Quiz in Progesterone Testing

Identification:

1-3 What are the three ovarian hormones?

_____________
_____________
_____________

4-5 Give the reagents used in Kober's test.

_____________
_____________

6-7 Give the two positive reaction in Allen Doisy Test.
8-10 Give conditions wherein progesterone levels may be elevated


Case analysis:

Linda a 35 yr/old woman is experiencing severe nausea,vomiting, vaginal bleeding and very high blood pressure. Her pregnancy test is positive, but no fetal heartbeat and no fetal movement are detected, and her uterus is much more larger than expected.
Her laboratory tests shows the following:

Progesterone: 15 ng/ml
hCG: 10 mIU/ml

What's the possible cause of Linda's condition?

NOrmal values:
hCG:Non-pregnant females: <5.0>

You can check out on this site for reference values: http://health.yahoo.com/reproductive-diagnosis/progesterone/healthwise--hw42146.html

Image by:http://www.justmommies.com/articles/corpus-luteum.shtml

Progesterone Screening Tests

Ovarian Hormones

1. estrogen
2. estriol
3. estradiol

• Progesterone - A woman's progesterone levels are very high during pregnancy, along with estrogens, especially estriol.
• Normal values of progesterone:
  During a normal menstrual cycle
  8 - 10 ng/ml
  During menopause (high levels)
  16 ng/ml

Visit this site to clarify confusions with estrogen and progesterone :

http://www.project-aware.org/Managing/Hrt/estrogen.shtml

Screening Tests

Kober's Test

•TEST FOR URINARY ESTROGENS
A modification of this test is known as Bachmann-Pettit test. Kober - for naturally occurring estrogens, based upon the production of a pink color (absorption maximum: 520 mmu) when an estrogen is heated in a mixture of phenol and sulfuric acid.

Kurzkor Ratner Test
Specimen:Urine (first morning urine)

• ethyl acetate is the reagent that is used to extract the urine and after the purification, the extract is subjected to bioassay like in the Allen Doisy test.

Allen Doisy Test

• Estrogenic Activity Test
• the hormone to be tested is repeatedly injected to rats/mice.
• (+) positive reaction is the dis appearance of WBC's in vaginal smear of the rats and the presence of cornified cells.

Precautions before taking the test:

• note the last day of menstruation
• Avoid taking of medications containing the hormone estrogen before taking the test(contraceptives)
• Avoid strenuous activities
• Progesterone and estrogen levels may fluctuate during the day

Increased Levels:

• pregnancy
• multiple pregnancy
• H Mole
• Cancer of the ovaries or adrenala glands
• overproduction of hormones by the adrenal glands

Decreased Levels:

• miscarriage
• ovulation problems

References: Clinical Chemistry Principples,Procedures,Correlations (5th Edition) Michael Bishop,Edward Fody. Larry Schoeff

http://health.yahoo.com/reproductive-diagnosis/progesterone/healthwise--hw42146.html

Images by:

http://www.flickr.com/photos/13772049@N05/1448435233/

http://www.thebestprogram.net/images/estrogen.progesterone.jpg