NBME 24 Ovarian Sertoli-Leydig cells (NBME Answers)

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Retired NBME 24 Answers

nbme24/Block 4/Question#26 (reveal difficulty score)
A 10-year-old girl is brought to the ...
Ovarian Sertoli-Leydig cells 🔍 / 📺 / 🌳 / 📖
tags: repro

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submitted by ∗thotcandy(131)

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For anyone looking for more info:

Page 147 of Pathoma

3 types of Sex cord tumors: Granulosa-theca (follicle cells), Sertoli-Leydig, and fibroma.

G-T tumor: estrogen excess

Precocious puberty (prepub)
reproductive age: menorrhagia, metrorhagia
Postmeno: endometrial hyperplasia/uterine bleeding
minimal risk of metastasis

S-L tumor: androgen excess

hirsutism
virilization
reinke crystals
tubules and leydig cells between tubes

Fibroma: benign, fibroblasts, cause meig's syndrome

pleural effusion
ascites
resolves with removal of tumor

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mariame FA 19 pg 632 +

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submitted by ∗paperbackwriter(161)

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I think what threw me off was the fact that it said "most likely" and Sertoli-Leydig cell tumor in a female just seemed like such a rarity that I figured it had to be some cells females typically have.

Keeping this in mind for future questions. If one of the answers actually fits the bill, don't pick one that you're not sure of because the correct one seems unlikely! *bangs head

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submitted by ∗medstruggle(21)

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Why is it not ovarian follicle cells? I thought the female analog of Sertoli and Leydig is theca/granulosa cells.

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colonelred_ Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +16

brethren_md Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5

sympathetikey Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +6

s1q3t3 Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +13

masonkingcobra Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +4

mcl Wait, but did anyone mention that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen??? +42

mcl But seriously though, pathology outlines says sertoli-leydig tumor "may be suspected clinically in a young patient presenting with a combination of virilization, elevated testosterone levels and ovarian / pelvic mass on imaging studies." As for follicle cell tumors, granulosa cell tumors usually occur in adults and would cause elevated levels of estrogens. Theca cell tumor would also primarily produce estrogens. Putting the links at the end since idk if they're gonna turn out right lol Link pathology outlines for sertoli leydig granulosa cell tumor theca cell tumor +13

bigjimbo LOL +1

fallenistand Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +6

medpsychosis So after doing some intense research, UPtoDate, PubMed, an intense literature review on the topic I have come to the final conclusion that...... ...... ...... ...... Wait for it.... ..... ..... Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +10

charcot_bouchard Hello, i just want to add that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +2

giggidy Hold up, so I'm confused - I read all the posts above but I still am unsure - are sertoli-leydig cells notorious for producing androgen? +6

subclaviansteele Hold the phone.....Females can get sertoli leydig cell tumors which are notorious for producing androgen? TIL TL;DR - Females can get sertoli leydig cell tumors = high androgens +1

cinnapie I just found a recent study on PubMed saying "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +3

youssefa Hahahahaha ya'll just bored +11

water Bored? you wouldn't think so if you knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +6

nbmehelp I dont get it +1

redvelvet how don't you get it that females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen? +2

drmomo what if this means..... females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen +1

sunshinesweetheart hahahaha this made my day #futurephysicians #lowkeyidiots +1

sunshinesweetheart @medstruggle look up placental aromatase deficiency (p. 625 FA 2019), it would have a different presentation +1

deathbystep1 i am sure i would ace STEP 1 if i only knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +3

noplanb Wait... I might actually never forget this now lol +4

drmohandes Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +2

lilmonkey Don't forget that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! You're welcome! +1

drpatinoire Now I get it that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens. Thank you very much.. So why choose Sertoli-Leydig cell tumor again? +1

dr_ligma The reason is because females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! This is easy to remember, as you can remember it through the simple mnemonic "FCGSLCTWANFPLOA" which stands for "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen!" +22

minion7 after receiving a f*king score..... this post made me smile and thanks to the statement-- females can get sertoli-leydig cell tumours, which are notorious for producing lots of androgen! +2

djtallahassee My worthless self put adrenal zona fasciculate but now I will never forget that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +2

medguru2295 Wait..... so can females get Sertoli Leydig cells that produce androgens then?????? +1

peqmd Going to snapshot this to my anki deck card: "females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of {{c1::androgens}}" +2

paperbackwriter Watch me f*ck up the fact that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgens on the real deal. +3

alexxxx30 just made sure to add to my notes "Females can get sertoli leydig cell tumors, which are notorious for producing lots of androgens" +3

peridot I also just wanna add that if you look on in FA on p.696969, you'll see that they'll mention "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +2

mbate4 According to the literature [lol] females can get sertoli-leydig cell tumors, which are notorious for producing lots of antigens +1

drdoom the tradition lives on +2

jamaicabliz Wait... so for clarification, is it that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen? Or that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen?? HELP +1

abkapoor Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen sorry for bad Englesh +1

faus305 Sertoli-leydig cells are notorious for producing lots of androgens, females can get these. +1

djeffs1 the fact that a bunch of medstudents can get so weird about how females can get sertoli-leydig cell tumors: notorious for producing lots of androgens- just made my week!! I love you guys +1

niftykoala As an extra piece of information, I would like to add that Bungee Gum possesses the properties of both rubber and gum. +

neurotic999 Oh I get it! Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgens. Makes alot more sense now after reading it a hundred times. Thanks guys! +

rdk3434 okay , this actually made my day and i also learned that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgens!!productive +

laravonter Since it has been a month, I feel the need to remind all that sertoli-leydig cell tumors are notorious for producing lots of androgens +

thisisnewgg FCGSLCTWANFPLOA +

So, after reading all the posts from scholars I have finally come to the conclusion that,

"Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen!"

+14/- bk2458(14)

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submitted by ∗an_improved_me(91)

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I think its also help to eliminate the other answers.

Adrenal fasciulata cells (producing adrenal androgens) can be eliminated b/c this pt has adrenal androgens in the normal ranges. If you wanted to make the leap that adrenal androgens could be peripherally converted to stronger androgens (testosterone/DHT), then the inciting adrenal androgens should also be elevated.

Glomerulosa: would produce aldosterone. Though we aren't given her aldo levels, her Sx wouldn't match a Conn's syndrome picture.

Ovarial Follicle cells: have the enzymatic machinery to produce androstenedione (theca cells, its downstream cholesterol product, DHEA, is not elevated) and estrogen (granulosa cells), which doesn't fit the clinical picture this pt has.

Acidophilic hormones (prolactin/GH) are not consistent with this pt clinical picture (like gigantism, galactorrhea)

Basophil (all the others) again, not consistent, even with the gonadotropic cells, since we see LH is low. That leaves you with (D), which as others have pointed out, is consistent with this pt's presentation.

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submitted by kbizzitt(9)

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Article describing Sertoli-Leydig cell tumor

https://www.medscape.com/viewarticle/565147_2

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leemax just to add...... "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen!" +

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