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MRCOG Part 1 > Endocrinology: Sex Hormones > Flashcards

Endocrinology: Sex Hormones Flashcards

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1
Q

List the 11 hormones the ovary secretes:

A
  1. Oestrogen
  2. Progesterone
  3. Androgens
  4. Insulin
  5. Relaxin
  6. Activin
  7. Oxytocin
  8. Vasopressin
  9. Pro-renin
  10. Follistatin
  11. Prostaglandins
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2
Q

Which three sites in the female produce oestrogen?

A
  1. Ovary (25%)
  2. Adrenal glands (25%)
  3. Peripheral conversion (of androstenedione) (50%)
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3
Q

What are the two markers of corpus luteum function?

Sex Hormones

A
  • 17-hydroxyprogesteorne (not secreted by placenta)
  • Relaxin

Sex Hormones

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4
Q

What are the 3 natrually occurring oestrogens and when are they found?

A
  1. Oestrone (E1) - produced in menopause
  2. Oestradiol (E2) - non-pregnant women
  3. Oestriol (E3) - pregnancy
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5
Q

Which form of oestrogen is the most active of the three naturally occurring oestrogens?

A

Oestradiol (E2)

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6
Q

Where is Oestradiol (E2) produced?

Seven areas

A
  1. Developing follicles in the ovary
  2. Corpus luteum
  3. Placenta
  4. Liver
  5. Adrenal glands
  6. Breast
  7. Adipocytes
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7
Q

What proteins does oestradiol (E2) bind to in the blood?

Two proteins

A
  1. Sex-hormone binding globulin (SHBG)
  2. Albumin
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8
Q

What is oestradiol (E2) metabolised to and where does this occur?

A

Oestradiol –> Oestrone (E1) + Oestriol (E3)
In the liver

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9
Q

What is oestradiol (E2) metabolised to and where does this occur?

A

Oestradiol –> Oestrone (E1) + Oestriol (E3)
In the liver

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10
Q

What are the two cardiovascular functions of oestrogen?

A
  1. Vasodilator (increases NOS so increases NO)
  2. Prevents atherosclerosis
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11
Q

What are the two bone functions of oestrogen?

A
  1. Maintenance of bone density - decreases resorption of bone by antagonising PTH
  2. Fusion of epiphyseal plates
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12
Q

What are the clotting functions of oestrogen?

Three

A
  1. Increases factors II, VII, IX, X and plasminogen
  2. Decreases anti-thrombin 3
  3. Increases platelet adhesiveness
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13
Q

Whar are the gastrointestinal functions of oestrogen?

Two

A
  1. Decreases bowel motility
  2. Increases bile production
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14
Q

What metabolic changes does oestrogen cause?

Four

A
  1. Increases HDL
  2. Decreases LDL
  3. Decreases cholesterol
  4. Increases TAG synthesis
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15
Q

What ares does oestrogen increase skin pigmentation by increasing phaeomelanin?

Three

A
  1. Nipple
  2. Areola
  3. Genital regions
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16
Q

What is the effect of oestrogen on the kidney?

A

Causes Na+ and H2O retention

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17
Q

What is the effect of oestrogen on the endometrium?

A

Causes proliferation

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18
Q

What are the three sources of progesterone in the body?

A
  1. Corpus luteum
  2. Adrenal glands
  3. Placenta
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19
Q

Where is progesterone stored?

A

Adipose tissue

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20
Q

What two proteins does progsterone bind to in the plasma?

A
  1. Corticosteroid binding globulin
  2. Albumin
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21
Q

Where is progesterone metabolised?

A

The liver

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22
Q

What is progesterone metabolised to?

A

Pregnanediol

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23
Q

How is progesterone excreted?

A

Renally as pregnanediol glucoronide

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24
Q

What are the pre-ovulation, post-ovulation and at term?

A
  1. Pre-ovulation = <2ng/ml
  2. Post-ovulation = 5ng/ml
  3. At term = 100-200 ng/ml
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25
How much progesterone does the at term placenta produce per day?
250mg/day
26
What are the four functions of progesterone at the uterus, cervix and vagina?
1. Converts proliferative to secretory endometrium 2. Withdrawal of progesterone causes menstruation 3. Thickens cervical mucus 4. Inhibits uterine contraction until term
27
What is the effect on progesterone on lactation during pregnnacy?
Progesteorne inhibits lactation
28
What is the role of progesterone in respiration?
1. Increased ventilator response to CO2 2. Decreased arterial and alveolar pCO2
29
What is the effect of progesterone on the kidney?
Increases aldosterone production (leading to salt and water retention)
30
What is the effect of progesterone on the vasculature?
1. Reduces pressor responeisveness to angiotensin-2 2. Smooth muscle relaxant
31
What is the effect of progesterone on metabolism?
1. Catabolic (thus causes an increase in appetite) 2. Increases core temperature following ovulation
32
What is the effect of progesterone on the central nervous system?
Neuroprotective (role in treatment of multiple sclerosis; demyelination halts during pregnancy
33
What family do the inhibins belong to?
Peptide members of transforming growth factor TGF-beta
34
What are the two forms of inhibin?
Inhibin A Inhibin B
35
Where is inhibin secreted from?
Ovarian granulosa cells
36
What is the function of inhibin?
Selectively inhibit FSH production but *not* LH secretion
37
Where is inhibin produced? | Three locations
1. Gonads 2. Pituitary 3. Placenta
38
Inhibin A makes up part of the hormone screen in Down's Syndrome and is elevated in positive cases - what are the other hormones and their levels?
1. Elevated beta-HCG 2. Dcreased alpha-fetoprotein (AFP) 3. Decreased oestriol
38
Inhibin A makes up part of the hormone screen in Down's Syndrome and is elevated in positive cases - what are the other hormones and their levels?
1. Elevated beta-HCG 2. Dcreased alpha-fetoprotein (AFP) 3. Decreased oestriol
39
Inhibin A makes up part of the hormone screen in Down's Syndrome and is elevated in positive cases - what are the other hormones and their levels?
1. Elevated beta-HCG 2. Dcreased alpha-fetoprotein (AFP) 3. Decreased oestriol
40
What family do Activins belong to?
Peptide members of TGF-beta family
41
Where are Activins secreted from? | Two locations
1. Ovarian granulosa cells 2. Pituitary gonadotropes
42
What are the functions of Activin | Three
1. Augment FSH activity in the ovary 2. Stimulate FSH secretion in the pituitary 3. Inhibit prolactin, GH and ACTH responses
43
Where is Relaxin produced? | Four locations
1. Corpus luteum 2. Placenta 3. Breast 4. Prostate
44
What are the three functions of Relaxin?
1. Relaxes pelvic ligaments in pregnancy 2. Plays a role in cervical dilatation 3. Inhibits cotnractility of myometrium
45
What three main hormones do the testes secrete?
1. Testosterone 2. DHT - strictly it is a paracrine hormone 3. Oestradiol
46
What 7 minor hormones do the testes secrete?
1. DHEA 2. Androstenedione 3. Oestrone 4. Pregnenolone 5. Progesterone 6. 17-alpha hydroxyprogesterone 7. 17-alpha hydroxypregnenolone
47
What type of hormone is testosterone?
Anabolic steroid
48
Where is testosterone secreted? | Four locations
1. Testis (leydig cells) 2. Ovary (theca cells) 3. Adrenals (zona reticularis) 4. Placenta (cyto or syncytoptrophoblastic cells)
49
What forms does testosterone exist in serum?
1. Freely (2%) 2. Bound to SHBG (60%) 3. Bound to albumin (38%)
50
By what two mechanisms does testosterone exert its effects on tissue?
1. By activation of nuclear androgen receptors 2. By aromatisation of testosterone to oestradiol (occurs in bone and brain)
51
What is testosterone converted to by 5-alpha reductase?
DHT
52
What and where is testosteorne excreted as?
Urine as 17-ketosteroid
53
How many isoforms of testosterone exist?
Two
54
Where is 5-alpha reductase produced? | Five locations
1. Skin 2. Seminal vesicles 3. Prostate 4. Epididymis 5. Brain
55
What are the four consequences of 5-alpha reductase deficiency?
1. Low DHT levels 2. Increased testosterone levels 3. Gynaecomastia 4. Ambigous genitalia at birth (DHT is necessary for development of male genitalia in utero)
56
Where is sex hormone binding globulin synthesised?
Liver
57
Where is the gene for SBHG located?
Chromosome 17
58
Are SHBG levels higher in women or men?
Women
59
What four things can increase SHBG levels?
1. Oestrogen 2. Tamoxifen 3. Phenytoin 4. Thyroid hormone
60
What 6 factors decrease SHBG?
1. Exogenous androgens 2. Progestin 3. Glucocorticoids 4. Growth Hormone 5. Hypothyroidism 6. Obesity

MRCOG Part 1 (8 decks)

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