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RDS Test 1 > B8.004 Female Endocrinology > Flashcards

B8.004 Female Endocrinology Flashcards

1
Q

what part of the hypothalamus secretes GnRH

A

median eminence

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2
Q

role of GnRH

A

gonadotropin releasing hormone
10 AAs
stimulates LH and FSH release from anterior pituitary

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3
Q

role of FSH in ovary

A

follicle stimulating hormone

stimulates growth of follicles and estrogen synthesis and secretion

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4
Q

role of LH in ovary

A

stimulates ovulation of mature follicle and formation of corpus luteum; stimulates estrogen and progesterone synthesis and secretion by corpus luteum

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5
Q

regulation of GnRH

A

kisspeptin protein plays a role
receptor = GPR54
mutations can cause hypogonadotropic hypogonadism which leads to infertility

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6
Q

2 types of kisspeptin expressing neurons

A

arcuate
AVPV
act via GPR54 on GnRH neurons

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7
Q

what are gonadotrophs

A

cells in the anterior pituitary that produce LH and FSH

3-5% of cells, but contribute a lot to function

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8
Q

function of GnRH neurons in HP axis

A

neurons release hormones into the median eminence that regulate anterior pituitary function

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9
Q

discuss the portal system in the anterior pituitary

A 
portal vein connects median eminence to anterior pituitary capillary bed
allows for:
low volume of hormones to be secreted
high concentration
pulsatile release
rhythmic release
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10
Q

life cycle of a follicle

A 
primordial follicle
vesicular follicle
mature follicle (w antrum)
ovulation/ corpus hemorrhagicum
young corpus luteum
mature corpus luteum
regressing corpus luteum
**a significant # of follicles go through atrophy rather than ovulating
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11
Q

where does LH act in the ovary

A 
thecal cells (antral follicles)
granulosa cells (preovulatory follicles)
luteal cells
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12
Q

where does FSH act in the ovary

A

granulosa cells (follicles)

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13
Q

types of estrogens

A

estradiol 17B (E2) most potent
estrone (E1) 10% potency
estriol (E3) 1% potency

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14
Q

functions of estrogens

A
  1. stimulate secondary sex characteristics of female
  2. prepare uterus for sperm transport
  3. increase vascular permeability and tissue edema
  4. stimulate growth and activity of mammary glands and endometrium
  5. prepare endometrium for progestagen action
  6. mildly anabolic; stimulates calcification
  7. active during pregnancy
  8. regulate behavior and secretion of gonadotropins
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15
Q

types of progestagens

A

progesterone (P4)

17a-OHP 40-70% potency

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16
Q

functions of progestagens

A
  1. prepare uterus to receive conceptus
  2. maintain uterus during pregnancy
  3. stimulate growth of mammary glands, but suppress secretion of milk
  4. general mild catabolic effect
  5. regulate secretion of gonadotropins
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17
Q

types of androgens

A

DHT (most potent)
T 50% potency
androstenedione 8% potency
DHEA 4% potency

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18
Q

functions of androgens in women

A
  1. induce body hair
  2. influence sexual behavior
  3. promote protein anabolism, somatic growth and ossification
  4. regulate secretion of gonadotropins
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19
Q

significant source of androgens in females

A

adrenal cortex

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20
Q

estrogen and progesterone receptor types

A

function as transcription factors

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21
Q

ERa vs ERb

A 
ERa slightly longer
distribution of specific estrogen receptors with certain organs
CNS: a and b
cardio: a and b
lung: b
GI: b
GU tract: a and b
bone: a and b
liver: a
breast: a and b
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22
Q

what are activin and inhibin

A

members of TGFB superfamily

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23
Q

activins function

A

produced by granulosa cells and pituitary folliculostellate cells
stimulate FSH transcription

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24
Q

inhibins function

A

produced by granulosa cells

inhibit FSH transcription

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25
Q

follistatins function

A

produced by granulosa cells and pituitary folliculostellate cells
bind to and antagonize activins to prevent their action within gonadotrophs

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26
Q

estrogen functions in the HP axis

A

negative feedback
positive feedback
stimulates prolactin behavior

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27
Q

progesterone functions in the HP axis

A

negative feedback

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28
Q

androgens functions in the HP axis

A

behavior

negative feedback

29
Q

inhibin functions in the HP axis

A

decreases FSH

30
Q

activin functions in the HP axis

A

stimulates FSH

31
Q

follistain functions in the HP axis

A

indirectly decrease FSH

32
Q

function of estrogen in the uterus

A

proliferation

myometrium

33
Q

function of progesterone in the uterus

A

development of glands and vasculature
myometrium
decidua cells

34
Q

function of estrogen in the mammary gland

A

duct growth
fat deposition
inhibits milk synthesis

35
Q

function of progesterone in the mammary glands

A

growth of the alveolar epithelium

inhibits milk synthesis

36
Q

other sites of estrogen action

A

vagina/cervix
liver
water retention
anabolic

37
Q

other sites of progesterone action

A

vagina/cervix

catabolic

38
Q

primary functions of ovaries

A
  1. folliculogenesis - oocyte maturation

2. hormone synthesis/secretion

39
Q

structural changes that take place as follicle matures

A

grow larger with FSH and LH regulation
granulosa cells proliferate until multiple layers are present, eventually some die and the antrum (follicular fluid space) forms
thecal cells surround the follicle; initially one later (externa) but eventually and interna layer develops

40
Q

layers of mature follicle from inside to outside

A 
fully grown oocyte
zona pellucida
corona radiata
antrum
granulosa cells (multiple layers)
basement membrane
theca interna
theca externa
41
Q

steroidogenesis within the ovary

A

cholesterol is starting point of steroid hormones
enzyme 3BHSD makes P4 from cholesterol
enzyme aromatase makes E2 from T

42
Q

what happens with hormonal control as the follicle grows?

A

initially, large wave of multiple follicles growing
follicle needs FSH to grow
EVENTUALLY one follicle will reach a critical size at which point it becomes more FSH independent
granulosa cells in this follicle start producing more inhibin and estradiol to inhibit FSH secretion and prevent other follicles from growing larger
ONLY ONE FOLLICLE REMAINS

43
Q

2 cell theory: theca cells

A

LH receptors present
-can be induced by LH or IGF1
convert cholesterol to T and intermediates (pregnenolone, 17OH pregnenolone, DHEA, androstenedione)
androstenedione and T then transported into granulosa cells for further conversion
produces substrates for hormone production

44
Q

2 cell theory: granulosa cells

A

FSH receptors present
take androstenedione and T from theca cells and convert them to estrogens
during follicle growth, ratio of theca: granulosa favors granulosa cells

45
Q

structures of LH and FSH receptors

A

g protein coupled

46
Q

2 subtypes of graulosa cells

A

mural: outer layer
cumulus: surround oocyte, in direct communication

47
Q

E2 secretion during the menstrual cycle

A

days 0-14: consistent rise
day 14: sudden drop with ovulation
days 14-28: flat line at intermediate level
dominant in follicular phase

48
Q

P4 secretion during the menstrual cycle

A 
days 0-14: low
day 14: spike
days 14-22: sharp rise
days 22-24: flat line
days 24-28: fall back to low levels
**dominant in luteal phase**
49
Q

levels of feedback within the HPG axis

A
  1. hypothalamic neurons (kisspeptin)
  2. GnRH neurons at median eminence
  3. gonadotropes in anterior pituitary
50
Q

regulation of GnRH by hormone action at higher order neurons

A

negative feedback by estrogen on arcuate kisspeptin neurons

positive feedback by estrogen on AVPV kisspeptin neurons once a threshold is reached

51
Q

feedback loops during follicular phase

A

within ovary: granulosa cell mitosis, FSHR expression, and inhibin secretion
estrogen provides negative feedback at both hypothalamus and gonadotrophs
FSH dominant over LH

52
Q

feedback loops during late follicular phase/ gonadotropin surge

A

estrogen provides POSITIVE feedback at hypothalamus and gonadotropes
-increased GnRH secretion
-increased GnRH-R number (more sensitive)
gonadotropes produce LH predominantly over FSH

53
Q

result of LH surge in the ovary

A

increased granulosa cell LH-R
proteolytic factors allow breakdown of membrane surrounding follicle
meiotic block is removed

54
Q

changes in granulosa cells at the luteal phase

A

acquire LH receptors, start to resemble theca cells more

differentiation, reorganization, and altered gene expression

55
Q

steroidogenesis within the ovary during the luteal phase

A

P4 predominantly produced

estradiol at low levels

56
Q

effects of progesterone secretion on HPG axis

A

negative feedback at levels of hypothalamus and gonadotropes

57
Q

GnRH release pattern during luteal phase

A

higher amplitude
lower frequency
P4>E2

58
Q

GnRH release pattern during follicular phase

A

lower amplitude
higher frequency
P4 declines, E2 rises

59
Q

GnRH release pattern during gonadotropin surge

A

same amplitude as follicular phase
higher frequency (interpulse intervals don’t allow for complete clearance)
high levels of E2

60
Q

characterize the uterus during the follicular phase

A
  1. proliferation
  2. expression of P4-R
  3. contractions
  4. cervix changes
61
Q

characterize the uterus during the luteal phase

A
  1. gland development
  2. uterine secretions
  3. uterine vasculature
  4. quiescence
62
Q

adrenarche

A

adrenal androgen production prior to puberty

secondary sex characteristics

63
Q

FSH and LH levels during lifetime

A

peaks during 2nd trimester of fetal life, prior to 6 months of infancy, and rises again after menopause
remains relative low during childhood
slight rise during puberty
cyclic rising and falling during reproductive years

64
Q

gonadotropin secretion during childhood

A

GnRH neurons primarily inhibited via GABA

65
Q

gonadotropin secretion during puberty/adolescence

A 
more excitatory neurotransmission acting on GnRH neurons
excitatory neurotransmitters:
-glutamate
-NMDA
-kisspeptin
66
Q

maturational changes in estradiol negative feedback to the hypothalamus

A

child: even a low level of steroids blocks the release of gonadotropins
adults: much higher levels occur
high sensitivity of gonadotropin release to negative feedback during childhood, low sensitivity during adulthood

67
Q

changes in HPG prior to puberty

A

early nocturnal increases in gonadotropin secretion

68
Q

HPG axis during sexual maturation (puberty)

A

first ovulation: E2 positive feedback and LH surge
initiation of menstural cycles
sexual maturity = establishment of patterns at the level of the hypothalamus, pituitary, ovary, and uterus + changes in phenotype and behavior

69
Q

female secondary sex characteristics

A 
breasts
pubic hair
growth spurt
changes in habitus
menarche
axillary hair

RDS Test 1 (22 decks)

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