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OBSTETRICS 1.0 > 1.2 Physiology of Menstruation and Decidua > Flashcards

1.2 Physiology of Menstruation and Decidua Flashcards

1
Q

What are the 4 predominant hormones in the menstrual cycle

A

GnRH, FSH, LH, estrogen

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2
Q

It stimulates the release of LH and FSH from the anterior pituitary

A

GnRH

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3
Q

True or False. High levels of estrogen exerts a negative feedback on LH and FSh secretion

A

False

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4
Q

At what phase of the ovarian cycle is FSH secretion highest and most critical?

A

1st week of follicular phase

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5
Q

What are the 2 cycles involved in menstrual cycle?

A

Ovarian Cycle

Endometrial Cycle

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6
Q

What are the phases of the ovarian cycle

A

Follicular/ Preovulatory
Ovulation
Luteal
Pre-menstrual

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7
Q

What are the phases of the endometrial cycle

A

Proliferative
Secretory
Menstrual

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8
Q

What cells secrete FSH

A

granulosa cells

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9
Q

What cells secrete LH

A

theca cells

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10
Q

It is the most potent and abundant form of estrogen

A

Estradiol

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11
Q

Which of the ff is not an action of estradiol?

a. nitric acid production
b. proliferation of endometrial glands
c. further induction of proliferation of estrogen-converting granulosa cells
d. induction of FSH and LH receptors on granulosa cells
e. proliferation of stromal and epithelial cells
f. none of the above

A

None of the above. Action nya yan lahat

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12
Q

Which is more sensitive to changes in GnRH? LH or FSH

A

LH

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13
Q

What triggers ovulation?

A

LH surge

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14
Q

What is the predominant hormone during the Follicular phase?

A

Estradiol

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15
Q

What is the predominant hormone during the luteal phase?

A

Progesterone

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16
Q

True or False. High levels of FSH exert a negative feedback on GnRH secretion

A

True

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17
Q

What hormone induces estrogen and progesterone at the level of the ovary by activating aromatase and p450

A

FSH

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18
Q

What hormones is required for the induction of LH receptors on granulosa cells

A

FSH
LH
Estradiol

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19
Q

What cells produces progesterone?

A

Corpus luteum

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20
Q

At what phase of the ovarian cycle is estrogen highest?

A

end of the follicular phase (directly preovulation)

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21
Q

At what phase of the ovarian cycle is progesterone highest?

A

5-7 days post ovulation

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22
Q

What are the 2 circulating forms of progesterone?

A

progesterone

17-hydroxy-progesterone

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23
Q

Which of the following is not a function of prgesterone?

a. stimulate prostaglandin secretion in follicular tissues
b. induction of migration of blood vessel into follicle wall
c. stimulate the release of proteolytic enzymes from thecal cells
d. development of antrum and maturation of graafian follicle
e. none of the above

A

D. –> estrogen

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24
Q

What are the 2 types of progesterone receptors?

A

PR-A

PR-B

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25
Q

It acts as an inhibitor of PR-B gene regulation

A

PR-A

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26
Q

At what phases of the ovarian cycle is PR-A expressed?

A

Whole ovarian cycle

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27
Q

At what phases of the ovarian cycle is PR-B expressed?

A

only up to midluteal phase

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28
Q

It is a vasoconstrictor that initiates menstruation

A

Prostaglandin

29
Q

What degrades endothelins? In what cells is it localized?

A

Enkephalinase; endometrial stromal cells

30
Q

Its activity is in parallel with blood levels of progesterone

A

Enkephalinase

So it is highest during the midluteal phase and declines when progesterone levels decline

31
Q

In the absence of fertilization, the corpus luteum becomes what?

A

corpus albicans

32
Q

How many days will a corpus luteum last in the absence of fertilization

A

14 days

33
Q

What inhibits FSH secretion?

A

Inhibin B

34
Q

At what phase/s is estrogen increasing in level?

a. preovulatory phase
b. early luteal phase
c. midluteal phase
d. end of luteal phase
e. A and C

A

E. A and C

35
Q

At what phase of the ovarian cycle is LH highest?

A

10-12 hrs after ovulation

36
Q

It is the process of development of a graafian follicle into corpus luteum

A

luteinization

37
Q

What hormone will be highest in level in implantation occurs?

A

hCG

38
Q

What produces hCG?

A

blastocyst

39
Q

What happens during day 5 of proliferative phase?

A

revascularization and epithelial restoration

40
Q

What events span the proliferative phase of endometrial cycle

A

follicular phase (from end of menstruation to ovulation)

41
Q

What events span the secretory phase of endometrial cycle

A

luteal phase (from ovulation until menstrual phase of next cycle)

42
Q

Which does NOT happen during proliferative phase

a. proliferation of vascular epithelial, stromal and glandulara stromal cells
b. elongation of endometrial and glands and spiral arteries
c. induction of endometrial glands to secrete glycogen due to progesterone
d. microvilli in epithelial cells
e. C and D

A

C. happens during secretory phase

43
Q

It is essential for establishing the changes in blood flow that permit either menstruation or implantation

A

Spiral artery

44
Q

This phase of endometrial cycle is highlighted by the growth and dev’t of endometrial spiral artery which arises from the arcuate artery

A

Secretory Phase

45
Q

Cytokine that recruits neutrophils to the endometrium prior to onset of menstruation

A

IL-8

46
Q

Phase of endometrial cycle where there is infiltration of neutrophils

A

menstrual phase

47
Q

Infiltration of neutrophils causes breakdown of what layer

A

functionalis layer

48
Q

Phase of endometrial cycle responds to rising levels of progesterone?

A

secretory phase

49
Q

inititates matrix degradation

A

metalloproteinases

50
Q

Events during menstrual cycle

A 
infiltration of neutrophils
metalloproteinases
severe coiling of spiral artery
resistance to blood flow --> hypoxia, ischemia and degradation of endometrium
vasoconstriction
51
Q

mucosal lining of uterine cavity w/c is shed during menstruation

A

endometrium

52
Q

specialized endometrium of pregnancy

A

Decidua

53
Q

What is the stimuli for formation of decidua

A

implanting blastocyst

54
Q

specialized structure that nourishes the developing fetus

A

decidua

55
Q

anatomical site of blatocyst apposition, implantation and placental dev’t

A

endometrium

56
Q

a function of hemochorial placentation

A

decidua

57
Q

3 parts of decidua

A

decidua basalis
decidua capsularis
decidua parietalis

58
Q

3 layers of decidua parietalis + decidua basalis

A

zona basalis
zona spongiosa
zona compacta

59
Q

zona spongiosa + zona compacta =

A

zona functionalis

60
Q

portion of decidua directly beneath the site of blastocyst implantation

A

decidua basalis

61
Q

portion of decidua overlying the enlarging blastocyst

A

decidua capsularis

62
Q

found at the periphery and lines the remainder of the uterus

A

decidua parietalis

63
Q

avascular, extraembryonic fetal membrane internally connected to decidua capsularis

A

chorion levae

64
Q

decidua capsularis + decidua parietalis =

A

decidua vera

65
Q

remains after delivery and gives rise to new endometrium

A

zona basalis

66
Q

month of pregnancy during which decidua capsularis is most prominent

A

2nd month

67
Q

what happens to blood supply of decidua capsularis as the embryo grows

A

lost

68
Q

what happens to blood supply of decidua parietalis as the embryo grows

A

persists (spiral arteries)

69
Q

what happens to blood supply of decidua basalis as the embryo grows

A

unresponsive (there is cytotrophoblast invasion which destroys the smooth muscle walls of the spiral arteries and arterioles)

OBSTETRICS 1.0 (6 decks)

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