[8] Drugs for Reproductive Endocrinology

Question 1

Testosterone is converted to DHT via?

Answer 1

5-alpha Reductase

Question 2

Testosterone is converted to Estradiol via?

Answer 2

Aromatase

Question 3

Common precursor of androgen and estrogen

Answer 3

Progesterone

Question 4

Most potent form of estrogen

Answer 4

Estradiol

Question 5

Steroid hormones are derived from?

Answer 5

Cholesterol

Question 6

In postmenopausal women, hormones come from?

Answer 6

Adipose tissue

Question 7

Adrenal Medulla produces which adrenal hormones

Answer 7

Norepinephrine

Adrenaline

Question 8

Glomerulosa layer produces

Answer 8

Aldosterone

Question 9

Fasciculata produces

Answer 9

Glucocorticoids

Question 10

Reticularis produces

Answer 10

Sex Hormones

Question 11

Adrenal Cortex produces which adrenal hormones

Answer 11

Androgens

Question 12

[T/F] There is complete selectivity between Progestins, Androgens, and Estrogens

Answer 12

F, their close structural similarities make cross reactivity possible

Question 13

Location of LH Receptors in Males

Answer 13

Leydig Cells

Question 14

Location of FSH Receptors in Males

Answer 14

Sertoli Cells

Question 15

Effect of LH binding on Males

Answer 15

Increased testosterone synthesis

Question 16

Effect of FSH binding on Males

Answer 16

Increased Androgen Binding Protein synthesis

Increased Sperm Cells

Question 17

Location of LH Receptors in Females

Answer 17

Thecal Cells

Question 18

Location of FSH Receptors in Females

Answer 18

Granulosa Cells

Question 19

Effect of LH binding on Females

Answer 19

Increased Androgen Synthesis (Androstenedione)

Question 20

Effect of FSH binding on Females

Answer 20

Increased aromatase activity (conversion of testosterone -> estradiol)

Question 21

Increase in basal body temperature is from progesterone or estrogen?

Answer 21

Progesterone

Question 22

Orally active form of Estorgen

Answer 22

Ethinyl Estradiol

Question 23

Central Effect of COC

Answer 23

Progestin suppresses LH secretion

Estrogen suppresses FSH

Question 24

Peripheral Effect of COC (3)

Answer 24

1. Reduced sperm transport
2. Changed endometrium
3. Thickened cervical mucosa

Question 25

What component of COCs increase the chance of Thrombosis?

Answer 25

Estrogen: Increases production of clotting factors 1972 (IX, X, VII, II)

Question 26

Effect of OCs on MI and Stroke

Answer 26

No increased risk

Question 27

What component of COCs affect Carbohydrate Metabolism

Answer 27

Progestin component affects insulin sensitivity

Question 28

[Effect of OCs] Endometrial Cancer Ovarian Cancer Breast Cancer

Answer 28

E: Reduced by 50% O: Reduced by 40-80% depending on time B: MAY be associated with 20% increased risk

Question 29

Preferred oral contraceptives for Lactating Women

Answer 29

Progestin-Only Pills (Minipill) No effect on quantity or quality of breastmilk

Question 30

This drug is used in palliative treatment in postmenopausal women with breast CA but may increase the risk of endometrial CA

Answer 30

Tamoxifen

Question 31

This drug is approved for prevention of postmenopausal osteoporosis and is a partial agonist-antagonist in target tissues

Answer 31

Raloxifene

Question 32

1st line drug for ovulation induction

Answer 32

Clomiphene Citrate

Question 33

This must be supplemented with Clomiphene to allow fetus implantation

Answer 33

Estrogen (Since Clomiphene is an antagonist to uterine tissues)

Question 34

This drug is a pure estrogen receptor antagonist

Answer 34

Fulvestrant

Question 35

Most important androgen secreted by the testis

Answer 35

Testosterone

Question 36

% Free Testosterone

Answer 36

2%

Question 37

Route of Administration of Testosterone

Answer 37

Transdermally or parenterally, ineffective when given orally

Question 38

Why is GnRH released in a pulsatile fashion?

Answer 38

Continuous administration of GnRH causes depression of pituitary activity

Question 39

Mechanism of Action: Leuprolide

Answer 39

GnRH Agonist Suppresses gonadotropin secretion and inhibits ovarian production of estrogens and progesterone

Question 40

Mechanism of Action: Ganirelix and Cetrorelix

Answer 40

GnRH Antagonist

Question 41

Mechanism of Action: Cyproterone acetate Uses

Answer 41

Androgen Receptor Antagonist Treatment of hirsutism