTHER READING: Abramowitz, M., and Stegun, I.A. 1964, Handbook of Mathematical Functions , Applied Mathe- matics Series, Volume 55 (Washington: National...

Ngày tải lên: 21/01/2014, 18:20