Скачать с ютуб Intersex disorders - Gynecology в хорошем качестве

Intersex disorders - Gynecology

📌𝐅𝐨𝐥𝐥𝐨𝐰 𝐨𝐧 𝐈𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦 :-   / drgbhanuprakash   Intersex The congenital presence of chromosomal, gonadal, and/or phenotypical patterns that do not fit binary notions of male or female sex. Individuals with intersex traits may identify as “intersex,” but gender identity is not inherently contingent on phenotype or genotype and individuals may also identify as otherwise nonbinary, male, or female. The term "intersex" is the historical term for a group of conditions referred to today as "Differences (disorders) of sex development" (DSD). There are three factors which determine an individual's sexual development. These are the effect of the sex chromosomes on the differentiation of the gonad, the proper functioning of the differentiated testis and the response of the end organ to this testicular function. The testes carry out their intrauterine function by producing two substances, testosterone and MIS. Testosterone stimulates the development of the Wolffian duct, which differentiates into the internal male genitalia and also to the masculinization of the cloaca. MIS inhibits the development of the Mullerian structures which are always present and capable of development. MIS is a gly-coprotein produced by the Sertoli cells [15] and its action seems to be mediated by the release of hyalunidase by the Mullerian duct cells, and local destruction occurs. There may also be inhibition of growth factor stimulation, presumably through specific cell membrane-associated receptors, as the regression is quite specific. MIS may have unilateral action so that each testis appears to produce the hormone, which results in regression of the Mullerian structures on its own side. The sensitivity of Mullerian structures to MIF is present only during the first 8 weeks of gestation. The manner in which testosterone, produced by developing testes, is utilized to bring about masculinization of the cloaca is through conversion of testosterone to dihydrotestosterone through the action of the enzyme 5a-reductase. Wolffian structures, however, are capable of utilizing testosterone directly and are therefore independent of 5a-reductase activity. Thus, in those patients with 5a-reductase deficiency abnormal development of the external genitalia will occur and an intersex state results. For effective utilization of both testosterone and 5a-reductase it is necessary for the testosterone to be bound to the receptors on the cell membranes and ineffective binding of testosterone leads to abnormal sexual differentiation in disorders known as androgen insensitivity Clinical presentation --------------------------------- The child with ambiguous genitalia may present in a number of ways: 1 a masculinized female due to congenital adrenal hyperplasia (CAH) or androgen stimulation from another source; 2 an undermasculinized male for one of the reasons discussed above; or 3 a true hermaphrodite. #intersex #intersexdisorders #gynecology #obg #marrow #prepladder #osmosis #lecturio #proceum #drbhanuprakash #usmle #usmlestep1 #usmlestep2ck #usmlesteps #medicalstudent #medicalstudents #medicalcollege #mbbslectures #nationalexittest #usmlevideos #mbbsfinalyear #mbbsstudentlife #mbbsstudy