Endocrinology in pharmacy Flashcards
1
Q
_____ ______ sheds in period
A
mucosal lining
2
Q
does the lumen of the muscle (uterus) wall change thickness throughout the period?
A
yes in the course of regrowing
3
Q
______ ______ triggers regrowth of uterine lining
A
oestrogen increasing
4
Q
increase in LH causes decrease in ______ and an increase in ______
A
oestrogen
progesterone
5
Q
what is menarche
A
onset of ovulation/ puberty
6
Q
what does monarch activate?
A
oocytes
7
Q
roughly _____ cycles in a lifetime
A
468
8
Q
3 phases of the period? and time frames
A
menses 1-5
follicular 5-14
luteal 14-28
9
Q
3 stages of ovulation?
A
follicle– rupture– corpus luteum
10
Q
when does ovulation occur in the cycle?
A
day 14
11
Q
gonadotrophin are _______ hormones
A
polypeptide hormones
12
Q
what do the gonadotrophin regulate
A
steroid production
13
Q
progesterone starts to _____ before ovulation
A
rise
14
Q
when does progesterone peak?
A
about a week after ovulation
15
Q
what are the gonadotrophin
A
LH and FSH
16
Q
What do female steroids all contain?
A
4 carbon rings
17
Q
why is oestrogen unique?
A
has an aromatic ring
18
Q
sex steroid synthesis pathway?
A
acetate—- cholesterol —– pregnenolone—— progesterone OR 17a-hydroxypregnenolone
17a-hydroxypregnenolone —–DHEA —– androstenedione—— testosterone
19
Q
what are androstenedione and testosterone
A
androgens
20
Q
what do androgens give rise to?
A
oestrogen compounds
21
Q
how do androgens give rise to oestrogen compounds?
A
aromatise enzyme is involved- needed for the aromatic ring
22
Q
what does hormone action require?
A
receptors on target tissues
23
Q
how do steroids travel in the blood?
A
binding proteins
very unsoluble
24
Q
where are the major steroid receptors?
A
intracellular in the nucleus
25
what does binding to steroid receptors in the nucleus lead to?
production of mRNA which usually leads to translation of a protein
26
receptors for all the major classes of steroid hormones (e.g.???) belong to a ______ ______
e.g. androgens, oestrogen, progestins
superfamily
27
structures of the major steroid super family receptors?
2 binding sites
| one for the steroid and there for DNA
28
What happens when the steroidal ligand binds to the receptor?
conformational change produces a complex that acts on DNA
29
what does this complex then do to the DNA after the steroidal ligand has bound?
alters the repertoire of genes being expressed by those cells
30
the way the steroids can change gene expression makes them _______ _______
transcription factors
31
can gonadotrophins (LH and FSH) get into cells?
no
| need receptors at the cell surface
32
oestrogen dominates the ______ phase of the cycle
follicular
33
progesterone dominates the _______ phase of the cycle
luteal
34
how is the production of gonadotrophin regulated?
HPO axis
35
what is the HPO axis?
hypothalamic pituitary access
connected by short blood vessels
hypothalamus signals to the pituitary (gonadotrophin releasing hormone) which controls gonadotrophin release
36
Gonadotrophins control ______ ______ production
sex steroid
37
TF: Gonadotrophins control follicle maturation/ ovulation?
true
38
is GnRH release in the HPO axis continuous or pulsatile?
PULSATILE
39
TF: the pulsatile release of GnRH at the anterior pituitary depend on pulse frequency not amplitude.
TRUE- depends on pulse frequency not amplitude
40
GnRH acts at what type of receptor?
GPCR
41
GnRH is regulated by?
sex steroids
42
what does GnRH stimulate the release of?
LH and FSH
43
FSH is stimulated by _____ GnRH pulse frequencies
SLOW
44
LH is stimulated by _____ GnRH pulse frequencies
FAST
45
How many AA's in GnRH?
10
46
antagonists or agonists of GnRH can be used to?
shut down the ovary in advance of a controlled cycle of ovulatory stimulation- good in IVF
47
Buserelin mechanism of action?
GnRH receptor agonist
stimulates FSH and LH production at long term constant levels
this causes GnRHR down regulation and loss of FSH and LH production.
48
once Buserelin is used to stop FSH and LH production, what can you do to make a synthetic cycle?
add exogenous steroids
49
puberty in girls is believed to be controlled by _______.
leptin
50
what neurone does leptin act through?
kisspeptin
51
what does the kisspeptin neurone stimulate when leptin acts on it?
the anterior pituitary to produce gonadotophins
52
being ______ _____ can stimulate earlier puberty.
over weight
| more leptin
53
early puberty is associated with higher risks of..... in women or men?
CVD
type 2 diabetes
in both women and men
54
why can early puberty be associated with higher risks of CVD and T2D?
longer time exposed to cyclical oesterogen
55
TF: increasing age of menarche is associated with lower risks of osteoporosis
FALSE- increasing risk
56
TF: increasing age of menarche is associated with lower risks of breast cancer?
TRUE
57
if steroid production kicks in earlier you get a ______ bone density
higher
58
___ causes ovulation
LH
59
we start out with about ______ follicles
a million
60
how many follicles are recruited each month?
20
61
what happens to these 20 follicles?
19 die away and you're left with a dominant follicle
62
where does this dominant follicle go?
moves to the ovarian surface and ovulates
63
when does early menopause occur?
when follicular stores are depleted quicker
64
what is the name of the cells that grow in the follicle?
granulosa cells
65
what do granulose cells contain?
full chromosomal complement- pink cells. these cells continue to grow and surround the follicle
66
what stimulates the development of follicle from the primary to tertiary state
FSH
67
what causes ovulation?
LH
68
What happens to the corpus luteum and steroid production if there's no pregnancy?
CL: regressed
| steroid production declines
69
meiosis one (n equation)?
2n--> n
70
meiosis II (n equation)?
n-->n
71
where does meiosis take place?
in the ovaries
72
when is the only time oestrogen has positive feedback? what does this result in?
when close to ovulation, this results in a spike in LH
73
progesterone only exerts _____ feedback
negative
74
post ovulation both FSH and LH _____
decline
75
when does the spike in LH occur? why?
about 36 hours before ovulation.
| as it causes ovulation
76
in females, positive feedback by steroid to the hypothalamus is followed by.....
negative feedback
77
in males androgens feed back ______ . there's no ______ feedback
negatively
| no positive feedback
78
combined oestrogen and progesterone inhibit _____. so can be used for?
GnRH
| contraceptives
79
effect of high prolonged oestrogen?
inhibits GnRH
| can cause endometrial cancer
80
______ is the target tissue of sex steroids.
endometrial tissue
81
oestrogen stimulates the growth of the _____
endometrium
82
why does oestrogen cause DNA synthesis?
incorporation of thymidine increases
83
how does an anti-oestrogen (faslodex) work?
binds the oestrogen receptor and blocks its ability to activate target genes- doesn't create complex which can activate gene expression
84
TF: oestrogen compounds are those which look like oestrogen. explain.
FALSE- they're classified as those which bind to a receptor and does something down stream
85
TF: tamoxifen is a oestrogen antagonist.
FALSE- its a partial agonist and partial antagonist
86
positive effects of oestrogen on the brain?
delay memory loss, sexual and reproductive development
| improve cognitive function
87
positive effects of oestrogen on the bones?
preserves bone density
88
define menopause?
permanent cessation of ovarian activity usually said to have occurred after 12 consecutive months of amenorrhoea
89
define perimenopause?
period before menopause and 1st year after it
90
define climacteric?
transition from reproductive life to non reproductive state
91
net effect of a later menopause is a _______ life span
increased
92
how are menopause flushes treated?
low dose oestrogen
93
effect of menopause in the genital tract tissues?
genitalia and bladder- more UTIs
94
what dose of oestrogen is required to stimulate receptors in the vagina and lower urethra?
10mg daily
95
wound healing is ______ after menopause.
slower
96
TF: oestrogen is a potent anti-inflammatory agent.
TRUE
97
bone density _____ with declining oestrogen
decreases
98
_____ is an option in osteoporosis
HRT
