CH 9 Female Reproductive Sys

Question 1

What regulates Gonadotropin Releasing Hormone from the pituitary?

Answer 1

+ (leptin), - (beta-endorphin, IL-1, Prolactin, GABA, dopamine)

Question 2

What occurs during the 14 day follicular phase?

Answer 2

FSH on Granulosa Cells stimulates follicular recruitment, growth, estrogen synthesis and upregulation of LH receptors. (now LH can stimulate granulosa cells)

Question 3

What occurs during 14 day Luteal Phase?

Answer 3

LH peak is responsible for ovulation and corpus luteum formation (and progesterone/estrogen formation by corpus lutem) - LH on Theca cells stimulates androstenedione production (–>17B-estradiol in granulosa cells)

Question 4

How does estradiol effect the hypothalamic-pituitary-ovarian axis?

Answer 4

enhances LH and inhibits FSH release

Question 5

How do Inhibins A & B effect the hypothalamic-pituitary-ovarian axis? What cell secretes them?

Answer 5

reduce FSH secretion at anterior pituitary; secreted by Granulosa Cells (B) & Corpus Lutem (A)

Question 6

How do theca cells and granulosa cells work together to produce progesterone?

Answer 6

Theca cells can synthesize androgens (cholesterol–>androstenedione) and Granulosa cells take them and aromatize them to Estradiol.

Question 7

What causes and How does the preovulatory LH surge make progesterone the primary steroid hormone rather than estrogen?

Answer 7

Caused by Estrogen; increase expression of P450 complex (cholesterol –> pregnenolone), & 3-beta-hydroxysteroid dehydrogenase (progesterone). decrease expression of enzymes that convert progesterone to estrogens.

Question 8

What is Inhibin A used to measure?

Answer 8

Corpus Lutem function under control of LH

Question 9

What is Inhibin B used to measure?

Answer 9

Granulosa Cell function under control of FSH

Question 10

What causes ovulation?

Answer 10

surge of LH causes release of oocyte and corona radiate (also stimulates oocytes to resume meiosis I)

Question 11

What happens to Corpus Luteum after ovulation?

Answer 11

produces progesterone and estradiol, suppress LH and FSH via GnRH.

Question 12

What happens to Corpus Luteum if fertilization occurs?

Answer 12

regression prevented by Placental hCG (stimulates granulosa cells to produces progesterone, 17-hydroxyprogesterone, estrogen, inhibin A, and relaxin)

Question 13

When does the Corpus Lutem regress to give way to placental hormones?

Answer 13

after first trimester

Question 14

What are the 3 phases of the endometrial cycle?

Answer 14

Proliferative, Secretory, Menstrual

Question 15

What do each of phases of the endometrial cycle do?

Answer 15

Proliferative [follicular phase] (induced by estrogen - upregulation of estradiol and progesterone receptors); Secretory Phase [luteal phase] (progesterone-induced differentiation of endometrial cells/implantation window); Menstrual Phase (shedding of endometrium)

Question 16

What is the metabolic fate of estrogen?

Answer 16

estradiol (+androstenedione) –> estrone in peripheral tissues –> estriol in liver for secretion –> 2 methoxysterone

Question 17

What is the metabolic fate of progesterone?

Answer 17

progesterone –> pregnenolone –> pregnandiol

Question 18

How does estrogen effect the Uterus?

Answer 18

stimulates endometrium proliferation, sensitizes to oxytocin, produce cervical mucus

Question 19

How does estrogen effect the Ovaries?

Answer 19

mitotic effects on granulosa cells; increase FSH-mediated differentiation

Question 20

How does estrogen effect the Liver?

Answer 20

decreases total cholesterol, increase synthesis of steroid binding proteins (increase total amnt of steroid hormone)

Question 21

How does estrogen effect bone?

Answer 21

antiresorptive

Question 22

What are the major physiological effects of progesterone?

Answer 22

stimulate release of mature oocyte, facilitate implantation, maintain pregnancy

Question 23

How does progesterone effect the myometrium?

Answer 23

hyperpolarization, prevent electrical coupling between cells, decrease extracellular Ca++ influx

Question 24

How does progesterone effect the endometrium?

Answer 24

proliferation

Question 25

What does Mifepristone do?

Answer 25

abortive effects; counteracts progesterone

Question 26

How does progesterone effect the breast?

Answer 26

antagonize prolactin effects in mid- to late pregnancy

Question 27

What does the outer layer of the blastocyst become?

Answer 27

Trophoblast

Question 28

What are the 2 cell types within the Trophoblast?

Answer 28

inner cytotrophoblast, outer invasive syncytiotrophoblast

Question 29

What produces hCG? Where is it found?

Answer 29

syncytiotrophoblast, found in fetal and maternal circulation

Question 30

What does hCG do?

Answer 30

maintain corpus luteum to ensure production of progesterone

Question 31

What produces Human Placental Lactogen hPL? Where is it found?

Answer 31

hPL is produced by the syncytiotrophoblast, found ni fetal and maternal circulation (after 6ty week of pregnancy)

Question 32

What does Human Placental Lactogen do? hPL

Answer 32

embryonic development and metabolism (produce IGFs, hormones, pulmonary surfactant)

Question 33

What produces Human Growth Hormone-V hGH-v? Where is it found?

Answer 33

hGH-V is produced by the placenta, found in MOTHER ONLY

Question 34

What does Human Growth Hormone-V do? hGH-V

Answer 34

becomes the maternal GH (stimulates IGF-1, increase glucose and amino acids for fetus)

Question 35

What is the principal source of progesterone at ovulation and at 8 weeks?

Answer 35

corpus lutem then syncytiotrophoblast

Question 36

How does the Feto-placental Unit work?

Answer 36

placenta creates estriol from fetal DHEAS (fetal adrenal DHEAS –> fetal liver [16-alpha-OHDEAS] –> placenta [estriol]

Question 37

How does the placenta make progesterone if it cannot convert acetate to cholesterol?

Answer 37

maternal liver converts acetate to cholesterol, which goes to placenta to make progesterone

Question 38

What do the 4 phases of parturition consist of?

Answer 38

Phase 0 (transition from quiescence to activation);
 Phase 1 ('activation' - via  stretch+tension of cervix fetal hypothalamic-pituitary-adrenal axis, increase prostaglandin synthesis, upregulation of smooth muscle contraction proteins);
 Phase 2 (active uterine contraction, prostaglandins induce myometrial contractility); 
 Phase 3 (postpartum uterine involution/shrinking)

Question 39

What are the stages of mammary gland development?

Answer 39

STAGE I: Estrogen (+GH, IGF-1, Epidermal Growth Factor) causes ductal elongation. Progesterone (+estrogen, cortisol, prolactin, TH) causes ductal branching & budding. STAGE II: Prolactin (+IGF-1, hPL, cortisol, insulin, oxytocin) causes expansion & differentiation.

Question 40

What hormonal changes occur during female puberty?

Answer 40

initiated by low-amplitude nocturnal pulses of Gonadotropin, which increases serum estradiol (+GH, IGF-1, EpidermalGF). (skeletal maturation, breast development, ovarian/follicular growth, hair growth, menses) - also notice a huge rise in Leptin concentration (parallel to body fat mass)

Question 41

What hormonal changes occurring during female menopaus?

Answer 41

decreased estradiol and inhibin levels (impaired negative feedback on GnRH); increase in FSH and LH levels, increase androstendione levels.

Question 42

40 yr. old woman presents with irregular menstrual cycles and hot flashes, night sweats, vaginal dryness, dyspareunia (painful intercourse), loss of libido, loss of bone mass (osteoporosis). What is her likely diagnosis?

Answer 42

menopause

Question 43

How does prolactin effect GnRH release?

Answer 43

inhibit