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Year 2 - Endocrinology > Endocrinology of Pregnancy > Flashcards

Endocrinology of Pregnancy Flashcards

1
Q

In the male RT, what is under E control?

A

Tubular fluid reabsorption

In:
x rete testis
x epididymis

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2
Q

In the male RT, what is under ANDROGEN control?

Why is it important?

A

Nutrient & glycoprotein secretion into:
x epididymal fluid

Important as:
o provides energy for journey
o coats the surface of the spermatozoa

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3
Q

What can LOW aromatase lead in males?

A

Convertes testosterone to E = LOW E

o TALL as difficile plate closure needs E
o Osteoporosis

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4
Q

What is released during ejaculation?

A

Semen

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5
Q

What does semen consist of?

A
  1. Spermatozoa (15-120million/ml)
  2. Seminal fluid (2-5ml)
  3. Leucocytes
    (so potential viruses e.g. hepB, HIV)
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6
Q

Where does the semen go when ejaculated?

A

Into the VAGINA or CERVICAL CANAL

1/100 = enter cervix
1/10,000 = cervix to ovum
1/million = ovum
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7
Q

What contributes to the seminal fluid?

A

SMALL contribution from:
o epididymis/testis

MAJOR contribution from:
o Accessory sex glands

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8
Q

What makes up the accessory sex glands?

A

o Seminal vesicles (produce fructose & fibrinogen)
o Prostate (produce citric acid)
o Bulbourethral glands

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9
Q

What is meant by ‘Capacitation of Sperm’?

A

o In the SEMINIFEROUS TUBULE the spermatozoa are incapable of fertilisation

o In the VAS DEFERENS they are
- capable of movement
BUT
- have little capability of fertilisation

HENCE for full fertilisation activity, needs to undergo capacitation in the OVIDUCT (female repro tract)

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10
Q

Where does Capacitation occur?

A

OVIDUCT/fallopian tube

i.e. female repro tract

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11
Q

Steps of Capacitation?

A
  1. Loss of GLYCOPROTEIN ‘coat’
  2. Change in SM characteristics
  3. Develop WHIPLASH movements of tail
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12
Q

Envrionment needed for Capacitation?

A

o Ionic & proteolytic envrionment in fallopian tube

o Oestrogen-dependent

o Ca2+-dependent

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13
Q

What does the acrosome reaction allow for the capacitated spermatozoa to do?

A
  1. BIND to
    AND
  2. PENETRATE the zona pellucida

via. the release of hyaluronidase & proteolytic enzymes

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14
Q

Describe the acrosome reaction

A

Location: Fallopian tubes
Result: expulsion of 2nd polar body from ovum

  1. Sperm binds to the ZP3 (sperm receptor - via. G-protein mediation)
  2. Ca2+ influx into the sperm (mediated via. PG)
  3. Penetrates the zona pellucida (via. hyaluronidase released by acrosome)
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15
Q

What prevents further sperm binding?

A

Cortical reaction!

Cortical granules release molecules which degrade zona pellucida (+ ZP2/3)

HENCE prevents further sperm binding as NO receptors

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16
Q

Conceptus?

A

Fertilised ovum

17
Q

How does the Conceptus develop?

A
  1. Continues to divide as it moves DOWN the fallopian tube –> uterus (3-4days)
    o recieves nutrients from uterine secretions
    o free-living phase can last for 9-10days
  2. Conceptus then compacts to an 8-16 cell MORULA
  3. Then a BLASTOCYST - 2 seperate cell populations
    o Inner mass = becomes embryo
    o Outer trophoblast = chorion
  4. Then reaches the uterus facilitated by INCREASED PG:E (luteal phase)
18
Q

What hormone is released when fertilisation takes place?

A

hCG - from the placenta

19
Q

2 stages of Implantation?

A
  1. Attachment Phase
    o OUTER trophoblast cells contact uterine surface epithelium
  2. Decidualisation Phase
    o changes in underlying uterine stromal tissue (within a few houes)
20
Q

What is required for implantation to take place in terms of hormones?

A

PG domination in the presence of E

21
Q

What is required for implantation to take place in terms of molecules?

A

LIF (leukaemia inhibitory factor)
o released from endometrial secetory glands (and ?blastocyst)
o stimulates ADHESION of blastocyst to endometrium

IL-11
o released into uterine fluid from endometrial cells

22
Q

Explain the Decidualisation Stage

A

Endometrial changes due to PG!

o Glandular epithelial secretion
o Glycogen accumulation in stromal cell cytoplasm (localised changes in IC composition)
o Growth of capillaries
o Increased vascular permeability (oedema!)

23
Q

What factors are invovled in the Decidualisation Stage?

A

IL-11
Histamine
Prostaglandins
TGF-beta (promotes angiogenesis)

24
Q

Describe the hormone changes in the first 5-6 weeks?

A

o Maternal ovaries release gonadal steroids

o Circulating [PG] & [oestradiol] are HIGH and rising

  • INHIBIT the release of LH & FSH
  • the STIMULATORY role on corpus luteum is hence taken over by hCG
25
Q

Describe the hormone changes in the after 40 days?

A

o hCG falls as foetalplacental unit takes over w. E and PG production

26
Q

How is PG and E produced in the first 40 days of pregnancy?

A

Corpus luteum - stimulated by hCG which acts on LH receptors

27
Q

Hormones that INCREASE during pregnancy?

A
  1. ACTH
    o pregnancy activates stress-axis SO more ACTH
  2. Adrenal steroids
    o more ACTH thus MORE CORTISOL
  3. Prolactin
    o supresses GnRH
  4. IGF1
  5. Iodothyronines
    o pregnancy increases metabolic rate
    o driven by hCG (shares common alpha-subunit w. TSH) and NOT TSH (TSH falls)
  6. PTH related peptides
    o more Ca2+ requirement for lactation
    o ensures enough Ca2+ passes to fetus
28
Q

Hormones that DECREASE during pregnancy?

A
  1. Gonadotrophins
    o prolactin supresses GnRH
  2. Pituitary GH
    o as the placental hGH-variant increases during term
  3. TSH
    o falls as hCG stimulates T4 production instead
29
Q

If worried about prolactinoma during pregnancy what test can be carried out?

A

CANNOT:
- measure prolactin (normal test) as elevated during pregnancy

INSTEAD
- check visual fields

30
Q

Partruition?

A

Childbirth

31
Q

Endocrine control of Partruition?

A

Oestrogen, Cortisol & OXYT

OXYT –> raised IC Ca2+ –> Contraction

  1. Calmodulin activated Cal-MK
  2. This contracts actin-myosin

Oestrogen stimulates phospholipase A2 (PG inhibits this)

  • stimulates arachidonic acid
  • produces PGF2a
  • raises IC Ca2+ from microsomes
32
Q

Function of OXYT?

A

o Uterine contraction

o Cervical dilation

o Milk ejection

33
Q

Endocrine control of lactation?

A

Prolactin - milk SYNTHESIS

OXYT - milk EJECTION

Year 2 - Endocrinology (19 decks)

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