1.2 Physiology of Menstruation and Decidua

Question 1

What are the 4 predominant hormones in the menstrual cycle

Answer 1

GnRH, FSH, LH, estrogen

Question 2

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

Answer 2

GnRH

Question 3

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

Answer 3

False

Question 4

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

Answer 4

1st week of follicular phase

Question 5

What are the 2 cycles involved in menstrual cycle?

Answer 5

Ovarian Cycle

Endometrial Cycle

Question 6

What are the phases of the ovarian cycle

Answer 6

Follicular/ Preovulatory
Ovulation
Luteal
Pre-menstrual

Question 7

What are the phases of the endometrial cycle

Answer 7

Proliferative
Secretory
Menstrual

Question 8

What cells secrete FSH

Answer 8

granulosa cells

Question 9

What cells secrete LH

Answer 9

theca cells

Question 10

It is the most potent and abundant form of estrogen

Answer 10

Estradiol

Question 11

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

Answer 11

None of the above. Action nya yan lahat

Question 12

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

Answer 12

LH

Question 13

What triggers ovulation?

Answer 13

LH surge

Question 14

What is the predominant hormone during the Follicular phase?

Answer 14

Estradiol

Question 15

What is the predominant hormone during the luteal phase?

Answer 15

Progesterone

Question 16

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

Answer 16

True

Question 17

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

Answer 17

FSH

Question 18

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

Answer 18

FSH
LH
Estradiol

Question 19

What cells produces progesterone?

Answer 19

Corpus luteum

Question 20

At what phase of the ovarian cycle is estrogen highest?

Answer 20

end of the follicular phase (directly preovulation)

Question 21

At what phase of the ovarian cycle is progesterone highest?

Answer 21

5-7 days post ovulation

Question 22

What are the 2 circulating forms of progesterone?

Answer 22

progesterone

17-hydroxy-progesterone

Question 23

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

Answer 23

D. –> estrogen

Question 24

What are the 2 types of progesterone receptors?

Answer 24

PR-A

PR-B

Question 25

It acts as an inhibitor of PR-B gene regulation

Answer 25

PR-A

Question 26

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

Answer 26

Whole ovarian cycle

Question 27

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

Answer 27

only up to midluteal phase

Question 28

It is a vasoconstrictor that initiates menstruation

Answer 28

Prostaglandin

Question 29

What degrades endothelins? In what cells is it localized?

Answer 29

Enkephalinase; endometrial stromal cells

Question 30

Its activity is in parallel with blood levels of progesterone

Answer 30

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

Question 31

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

Answer 31

corpus albicans

Question 32

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

Answer 32

14 days

Question 33

What inhibits FSH secretion?

Answer 33

Inhibin B

Question 34

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

Answer 34

E. A and C

Question 35

At what phase of the ovarian cycle is LH highest?

Answer 35

10-12 hrs after ovulation

Question 36

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

Answer 36

luteinization

Question 37

What hormone will be highest in level in implantation occurs?

Answer 37

hCG

Question 38

What produces hCG?

Answer 38

blastocyst

Question 39

What happens during day 5 of proliferative phase?

Answer 39

revascularization and epithelial restoration

Question 40

What events span the proliferative phase of endometrial cycle

Answer 40

follicular phase (from end of menstruation to ovulation)

Question 41

What events span the secretory phase of endometrial cycle

Answer 41

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

Question 42

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

Answer 42

C. happens during secretory phase

Question 43

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

Answer 43

Spiral artery

Question 44

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

Answer 44

Secretory Phase

Question 45

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

Answer 45

IL-8

Question 46

Phase of endometrial cycle where there is infiltration of neutrophils

Answer 46

menstrual phase

Question 47

Infiltration of neutrophils causes breakdown of what layer

Answer 47

functionalis layer

Question 48

Phase of endometrial cycle responds to rising levels of progesterone?

Answer 48

secretory phase

Question 49

inititates matrix degradation

Answer 49

metalloproteinases

Question 50

Events during menstrual cycle

Answer 50

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

Question 51

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

Answer 51

endometrium

Question 52

specialized endometrium of pregnancy

Answer 52

Decidua

Question 53

What is the stimuli for formation of decidua

Answer 53

implanting blastocyst

Question 54

specialized structure that nourishes the developing fetus

Answer 54

decidua

Question 55

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

Answer 55

endometrium

Question 56

a function of hemochorial placentation

Answer 56

decidua

Question 57

3 parts of decidua

Answer 57

decidua basalis decidua capsularis decidua parietalis

Question 58

3 layers of decidua parietalis + decidua basalis

Answer 58

zona basalis zona spongiosa zona compacta

Question 59

zona spongiosa + zona compacta =

Answer 59

zona functionalis

Question 60

portion of decidua directly beneath the site of blastocyst implantation

Answer 60

decidua basalis

Question 61

portion of decidua overlying the enlarging blastocyst

Answer 61

decidua capsularis

Question 62

found at the periphery and lines the remainder of the uterus

Answer 62

decidua parietalis

Question 63

avascular, extraembryonic fetal membrane internally connected to decidua capsularis

Answer 63

chorion levae

Question 64

decidua capsularis + decidua parietalis =

Answer 64

decidua vera

Question 65

remains after delivery and gives rise to new endometrium

Answer 65

zona basalis

Question 66

month of pregnancy during which decidua capsularis is most prominent

Answer 66

2nd month

Question 67

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

Answer 67

lost

Question 68

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

Answer 68

persists (spiral arteries)

Question 69

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

Answer 69

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