Urologist Essay

Urologist Essay
Who is an urologist and why is it important to meet him?
An urologist is a medical doctor who is specialized in urinary tract anatomy. The urologist in Delhi
NCR is trained professional who take care of malfunctions and other pathological diseases that
occur in urinary system. They also treat issues in kidneys, adrenal glands, urinary track, urinary
bladder, testes, penis, etc.
Below are few pointers which explain you about the role of an urologist. These pointers will help
you to select an urologist in your locality.
Urologists
Urologists are specialized doctors who work along with specialists in gynecology, nephrology,
oncology, pediatric surgery, endocrinology, and gastroenterology. Since diseases and disorders they
treat are treated by urologists. In many cases, your symptoms make you think to visit a nephrology
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Eventually, the Urologist needs to complete general medical educational training as well as an
accredited residency program. Thus they are approved by the state board of Urology with board
certification.
The next important thing to see is the experience of the Urologist in their field. Only sound
experience in this field will help the practitioner to diagnose the problem in the patient and to
provide proper treatment for it.
Most often the urologist work along with gastroenterology doctors in order to diagnose intestinal
problems which are directly connected to urinary system. But the fact is that finding a
gastroenterologist in Delhi NCR is quite difficult. In such cases you may directly visit an urologist
in your area.
Do remember that, meeting an urologist is really important in our life span. Since, they are the
professionals who can diagnose your problems related to urinary system and reproductive system.
They can refer you to consultants or specialist who can provide you advance treatment for your
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Adrenal Proficiency Syndrome
Adrenal insufficiency (AI) is an impairment in cortisol/aldosterone production.(1) Common
manifestations of the disease include hyperpigmentation, hypoglycemia, lethargy, fatigue, muscle
weakness, weight loss, dizziness and hypotension.(2) Biochemical criteria for AI diagnosis include
very low serum cortisol levels (200 pmol/l).(2, 3)
AI can be produced either by congenital or acquired pathologies.(4) Congenital causes include
congenital lipoid adrenal hyperplasia (CAH) (caused by defects in STAR), P450 side chain cleavage
syndrome (by mutations in CYP11A1), 3β–hydroxysteroid dehydrogenase deficiency (by mutations
in HSD3B2), 21–hydroxylase deficiency (by mutations in CYP21A2), 11β–hydroxylase deficiency
(by mutations in CYP11B1), 17–hydroxylase ... Show more content on Helpwriting.net ...
This splice site variant destroys the canonical splice donor site in intron 2. It is predicted to cause
abnormal gene splicing resulting in an in–frame protein product with an abnormal message. The
c.425+1G>A variant was not observed in approximately 6,500 individuals of European and African
American ancestry in the NHLBI Exome Sequencing Project, indicating it is not a common benign
variant in these populations. We interpret c.425+1G>A as a pathogenic variant. To our knowledge,
the c.425+1G>A pathogenic variant in the CYP11A1 gene has not been reported previously as a
pathogenic variant nor as a benign variant. This splice site variant destroys the canonical splice
donor site in intron 2. It is predicted to cause abnormal gene splicing resulting in an in–frame
protein product with an abnormal message. The c.425+1G>A variant was not observed in
approximately 6,500 individuals of European and African American ancestry in the NHLBI Exome
Sequencing Project, indicating it is not a common benign variant in these populations. We interpret
c.425+1G>A as a pathogenic

What´s Polycystic Ovary Syndrome?
Polycystic ovary syndrome (PCOS), was first described in 1935 and named Stein–Levinthal
syndrome after the doctors who noted the characteristic body changes and tiny cysts covering the
ovaries. Although the first observation was made as early as 1721, when Italian scientist Antonio
Vallisneri observed "young married peasant women, moderately obese and infertile, with two larger
than normal ovaries, bumpy and shiny, whitish, just like pigeon eggs" (Kovacs, 2002). It was not
until 1921 that Achard and Thiers noticed a relationship between hyperandrogenism and insulin
resistance in their study of the "bearded diabetic woman" (Archard, 1921). This relationship is
present in PCOS in what might be called the "hirsute hyperinsulinemic woman." In 1935, Stein and
Leventhal made the connection between amenorrhea and polycystic ovaries. In ... Show more
content on Helpwriting.net ...
*Congenital adrenal hyperplasia, androgen–secreting tumours, Cushing's syndrome, 21–
hydroxylase–deficient non–classic adrenal hyperplasia, androgenic/anabolic drug use or abuse,
syndromes of severe insulin resistance, thyroid dysfunction, hyperprolactinaemia.
Teede ET AL. BMC MEDICINE 2010 8:41

Adrenocorticotropic Hormone Test Research Paper
Why am I having this test? The adrenocorticotropic hormone test, also called an ACTH test, is a test
that evaluates the functioning of the pituitary gland in your brain. Your health care provider may
order this test if you have symptoms of either too much or too little ACTH. For example, too much
ACTH can be seen in Addison disease, where symptoms include being tired (fatigue). Too little
ACTH can be seen in Cushing syndrome, where symptoms include being overweight, having acne,
and having more hair on your body. What is being tested? The ACTH test measures the level of
ACTH produced by your pituitary gland in the brain. The test examines a part of the pituitary gland
in your brain called the anterior pituitary gland, and it measures how much adrenocorticotropic
hormone (ACTH) that gland is producing. ... Show more content on Helpwriting.net ...
These changes during the day are called diurnal variation. What kind of sample is taken? How do I
prepare for this test? Do not eat or drink anything after midnight on the night before the test or as
directed by your health care provider. You may have this test both in the morning and in the evening.
This checks for diurnal variation. How are the results reported? Your test results will be reported as
a range of values. Your health care provider will compare your results to normal ranges that were
established after testing a large group of healthy people. Reference ranges may vary among different
people, labs, and hospitals. For this test, reference ranges are: Children, male or female: 1 week to 9
years: 5–46 pg/mL. 10–18 years: 6–55 pg/mL. Adults, age 19 and older: Female: 6–58

Gender Labeling Research Paper
Throughout history, some babies have always been born with ambiguous genitalia, partially formed
sex organs, micro–organs, or organs of both sexes. This was either due to deviations in the
anatomical development of the fetus and because of exposure during fetal gestation to hormones and
chemicals. To describe such people, sexologists have gradually begun to use the more neutral term
intersex children or children with developmental sex disorders. However, various ethical issues
come in light as these children grow into adults or when physicians assign a gender to babies
following the traditional view of gender labeling means a happy adjustment in school, in the family,
and in society. Intersex and transsexual labeling especially create problems in sports where athletes
must compete with as female or male. Transgender differs from intersex such that transgender
people feel they live in a body of the wrong gender hence seeking hormone therapy while intersex
have abnormal sex organs. Both kinds of people want the right to choose their gender and may seek
hormones and surgery to do so. One such example is an ophthalmologist Richard Raskind who
underwent surgery to become Rene Richards and competed on the professional women's tennis
circuit creating a huge controversy. Another example is of South African runner Caster Semenya, ...
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Another researcher, Milton Diamond, believed that biology and hormones made gender identity, not
childhood socialization, and hence, became a life–long skeptic of John Money's views on the social
construction of gender. Diamond, with other researchers, explained that a fetus's over–exposure to
androgens from a mother's unknown tumor will give the child a masculine or androgynous
experience. so he says that although biology may be destiny, it a biology that's part genes and part
what happens to the fetus in

A & P Case Study on Addisons Disease Essay
Unit 1 Case Study
Addison's disease is from a result from damage to the adrenal cortex. These two
adrenal glands are located on top of the kidneys, where they are enclosed in a
fibrous capsule and a cushion of fat. . The have an outer portion, called the
cortex, which is a glandular tissue derived from embryonic mesoderm. The inner
portion called the medulla, which is more like a knot of nervous tissue than a gland
and it is part of the sympathetic nervous system. The adrenal cortex synthesizes
over two dozen steroid hormones called corticosteroids. The Adrenal medulla is part
of the autonomic nervous system. They are often referred to as the suprarenal
glands. That damage causes the cortex to produce ... Show more content on Helpwriting.net ...
Treatment with
replacement corticosteroids will control the symptoms of this disease, and this
usually will require the patient to take these drugs for life. It is receive a
combination of glucocorticoids and mineralocorticoids. The provider may increase
the dose in times of infection, injury and stress. With adrenal crisis patients will
need an immediate injection of hydrocortisone, either IM, or IV. If the blood
pressure is extreme low IV fluids will be helpful. Complications can occur if you
take too much or not enough of the adrenal hormone supplement. This

complications can arise due to related illnesses such as diabetes, chronic thyroiditis,
hypoparathyroidsim, ovarian hypofunction or testicular failure, thyrotoxicosis and
pernicious anemia. Low sodium with Addison's should be carefully corrected, if
done to quickly it can lead to brain damage, this is noted in a 2004 article in
"American family Physician" they require immediate but slow administration of
saline, which is basically salt water, composed of sodium chloride in water. They list
a second step which then be finding the underlying cause. Primary adrenocortical
insufficiency is not a common disorder. It's incidence in western populations are
near 50 cases per 1,000, 000. However with the widespread corticosteroid use
secondary adrenocortical insufficiency due to steroid withdrawal

Hirsutism Research Paper
Hirsutism In Women:
An Unfortunate Hairy Situation
Hirsutism is excess terminal hair that commonly appears in a male pattern in women. Terminal hair
refers to the stiff, pigmented hairs normally seen in men on the face, chest, abdomen and back,
which are not normal for women. The cause of hirsutism can be either an increased number of
androgen's in women, an oversensitivity of hair follicles to natural levels of androgen's in women,
adrenal hyperplasia, thyroid dysfunction, Cushing syndrome, androgen–secreting tumors and certain
medications. The most common cause of hirsutism is polycystic ovary syndrome, accounting for
every three out of four cases. In those not related to medication use, evaluation is focused on
endocrinopathies and neoplasms. ... Show more content on Helpwriting.net ...
With medications ruled out, evaluation is focused on testing for endocrinopathies and neoplasms
(uncontrolled growth of abnormal tissue/tumor). Hirsutism can also occur in some premenopausal
women and continue for a few years after menopause. This is due to decreased ovarian estrogen
secretion with continuous androgen production. This condition can be first noted in late teens and
worsen with age, during menopause or abnormal onset. Environment, diet, & lifestyle does not seem
to play into this condition, yet obesity and some ethnicities have been found to be a factor and/or
may be more prone. Hirsutism in itself is not fatal, yet it may be a potential indication of an
underlying medical disorder that may require specific treatment. These include thyroid dysfunctions,
polycystic ovaries, and metabolic

Virginia Vallian Claim
Virginia Valian reflect on Lewis Wolpert's claim in the "Why Can't a Women be more Like a Man?"
book and specific about the differences in biological sexes. Wolpert disguised the differences in
male and female according to skills, cognition and language, which Virginia believe that Wolpert
does not have creditable evidences to supporting his claim such as the claim that brain and hormonal
differences contributors to disparities in professional success. (Valian, 2014) Wolpert also continue
this by claiming that the extent of grey and white matter between male and female that is what
makes both sexes behavior difference. Virginia argued that Wolpert's claim are too simply and
cartoonish with the use of "may" and "might" and the repeating observation that ... Show more
The result of this case show that girl tend to increase its superior ability to the 3D image but show a
reduction in the male, which this is to point out that normal male will have more of this ability than
normal female because these hormones are availed in male. Even so, Virginia argued that this may
be true but does not proved that it's the case to the rest of male population. Wolpet use the
perspective from the development psychologist Uta Frith, which supporting the argument that both
gender do not have same neural mechanism. The agreement that "... neural and hormonal sex
differences can interact to eliminate or create behavioral differences." (Valian, 2014) The author
argued that Wolpert, did not included the implications of social and political factors inherent in
transnational difference, like China that have much higher percentage of women in engineering than
the United States. Wolept claiming that empathy mark the difference between genders and so as a
reason male's dominance in

Relation Between Gender And Infants
Researchers have hypothesized that the hormone that makes an infant a male also organizes the
brain in a masculine way. Studies have shown when testosterone is blocked in the developing fetus
then the male child engages in less rough and tumble play. If the brain plays a part in masculinizing
a male infant then one can obviously see that gender assignment before the child decides their
gender would not be the best treatment option. Studies have shown that boys as young as thirteen
months like to play with so called boy toys such as trucks and girls prefer dolls. Social interaction
also forms the infant's gender, parents interact different with boys versus girls. For example parents
tend to be more vocal with girls. Infants born with congenital

Congenital Adrenal Hyperplasia (CAH)
Congenital adrenal hyperplasia (CAH) describes several autosomal recessive diseases which are
caused by the mutation of genes for enzymes which mediate the biochemical steps of sex steroids,
mineralocorticoids or glucocorticoids production by adrenal glands. The most common type (95% of
cases) involves gene for 21–hydroxylase found on chromosome 6p21 as part of the HLA complex.
The severity of CAH depends on the degree of 21– hydroxylase deficiency. There are 3 main
phenotypes of 21– hydroxylase deficiency: classic salt–losing, classic non–salt–losing (simple
virilizing), and non–classic (late–onset). It is likely the son is facing the salt loosing phenotype, the
severe form, which occurs in occurs in boys 7 to 14 days old and accounts for 75% of CAH cases. In
the salt loosing form, males can experience severe ... Show more content on Helpwriting.net ...
Adrenal glands contain cells which produce hormones cortisol, aldosterone (salt retaining hormone)
and androgen. Adrenal glands also form small amounts of sex hormones such as testosterone and
oestrogen. The amount of cortisol made is controlled by adrenocorticotrophic hormone (ACTH),
made by the pituitary gland. Cortisol protects the body from illness or injury by maintaining
immunity and anti–inflammatory processes and maintains blood pressure. Cortisol is also
responsible for feeding back to inhibit ACTH production. If too much cortisol reaches the pituitary,
pituitary inhibits adrenal glands, to return cortisol levels to normal. Cortisol normally starts to be
produced in the second month of foetal life however, CAH prevents the formation of

Prenatal Sexual Differentiation
Two syndromes that embody the intersex condition in which the physical appearance of an
individual's genitals does not reflect the individuals gender include CAH and AIS. Congenital
adrenal hyperplasia happens when an individual's genetic make up is that of a female. However,
during prenatal development, which is the first most important process and healthy and normal
individuals; the syndrome causes the adrenal gland to go haywire and overproduce androgens due to
a genetic condition. Thus, the prenatal sexual differentiation is one that does not occur in the manner
that it normally would for a female. The overproduction of these androgens is directly connected to
the fact that the individual who is genetically born a female begins to grow

Concealment-Centered Model Of Intersex
SECTION A, PROMPT #2: Intersexuality is the term used to describe a set of conditions which
make it difficult to distinctly identify a person as biologically male or female [1]. This variation of
human biology is used to describe people when genitals are ambiguous at birth and/or the genotype
is mosaic–when some cells in the body have XX chromosomes while other cells have XY
chromosomes [1]. An example of an intersex condition is congenital adrenal hyperplasia–in which
the adrenal glands produce abnormal amounts of hormones that cause female embryos to develop a
larger clitoris (clitoromegaly) and cause masculinizing characteristics later in life. Another example
is micropenis–in which a genetically male person is born with a penis that 2.5 standard deviations or
below normal penis length. ... Show more content on Helpwriting.net ...
Genitals that were ambiguous were just thought of as a natural variation of human anatomy [2]. Due
to a huge leap in medicine in the 20th century, the medical field started to view intersexual
conditions as abnormal and curable through surgery and other options. Starting in the 50s, doctors
have used the "concealment–centered model" of healthcare when intersexuality is encountered.
Using this model's derivation, the "optimum of gender rearing model", doctors "correct" the
ambiguous genitals by means of surgery and hormonal treatments. Under this model, gender
assignment should be done as early as possible so that children would "grow up to be good
(believable and straight) girls and boys" [1]. This method of healthcare tries to "normalize" intersex
individuals because it is trying to prevent the individuals from being "ostracized" in society

Genetic Case Studies
GENETIC CASE STUDIES 4 Case 1 Q1. This infant exhibits a genetic defect known as 21–
hydroxylase deficiency classical congenital adrenal hyperplasia (CAH), which "is an inherited
disorder that affects the adrenal glands" (What is 21–hydroxylase deficiency, 2010, NIH). The
female infant in this case study exhibits the 'classic' form of the condition, resulting in ambiguous
genitalia. "The adrenal glands are located on top of the kidneys and produce a variety of hormones
that regulate many essential functions in the body. In people with 21–hydroxylase deficiency, the
adrenal glands produce excess androgens, which are male sex hormones" (What is 21–hydroxylase
deficiency, 2010, NIH). Females with the condition may exhibit male sex traits such hirsutism and
pattern baldness as well as irregular menstruation and impaired fertility. The source of the condition
is a mutation in the CYP21A2 gene which is necessary for the creation of the enzyme 21–
hydroxylase. "This enzyme is found in the adrenal glands, where it plays a role in producing
hormones called cortisol and aldosterone" and without the enzyme, "substances that are usually used
to form cortisol and aldosterone instead build up in the adrenal glands and are converted to
androgens. The excess production of androgens leads to abnormalities of sexual development in
people with 21–hydroxylase deficiency" (What is 21–hydroxylase deficiency, 2010, NIH). Q2.
There is no known 'cure' for this disorder. However, early

Addison Disease Case Study
The prevalence of Addison disease in the United States is 40–60 cases per 1 million population.
Addison disease seldom occurs. In countries where data are available reported prevalence is 39
cases per 1 million population in Great Britain and 60 cases per 1 million population in Denmark.
The prevalence and number of death relating to Addison disease are as a result of to a failure or
delay in diagnosing or a failure to institute adequate mineralocorticoid replacement, glucocorticoid.
Acute Addisonian Crisis may precipitate; which may result in death, if not treated promptly. This
may be triggered either starting from a new begining, eg. by adrenal hemorrhage, or the event that
result from the superimposition of an acute event on chronic or ... Show more content on
Helpwriting.net ...
PubMed: Epidemiology of Cushing's Disease. Retrieved November 4, 2015 from:
http://www.ncbi.nlm.nih.gov/pubmed/20829610 Non Pharmacological Intervention If possible,
surgery may be necessary to remove the pituitary tumor. After surgery, the pituitary gland may
slowly start to work again and return to normal. Radiation therapy of the pituitary gland may also be
used if the tumor is not completely removed. If these treatments are not successful, the adrenal
glands may need to be removed to stop the high levels of cortisol from being produced, in Cushing's
Disease. (Wisse, 2013) For addison's disease patient should be adviced to avoid exogenous factors
that may precipate or exacerbate this condition. Such as: Excessive use of corticosteroids and
ketoconozole etc... (Pharmacotherapy Handbook, 2009) Role of the pharmacist The pharmacist is
Responsiblities of the pharmacist includes counselling the patient counsel on treatment
complications, proper medication administration, expected outcome , adherence and possible side
effects of medications. (Pharmacotherapy Handbook,

Gender And : Gender Identity Disorder
Gender Dysphoria, formerly known as Gender Identity Disorder, is described by the DSM–IV as a
persistent and strong cross–gender identification and a persistent unease with ones sex. However,
gender identity is not diagnosed as such if it is comorbid with a physical intersex condition. Gender
dysphoria is not to be confused with sexual orientation, as people with gender dysphoria could be
attracted to men, women, or both. According to an article written by, Australasian Sciences there are
four very specific pieces of criteria that an individual needs to fulfilled in order to be considered
afflicted with gender dysphoria. There must be strong and persistent evidence cross gender
identification. However, this cross gender identification can not be determinant by any perceived
cultural advantages of being the opposite gender. The sole purpose of opposite gender identification
must be an uneasiness or uncomfortableness in one's birth gender. A viable diagnosis can not be
made if gender dysphoria is comorbid with physical intersex condition. Lastly, there must be
evidence of significant distress or impairment in important areas of functioning. Early research in
regards to gender dysphoria, is primarily rooted in psychological causality. Some of these main
causes were thought to be solely dysfunctional family dynamics or a traumatic childhood. However,
as research continued there was little evidence found to uphold this theory. According to Cindy
Meston, Ph.D. & Penny

Prenatal Androgen Model Essay
The prenatal androgen model, which has become a cliché in the field, argues that homosexuality in
men is due to under–exposure to prenatal androgens and in women, due to over–exposure.9
Attempts to support the model included hormone measurements, animal experimentations and
studies of rare disorders (i.e., congenital adrenal hyperplasia and testicular feminization) all of
which revealed inconsistent results.10 In the following surge of research in prenatal androgen
model, indirect consequences of prenatal hormone impact, such as digit ratio, fingerprint patterns
and oto–acoustic emissions have been studied, without reaching definitive conclusions.9 It is
warranted that prenatal androgenization is essential for male gender identity development, but
apparently not decisive.11 Thus, ... Show more content on Helpwriting.net ...
These hormones have a critical role in cell differentiation during development and help maintain
thermogenic and metabolic homeostasis in the adults.12 Thyroid disorders are highly prevalent in
the population and mostly affect women in childbearing age.13 In pregnancy, thyroid gland displays
mild to moderate enlargement because of increased physiological demands. Thyroid function is
altered by 4 factors in pregnancy: i) the transient increase in human chorionic gonadotropin (hCG)
during the first trimester, which cross–reacts with thyroid–stimulating hormone (TSH) receptor; ii)
the estrogen–induced rise in thyroxine–binding globulin (TBG) which is the major transport protein
for thyroid hormone; iii) increased autoimmunity; and iv) increased urinary iodide clearance, which
can cause impaired thyroid hormone production in areas of low iodine supply.12,14–17
Consequently, the levels of both T3 and T4, the major hormones released by the thyroid, increase by
~50% and serum TSH levels decrease in the first trimester and increase in the second and third

Case Study in Nursing
INTRODUCTION
Congenital Adrenal Hyperplasia (CAH) refers to a complex series of rare but well–studied
enzymatic errors of metabolism with deficient levels of different enzymes involved in the synthesis
of cortisol (hydrocortisone).
CAH comprises a group of disorders resulting from defective synthesis of adrenal corticosteroids.
Lack of glucocorticoids, especially cortisol, causes various kinds of metabolic problems. The
response to low levels of cortisol is increased production of corticotropin (ACTH). Lack of
mineralocorticoids, primarily aldosterone (steroid hormone), causes sodium and water imbalance
which, in some cases, can be fatal. The various forms of CAH represent defects in the different
stages of corticosteroid synthesis, ... Show more content on Helpwriting.net ...
There were two folds of skin coming from the top of the penis and encircling it on either side. These
were somewhat loose and resembled labia majora."
De Crecchio then described the internal organs, which included a normal vagina, uterus, tubes, and
ovaries.
It was of the greatest importance to determine the habits, tendencies, passions, and general character
of this individual... I was determined to get as complete a story as possible, determined to get at the
base of the facts and to avoid undue exaggeration which was rampant in the conversation of many of
the people present at the time of the dissection.
He interviewed many people and satisfied himself that Joseph Marzo "conducted himself within the
sexual area exclusively as a male, "even to the point of contracting the "French disease" on two
occasions. The cause of death was another in a series of episodes of vomiting and diarrhea.[5]
This account was translated by Alfred Bongiovanni from De Crecchio (Soprauncaso di
apparenzivirili in una donna. Morgagni 7:154–188, 1865) in 1963 for an article in the New England
Journal of Medicine.
Currently due to the impressive advocacy of CARES Foundation, all 50 states in the United States
and over 40 countries EVERY child born is screened for CAH at birth. This life saving screen will
detect elevated levels of 17–hydroxy–progesterone (17–OHP). Detecting high levels of 17–OHP
enables early detection of CAH. Newborns detected early enough can be placed on

Perceived Normality And Aesthetic Desire Analysis
Perceived Normality and Aesthetic Desire A mother sits on the cold metallic examination table of
her doctor's office, feet crisscrossed and tightly held together. Her doctor walks into the room, head
heavy, and breaks the news; prenatally screening has shown that the mother's future bundle of joy
has a genetic disorder, congenital adrenal hyperplasia, CAH. The mother in bewilderment asks what
the course of treatment would look like and what exactly CAH is, she seeks a plan, a way to ensure
the health of the child. The doctor lays out what CAH is and the implications that will be presented
after birth, but sidesteps and introduces a new topic to the conversation, appearance of genitals.
The doctor states that if the child is a girl, she runs ... Show more content on Helpwriting.net ...
When an illness is becoming medicalized it can appear to be fueled by three factors; influence of the
medical profession, social movements, and directed organizational activity (Conrad, 3–4).
Medicalization can be useful in giving knowledge to individuals dealing with an unknown
predicament, but sometimes, like the case in CAH, it can be questioned to if a medicalized stance on
an illness is necessary. A key example of medicalization of a physical condition that aligns with the
genital concerns of CAH would be male impotence. This condition, like ambiguous genitals, does
not have a negative impact on the physical health of the individual at all, but a drug, Viagra, has
been administered to men anyway (Conrad, 6). The side effects of Viagra range from the minute
stuffy nose to very serious concerns such as memory problems and loss of hearing. Despite these
risks, men continue to take the medication because of the aesthetic around being able to perform in
the bedroom. This can be translated into the prenatal usage of

Annotated Soap Note Hair Loss
Chief complaint: hair loss that started several months ago. History of Present Illness This 45 year
old female presents with: 1. Hair loss The patient presents with hair loss that began 5 months ago.
The problem is mild to moderate and has worsened. The initial location of hair loss was the diffuse
scalp and temporal region that occurred gradually. Symptoms are associated with very low
carbohydrate dieting and new medication within 3 – 6 months (Aleve). Symptoms are not associated
with hair pulling, increased psychological stress, fever, recent illness, recent surgery or scalp rash.
Relevant history positive for family history of hair thinning on both sides. Relevant history negative
for anemia, hyperthyroidism, hypothyroidism, ... Show more content on Helpwriting.net ...
Extremities: No edema is present. Psychiatric: Oriented to time, place, person, and situation. Has
appropriate mood and affect. Assessment: Telogen effluvium (704.02) Hair loss is classified into 3
classifications, cicatricial alopecia (inflammatory), nonscarring alopecia and inherited and acquired
structural hair disorders. In evaluating hair loss it is important to assess duration and rate, location
and pattern, extent of loss, associated symptoms, hair care practices, and differentiation of hair
shedding from breakage. Medical and family history, diet, and medications need to be assessed
(Shapiro, Otberg, & Hordinsky, 2013). Telogen effluvium is diffuse hair loss that is reversible
caused by a significant stressor such as significant weight loss, pregnancy, major illness or surgery
(Goldstein & Goldstein, 2012). As the patient has lost 50 pound in 10 months, this is the most likely
cause of her diffuse hair loss. She will stop her very low carbohydrate diet for a more moderate,
varied diet. If the hair loss continues she will need further evaluation. Differential diagnosis 1.
Endocrine related hair loss: Hair loss may be caused by several endocrine disorders, presentation is
typically with non–scarring alopecia that is diffuse (Olszewska, Warszawik, Rakowska, Slowinska,
& Rudnicka, 2011). Hypopituitarism, not assessed, needs serum cortisol (Synder, 2012), will order if
symptoms continue. Hypothyroidism, ruled out,

Polycystic Ovarian Syndrome Analysis
The ovary is a critical organ of the female reproductive and endocrine system. When preforming in
an optimal manner, the ovary functions as a gonad, by producing mature gametes and by
synthesizing and excreting hormones within a set point. It is essential for sexual maturation and
reproduction. When it deviates away from this normal physiology, many serious heath problems can
emerge. A principal example of ovarian abnormal physiology is polycystic ovarian syndrome
(PCOS). Polycystic ovarian syndrome is one of the most prominent endocrinopathies in the world,
affecting anywhere between 5–10% of the female population (Dunaif, 1995). Although this disease
affects so many women, not much is known about the exact origin of it and all of the shortcomings
... Show more content on Helpwriting.net ...
Normally, each ovary is formed by dense tissue encircled by fibrous connective tissue. Starting at
age of puberty, the ovaries become fixed with around 300,000 follicles, with each one containing an
immature ovum. Through cyclic changes, 1 or 2 of these follicles become mature, releasing an
oocyte, and thus resulting in fertilization or menstruation (Stanfield, 2012, p.646). However, with
polycystic ovarian syndrome these cyclic changes are effected. Polycystic ovarian syndrome is
defined by many symptoms, however, numerous cysts on the ovaries and chronic anovulation from
hormone imbalances, normally characterize it. Chronic anovulation is described as infrequent or
nonexistent ovulation. This symptom is directly correlated with infertility and is one of the largest
identifying factors of polycystic ovarian syndrome. It is a result of nonclassical congenital adrenal
hyperplasia (NC–CAH), an autosomal disease. This disorder is caused by a CYP21 (21–hyroxylase)
gene mutation and thus, is lacked in the body. Due to its absence, 17–OHP (17–
hydroxyprogesterone) amounts climb and the anterior pituitary gland secrets excess amounts of
adrenocorticotropic hormone (ACTH) (Leung, 2004). The adrenocorticotropic hormone controls the
amount of steroid hormones, which in return

Sexual Orientation Within America 's Most Controversial...
Sexual orientation can be considered as one of America's most controversial topics. Although the
rationale and choice differs from person to person, and is considered to be a private matter of
personal preference, many people have experienced negative backlash and harsh criticism due to
their individual likings. In general, sexual orientation is defined as: a person 's sexual identity in
relation to the gender to which they are attracted; the fact of being heterosexual, homosexual, or
bisexual. While the definition seems to be straightforward and concise, the subject of sexual
orientation encompasses much more than just the intensity of emotional and erotic attraction and
response to members of the opposite sex, the same sex, or both ... Show more content on
Helpwriting.net ...
A person 's sexual orientation is distinct from a person 's gender identity and expression, but without
gender identity and expression, sexual orientation would be hard to distinguish. The term "gender
identity," distinct from the term "sexual orientation," refers to a person 's innate, deeply felt
psychological identification as a man, woman or some other gender, which may or may not
correspond to the sex assigned to them at birth (e.g., the sex listed on their birth certificate). For
example take a child who may be born a hermaphrodite or what is commonly known as an intersex.
When birthed this child would have either male and female sex organs or sexual characteristics.
Unlike those who are heterosexual, homosexual, or even bisexual, an intersexual in my opinion
would have the most difficult time finding their sexual orientation, due to the fact at times they are
given a gender identity based on their genital formation. When in the womb intersex infants can be
spotted. The choice is up to the parent's then if they would like to assign gender to the infant. Some
of the following diagnoses at times seem to be the logical reasons behind assigning gender to the
infant. Congenital Adrenal Hyperplasia (CAH) is an inherited condition that technically can be
found at birth and it does not allow the body to make enough cortisol. When the cells in the body try
to make cortisol they began to become enlarged. If not

Prenatal Testing: Genetic Differences And Anomalies
Genetic testing is the testing of human DNA which determines various genetic differences and
anomalies. With the help of various genetic testing, physicians are now able to look at a person's
DNA for any genetic abnormalities. There are many different types of genetic testing out there such
as newborn screening, carrier testing, prenatal testing, diagnostic testing, predictive and pre–
symptomatic genetic tests, pharmacogenomics testing and many more. (FAQ about genetic testing,
2015).
Prenatal testing, which can be optional, is done during the first trimester of pregnancy, can be really
helpful to parents in determining if their baby will have any future diseases. This particular testing
provides information on baby's health as it can help

The Five Sexes, Rectioned By Anne Fausto-Sterling
In THE FIVE SEXES, REVISITED, Anne Fausto–Sterling explains the variant forms of sexual
differentiation, such as congenital adrenal hyperplasia, which is a masculinization of genital in
genetic females. Through her explanation, she gives an item by item rebuttal of the two–sex system
because that system "is not adequate to encompass the full spectrum of human sexuality." In other
words, chromosomes, hormones, sex organs, the gonads are much various than the general public
think of. Therefore, she suggest the new sex system which including 5 sexes: males, females, herms,
merms, ferms. For the settlement of 5 sexes, we should not view the intersexual conations as
diseases. In addition, genitalia surgically not only should be minimized and reversed

Congenital Adrenal Hyperplasia Essay
Congenital adrenal hyperplasia is a well–known autosomal recessive disorder and the vast majority,
approximately 95%, of cases are due to a deficiency of 21–alpha–hydroxylase. The other common
type of CAH is caused by a deficiency of 11–beta–hydroxylase. In both types of the disorder, the
adrenal gland is unable to produce sufficient amounts of cortisol and aldosterone. CAH is estimated
to manifest in 1 of every 15,000 live births. In the United States, the prevalence of the disorder is
lower in African–American children in comparison to Caucasians. Moreover, the decreased
synthesis of cortisol results in diminished negative feedback of adrenocorticotropic hormone
(ATCH) and over–secretion of ACTH. This pathological increase of ACTH in an attempt to increase
serum cortisol levels is prevented because of the lack of appropriate enzymes and actually results in
increased androgen ... Show more content on Helpwriting.net ...
On the other hand, affected males present normally at birth with some showing signs of
hyperpigmentation of the scrotum or a large phallus. It is recommended that surgery on females with
ambiguous genitalia has the most positive outcomes between two and six months. Individuals with
CAH are also at higher risk of early pubertal development and short stature as adults. Additionally,
fertility rates in women with classic 21–alpha–hydroxylase CAH are low, while most males with the
disorder are fertile as adults with a minority exhibiting evidence of Leydig cell failure and impaired
spermatogenesis. In patients with classic 21–alpha–hydroxylase CAH there is an elevated serum 17–
hydroxyprogesterone concentration of higher than 1200 ng/dL. In fact, most of the neonates found
with the disorder have serum concentrations of 17–hydroxyprogesterone that exceed 3500

Endocrinology Personal Statement
The vagaries of human hormones have interested me since I watched all five of my dad's siblings
get diagnosed with diabetes. Watching adults check their blood sugars and teach each other to use
syringes became routine at family gatherings. I tried to understand how to avoid this seemingly
genetic inheritance was what drew me to pursue medicine in the first place. Now as I look to the
next stage of my education, Endocrinology is the most apt field for me. While reading about a
particular case in the Endocrine clinic, I came across a quote by an Endocrinologist who described
the field as, "a discipline that provides continuing intellectual stimulation, pragmatic satisfaction,
and great promise of discovery." This clearly delineated all the attributes of Endocrinology that I
look forward to, and my training thus far has prepared me to take this next step. ... Show more
I am fortunate to have seen interesting cases and even present at the American Society of
Nephrology. While I appreciate each opportunity and learned from the role models I found along the
way, I became most invested in the field of Endocrinology. As a new intern, I quickly realized that
the differential for nearly every patient's chief complaint included a thorough Endocrine evaluation.
Seemingly simple treatment of blood pressure or headache would involve engaging discussions of
negative feedback loops and hormone imbalances. I was convinced that a well rounded medical
education required a thorough understanding of Endocrinology. The comprehensive nature of
Endocrinology challenges physicians to translate basic biochemistry and physiology directly into
patient care. The chance to treat symptoms and pathologies of various organ systems while making
on impact on individuals or even whole communities reminds me daily of why I became a

Pros And Cons Of Having This Test
Why am I having this test? This test is used to diagnose the following conditions: Syndromes
associated with adrenal gland hormone production (virilizing syndromes). The absence of a
menstrual cycle (amenorrhea) in women. Androstenediones (ADs) are hormones that give rise to the
sex hormones. They are called precursors. Increased levels of ADs in an adult female cause male
characteristics to develop. Your health care provider may order this test if you experience: Deeper
voice. Hair growth. Sterility. What is being tested? This test measures the following steroid
precursors: Androstenediones (ADs). Dehydroepiandrosterone (DHEA). Dehydroepiandrosterone
sulfate (DHEA S). What kind of sample is taken? A blood sample is required for this test. ... Show
more content on Helpwriting.net ...
DHEA: Tanner Stage I: 0.14–2.76 ng/mL (females); 0.11–2.37 ng/mL (males). Tanner Stage II:
0.83–4.87 ng/mL (females); 0.37–3.66 ng/mL (males). Tanner Stage III: 1.08–7.56 ng/mL (females);
0.75–5.24 ng/mL (males). Tanner Stage IV and V: 1.24–7.88 ng/mL (females); 1.22–6.73 ng/mL
(males). DHEA S: Tanner Stage I: 7–209 mcg/dL (females); 7–126 mcg/dL (males). Tanner Stage II:
28–260 mcg/dL (females); 13–241 mcg/dL (males). Tanner Stage III: 39–390 mcg/dL (females); 32–
446 mcg/dL (males). Tanner Stage IV and V: 81–488 mcg/dL (females); 65–371 mcg/dL (males).
What do the results mean? This test can produce many different results. Increased levels of adrenal
steroid precursors may indicate: Adrenal gland tumor or other tumors. Inherited syndromes of the
adrenal gland, such as congenital adrenal hyperplasia. This condition is due to a defect in a protein
(enzyme) that results in low production of the hormone cortisol. Decreased levels of adrenal steroid
precursors may be associated with: Impaired adrenal gland function (adrenal insufficiency). Ovarian
failure. Questions to ask your health care provider Ask your health care provider, or the department
that is doing the

Facial Hairs
Facial Hairs Several factors can influence your probabilities of developing facial hairs. These factors
include: Family history– Several reasons that cause unwanted facial hairs are hereditary. These
conditions, including congenital adrenal hyperplasia and polycystic ovary syndrome. Ethnicity:
Women of Mediterranean, Middle Eastern and South Asian strains are more likely to develop
unwanted facial hair with no identifiable cause than women of other ethnicities. What are the causes
of unwanted facial hair? Here are some causes of facial hairs: Hormonal imbalance Polycystic
Ovary Syndrome (PCOS) Cushing's syndrome– This condition occurs when your body is exposed to
high levels of cortisol Congenital adrenal hyperplasia Menopause

Writing Assignment Guidelines And Type A Response For Each...
For this writing assignment, you will select one article from the Suggested readings posted on
Blackboard, and type a response for each of the questions listed below. Please find additional
guidelines in the file "Writing assignment guidelines" posted on Blackboard.
Please provide the following information:
Title: _______Fetal Testosterone Predicts Sexually Differentiated Behavior in Girls and in
Boys____________________________________________________________________
Author/s: ____Bonnie Auyeung, Simon Baron–Cohen, Emma Ashwin, Rebecca Knickmeyer, Kevin
Taylor, Gerald Hackett, and Melissa
Hines____________________________________________________________________
________________________________________________________________________________
Journal: _Psychological
Science________________________________________________________________________
Introduction
Brief review of the paper you choose (at least 200 words in length).
_ This article was quite statistically focused, which contributed to it being somewhat difficult to
read. I admit, I didn't fully understand all of the tables, relating the variables of each group study.
However, the results were well stated, making the experiment more accessible to people that are less
statistically inclined. I thought the article, even though it was quite dense, was an appropriate length
and stayed well within the realm of relevant information. I could not honestly recommend this
article to someone who is not interested in

Gender Orientation And Sexual Orientation
Did you know that gay men and lesbians do not choose their sexual orientation, but rather are born
with it? There has been extensive research proving that sexual orientation is caused by many
biological factors, whereas there is no solid proof that social factors after birth affect sexual
orientation (Swaab, 2007, p. 442). Sexual orientation is already programmed into the brain, with the
influence of sex hormones and genes, before a child is even born. The development of sexual
orientation is caused by sex hormones, genes, and the brain, which then cause differences in the
anatomical body (LeVay, 2011, p.271). Firstly, sex hormones that mainly influence a person's sexual
orientation are the levels of testosterone during critical periods of prenatal development (LeVay,
2011, p. 132). If androgen insensitivity syndrome occurs in individuals with XY chromosomes, the
gene coding for the androgen receptor is mutated, causing the receptor to either barely function, or
not at all (LeVay, 2011, p. 137). This causes their body to not respond to testosterone, so they begin
to develop physically as a female. From here on, they are usually raised as girls, and they develop an
attraction to males, as well a feminine–typical traits.
A condition that can occur in females is called Congenital Adrenal Hyperplasia, which is when there
are above normal amounts of prenatal testosterone and androgens, which causes a female to grow up
with masculinized traits (LeVay, 2011, p. 134). A majority

IU Scholarship Essay
Although a seemingly odd combination, I am double–majoring in Chemistry and French at IUPUI.
This is a complimentary pair for me in terms of my future endeavors, however. I aspire to attend
medical school, ultimately to become a pediatric endocrinologist at Riley Hospital for Children.
While some choose medicine for the paycheck, prestige, or to simply carry on the family business, I
wish to become a doctor for an entirely different reason. When I was eight years old, I was
diagnosed with congenital adrenal hyperplasia (CAH), a genetic disorder that affects the body's
general health, growth, and development. Devoting my career to becoming a pediatric
endocrinologist is a welcomed opportunity for me to serve as a source of care and comfort for my
patients and their families, as I was once in their shoes. My current plan of study at IUPUI is an
excellent plan of preparation for this lofty endeavor. While majoring in Chemistry will provide the
hard, scientific background required for medicine, majoring in French is the catalyst in giving me
the edge to becoming a caring, compassionate future physician. I shadowed Dr. Scott Renshaw at IU
Family Medicine last semester. I saw firsthand that the realm of medicine has turned its attention
from scientific knowledge to patient care. The successful practice of medicine ... Show more content
on Helpwriting.net ...
I am reminded specifically of Dr. Luise Morton's Introduction to Ethics course I completed this past
fall. This course challenged my critical thinking abilities while simultaneously shaping me into a
better young woman and future physician. The readings from Aristotle opened my eyes on what it
truly means to be an ethical person and how to lead a morally upright life. Such concepts are
absolutely indispensable to someone seeking a career in medicine, where patient care is the number
one

Congenital Adrenal Hyperplasia
Title:
Clinical approach to a case of congenital adrenal hyperplasia (Investigations, management and
complications).
Introduction:
Congenital adrenal hyperplasia is a number of autosomal recessive disorders, it is due to mutations
of enzymes responsible for adrenal steroidogenesis. Deficiency of 21–hydroxylase enzyme is the
most common form of CAH, responsible for about more than 90% of the cases. This limits the
ability of adrenal glands to produce the vital hormones cortisol and aldosterone. The absence of
these hormones causes the body to produce excessive androgen which can cause ambiguous
genitalia in female patients.[]
Aim:
Aim is to determine the efficacy of certain investigations in the diagnosis of CAH, to assess the role
of certain ... Show more content on Helpwriting.net ...
Clitoral pain is associated with clitoral recession and clitorectomy. We may give medications to
prevent more virilization [10].
Good value with using abdominal sonar in congenital adrenal hyperplasia with ambiguous genitalia
to demonstrate the uterus and renal anomalies [11].
CAH is one of the pathological etiologies of Addison's disease rendering infants with CAH more
prone to Addison disease (congenital Addison disease) in comparison to infants with adequate
adrenal function [12].
Steroids therapy is recommended in the case of congenital adrenal hyperplasia, the use of steroids
therapy twice a year After the patient's condition is stabilized [13].
There were no available studies showing:
The value of acetyl salicylic acid in the treatment of CAH.
That the length of repetition of CAG nor GGn is statistically significant modulators of genital
virilization in females with 21OHD[3].
The value of estrogen pills in treatment of an infant with ambiguous genitalia in a case of classical
CAH [6].
Conclusion:
Concerning the investigations studies show a good value for assessment of blood glucose and

galactose level, abdominal sonar and assessment of selective serum rennin but no studies
recommend screening for trinucleotide repeat expansion

Is Being A Lifestyle Choice?
Kassy Plambeck
915244972
TITLE
Is being gay a lifestyle choice, or does it's existence come from biological variations? Many people
have a preconceived notion that being gay is indeed a lifestyle choice. In the past mental health
practitioners went far enough to diagnose it as a mental illness up until 1973. Society believed that
people who were attracted physically or romantically to the same sex and even both sexes had
something wrong with them. Various reasons such as homosexuality being a sin and the inability to
reproduce with the same sex was reason enough to put it into the category of mental illness. It was
only socially acceptable for a woman and a man to be in a relationship. This is something that has
puzzled the minds of many ... Show more content on Helpwriting.net ...
Experiments that have been conducted in the past have shown that when monkeys are given more
testosterone that they become more rowdy, and when sheep have been given the same hormone,
females tend to assert more dominance (Levay 2011: 78). As for the human species the hormone
congenital adrenal hyperplasia (CAH) is found to be a reason why girls may have more masculine
traits later in their lives. CAH occurs in the process of a genetic mutation during fetal development
where an enzyme from the corticosteroid hormones gets pushed out of the equation thus resulting in
abnormally high levels of androgens. Women who carry this hormone have more childhood
characteristics that are similar to a male such as playing with boy like toys, and engaging in rough–
house play (Levay 2011: 78–79). Women who have CAH also may have genitilia closer to a male's
genitals, and it affects their behavior and brain patterns. A study that was conducted first in 1968
then replicated in 2007 showed that women with CAH had more sexual fantasies and dreams, during
masturbation or during sex with their partners that included bisexuality and homosexuality. There
actual partners that they were either physically or romantically attracted to and engaged with were
usually women as well (Bahlburg 2007: 95) So from evidence, women who have higher androgen
levels are

Adrenal Gland Essay
Adrenal gland
In mammals, the adrenal glands (also known as suprarenal glands) are the triangular–shaped
endocrine glands that sit on top of the kidneys. They are chiefly responsible for releasing hormones
in conjunction with stress through the synthesis of corticosteroids and catecholamines, including
cortisol and adrenaline (epinephrine), respectively.
Anatomy and function
Anatomically, the adrenal glands are located in the retroperitoneum situated atop the kidneys, one on
each side. They are surrounded by an adipose capsule and renal fascia. In humans, the adrenal
glands are found at the level of the 12th thoracic vertebra. Each adrenal gland is separated into two
distinct structures, the adrenal cortex and medulla, both of which ... Show more content on
Helpwriting.net ...
The suprarenal veins may form anastomoses with the inferior phrenic veins.
The adrenal glands and the thyroid gland are the organs that have the greatest blood supply per gram
of tissue. Up to 60 arterioles may enter each adrenal gland.[4]
Terminology
The adrenal glands are named for their location relative to the kidneys. The term "adrenal" comes
from ad– (Latin, "near") and renes (Latin, "kidney"). Similarly, "suprarenal" is derived from supra–
(Latin, "above") and renes. Colloquially, they are referred to as "kidney hats".
Adrenal cortex
Situated along the perimeter of the adrenal gland, the adrenal cortex mediates the stress response
through the production of mineralocorticoids and glucocorticoids, including aldosterone and cortisol
respectively. It is also a secondary site of androgen synthesis. Contents * 1 Layers * 2 Hormone
synthesis * 3 Production * 3.1 Mineralocorticoids * 3.2 Glucocorticoids * 3.3 Androgens * 4
Pathology * 5 See

Explain The Extent Of Normal Hair Growth
The extent of normal hair growth differs between people, families, and races. It is somewhat
extensive in the Mediterranean and some Asian subcontinent populations. Too much facial or body
hair growth in a woman is known as hirsutism. There is no absolute margin between the normal hair
growth and hirsutism. Usually, sex hormones affect the hair growth in the moustache, beard, breast,
chest, armpit, the midline of the abdomen, genital area, and the thighs. A type of soft hair (vellus
hair), which is normally present all over the body, is not affected by the sex hormones. If a woman
has excess hair growth over the regions, which contain the sex–hormone dependent hair, it shows
increased male hormone (androgen) production in the ovaries and adrenal glands. This process
commonly occurs due to polycystic ovary syndrome (PCOS) but occasionally other rarer conditions.
Other conditions include an abnormal growth of adrenal glands (congenital adrenal hyperplasia),
Cushing's syndrome, and tumours of the ovary and the adrenal gland.
Androgens are normally known as male hormones. However, both males and females produce
androgens. Men produce androgens in larger amounts compared to women. There are few male
hormones, of which testosterone is the well–known one. Hirsutism can occur due to increased levels
of androgens or raised sensitivity of the hair follicles to normal male hormone levels.
A few women with hirsutism produce excessive androgens. Sometimes, this is because of a medical

The Role Of Leptin And Its Effects On The Reproductive...
Role of leptin in PCOS. Leptin is a hormone secreted mainly from the adipose tissue, serum levels
of which are influenced by obesity, insulin resistance and the levels of sex steroids (androgens and
estrogens) and insulin. It is mainly involved in the regulation of body weight by decreasing appetite
and increasing energy expenditure. Besides regulating the energy metabolism of the body, leptin has
important actions on the reproductive system, which makes it an important link between the adipose
tissue and hypothalamus– pituitary–gonadal (HPG) axis (2). Long–term hyperinsulinemia in
humans, as is the case in PCOS patients, stimulates leptin secretion from adipose tissue (9).
Significantly higher leptin (P = 0.0028), and insulin concentrations, insulin: glucose ratio (IGR), and
a significant correlation between leptin and fasting insulin concentrations, IGR, WHR and LH have
been reported in obese PCOS women than in normal–weight women with PCOS. There is a
significant negative correlation between leptin and LH concentrations, independently of either BMI
or IGR, suggesting a possible involvement of leptin in LH hypersecretion (10). Estrogens increase,
whereas androgens suppress leptin production, suggesting sexual dimorphism in leptin levels (2).
The direct and indirect effects of leptin on the HPG axis, such as acceleration of GnRH pulsatility
(but not the pulse amplitude) in a dose dependent manner, suggest that leptin may play an important
role in the pathogenesis of PCOS.

The Biological View on Gender
Dr. Strode English 101:KK 17 September 2010 The Biological and Cultural View on Gender
Society has drilled an image into our minds as people of how the role of each gender should be
played out. There are two recognized types of genders, a male and a female. Most people come to
think that gender is just male or female. Yet it has become more complex then that. Today it is not
just that if you have male parts, you are a man, the opposite goes for women. According to the
authors Aaron Devor and Deborah Blum. Gender is much more complex then just male and female,
it is more socially composed. We are taught to be male and female trough things like media, our
parents, and role model figures. These ... Show more content on Helpwriting.net ...
By Blum using words like "congenital adrenal hyperplasia" and "testosterone", Blum means that it is
our chemical build up that determine our gender roles. Testosterone is what makes a man manly, so
any male lacking testosterone will look and act more feminine. The opposite goes for women who
have to much testosterone. Another example to support Blum's biological side for gender is that
testosterone is the leading cause of why men act the way they do. Men most often have more
testosterone then women. To further this idea Blum says, " it not only has some body–building
functions, it influences some behaviors as well. These behaviors include rowdy play, sex drive,
competitiveness, and in your face attitude"(578). Words like "rowdy play", "competitiveness" and
"sex drive" are masculine characteristics that is why women with more testosterone may choose the
toy truck or weapon to play with. Higher levels of testosterone could be what make some women
appear masculine and some men appear feminine. My side of the gender topic would be that gender
is cultural. Yes some things are biological like we get our eye color and our skin color from genetics.
But the way we act is far more cultural, we learn to act male or female from society. Our parents and
television show us demonstrations of these characteristics. I agree with Devor's beliefs on gender on
how society builds these strict guidelines

Hydrocortisone Case Summary
Hydrocortisone has vast uses in general daily practice such as (arthritis – acute adrenal insufficiency
) as well as an emergency drug especially in management of severe allergic reactions (septic shock
).The main action of this drug is to reduce swelling and inflammation.
Allergic status
It is used to control severe allergic reactions or patients who suffer from seasonal allergies such as
(pollen allergies ) etc
It's a treatment of choice to control asthma – contact dermitis – atopoc dermities as well as thr
treatment of hypersensitivity reactions and transfusion reactions
Recommendations from the International Guidelines for Management of Severe Sepsis and Septic
Shock 2012:
–Do not use intravenous hydrocortisone if adequate fluid resuscitation and vasopressor therapy
restore hemodynamic stability
–Use hydrocortisone alone
–Do not administer for sepsis in ... Show more content on Helpwriting.net ...
Usual Adult Dose for Ulcerative Colitis
100 mg rectal suspension (retention enema) nightly for 21 days or until clinical remission occurs.
Difficult cases may require 2 or 3 months of treatment. Clinical symptoms should subside within 3
to 5 days; discontinue use if no improvement within 2 to 3 weeks; some patients may require 2 to 3
months of therapy; if therapy lasts more than 21 days, discontinue slowly by decreasing use to every
other night for 2 to 3

Sex Between Children 's Toys Of Non Human Primates (...
Sex differences in response to children 's toys in non–human primates (cereopithecus aethiops
sabaeus)
The study of sex difference in toys boys and girls tend to play wit, has always been classified as
gender socialization. According to researchers such as, Connor and Serbin, 1977; Liss, 1981, the
explained that boys favour construction and transportation toys, while girls favour doll. Research
also shows that boys do tend to be more active (Campbell and Eaton, 1999; Eaton and Enns, 1986)
and show more physical play than girls (Dipietro, 1981). These sexual characteristics of play style is
said to have derived from learning and cognitive mechanisms in association with gender
socialization. Bandura, 1977; Fagot and Hagan, 1991; Langlois and Downs, 1990 state that sex
differences in play actions and toys preference arise from modelling and reinforcement of sex
typical paly, based on learning theory. Cognitive theories connote that as children grow, they tend to
develop awareness of their gender identity, which results in a mental representation of what gender
is defined as socially, appropriate behaviour and show a positive understanding of toys and activities
associated with their individual gender (Maccoby, 1988; Martin, 1999, Martin, Wood, and Little,
1990).
Biological factors can also influence sex difference in paly behaviour. In a research test conducted
on both female rats and rhesus monkeys, treated with androgen during periods of pre–or natal
development, showed

Congenital Adrenal Hyperplasia (CAH)
Congenital Adrenal Hyperplasia (CAH) is a family of autosomal recessive disorders caused by
impairment of biosynthesis of cortisol, aldosterone, and androgens. More than 85–90% of CAH is
due to 21–hydroxylase deficiency. This is due to the defect in 2 genes–CYP21P and CYP21. 90% of
the mutated forms causing 21–hydroxylase deficiency and they all recombination between CYP21
and CYP21P. Clinically they all are divided into two forms deficiency are described– the classical
form, which is subdivided into simple virilising form and salt–wasting form and non–classical form.
Treatment includes the glut corticoid treatment with mineral corticoid or without mineralocorticoid
and salt replacement. This review will focus on the basic etiology, epidemiology, pathogenesis,
clinical manifestations, laboratory findings, treatment and prognosis of congenital adrenal
hyperplasia due to 21–hydroxylase deficiency.
Introduction
Congenital Adrenal Hyperplasia (CAH), a group of autosomal recessive disorders characterized by
enzyme defects in the pathways of steroid biosynthesis involved in the formation of cortisol,
aldosterone and androgens. 21–Hydroxylase (21–OH) is the most common of the enzymatic
deficicient being found in 94% of cases, which is formed due to mutation of 21–hydroxylase gene
CYP21A2. Categorizations lead to two forms severe form or ... Show more content on
Helpwriting.net ...
17–hydroxyprogesterone levels should not be maintained in one way of treatment, since the doses of
glucocorticoid that may cause Cushing's syndrome. Rather, 17– hydroxyprogesterone levels should
be partially suppressed to the range of 90 to 1000 mg per deciliter (4 to 33 nmol per liter). only in
Androstenedione and testosterone levels are very important in prepubertal children Pubertal
development should be monitored by regular periodic charts, Radiographs shows skeletal
maturations of the hand and wrist for bone

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