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MRCOG Part 1 > Endocrinology: Sex Hormones > Flashcards

Endocrinology: Sex Hormones Flashcards

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
Q

How much progesterone does the at term placenta produce per day?

A

250mg/day

26
Q

What are the four functions of progesterone at the uterus, cervix and vagina?

A
  1. Converts proliferative to secretory endometrium
  2. Withdrawal of progesterone causes menstruation
  3. Thickens cervical mucus
  4. Inhibits uterine contraction until term
27
Q

What is the effect on progesterone on lactation during pregnnacy?

A

Progesteorne inhibits lactation

28
Q

What is the role of progesterone in respiration?

A
  1. Increased ventilator response to CO2
  2. Decreased arterial and alveolar pCO2
29
Q

What is the effect of progesterone on the kidney?

A

Increases aldosterone production (leading to salt and water retention)

30
Q

What is the effect of progesterone on the vasculature?

A
  1. Reduces pressor responeisveness to angiotensin-2
  2. Smooth muscle relaxant
31
Q

What is the effect of progesterone on metabolism?

A
  1. Catabolic (thus causes an increase in appetite)
  2. Increases core temperature following ovulation
32
Q

What is the effect of progesterone on the central nervous system?

A

Neuroprotective (role in treatment of multiple sclerosis; demyelination halts during pregnancy

33
Q

What family do the inhibins belong to?

A

Peptide members of transforming growth factor TGF-beta

34
Q

What are the two forms of inhibin?

A

Inhibin A
Inhibin B

35
Q

Where is inhibin secreted from?

A

Ovarian granulosa cells

36
Q

What is the function of inhibin?

A

Selectively inhibit FSH production but not LH secretion

37
Q

Where is inhibin produced?

Three locations

A
  1. Gonads
  2. Pituitary
  3. Placenta
38
Q

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?

A
  1. Elevated beta-HCG
  2. Dcreased alpha-fetoprotein (AFP)
  3. Decreased oestriol
38
Q

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?

A
  1. Elevated beta-HCG
  2. Dcreased alpha-fetoprotein (AFP)
  3. Decreased oestriol
39
Q

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?

A
  1. Elevated beta-HCG
  2. Dcreased alpha-fetoprotein (AFP)
  3. Decreased oestriol
40
Q

What family do Activins belong to?

A

Peptide members of TGF-beta family

41
Q

Where are Activins secreted from?

Two locations

A
  1. Ovarian granulosa cells
  2. Pituitary gonadotropes
42
Q

What are the functions of Activin

Three

A
  1. Augment FSH activity in the ovary
  2. Stimulate FSH secretion in the pituitary
  3. Inhibit prolactin, GH and ACTH responses
43
Q

Where is Relaxin produced?

Four locations

A
  1. Corpus luteum
  2. Placenta
  3. Breast
  4. Prostate
44
Q

What are the three functions of Relaxin?

A
  1. Relaxes pelvic ligaments in pregnancy
  2. Plays a role in cervical dilatation
  3. Inhibits cotnractility of myometrium
45
Q

What three main hormones do the testes secrete?

A
  1. Testosterone
  2. DHT - strictly it is a paracrine hormone
  3. Oestradiol
46
Q

What 7 minor hormones do the testes secrete?

A
  1. DHEA
  2. Androstenedione
  3. Oestrone
  4. Pregnenolone
  5. Progesterone
  6. 17-alpha hydroxyprogesterone
  7. 17-alpha hydroxypregnenolone
47
Q

What type of hormone is testosterone?

A

Anabolic steroid

48
Q

Where is testosterone secreted?

Four locations

A
  1. Testis (leydig cells)
  2. Ovary (theca cells)
  3. Adrenals (zona reticularis)
  4. Placenta (cyto or syncytoptrophoblastic cells)
49
Q

What forms does testosterone exist in serum?

A
  1. Freely (2%)
  2. Bound to SHBG (60%)
  3. Bound to albumin (38%)
50
Q

By what two mechanisms does testosterone exert its effects on tissue?

A
  1. By activation of nuclear androgen receptors
  2. By aromatisation of testosterone to oestradiol (occurs in bone and brain)
51
Q

What is testosterone converted to by 5-alpha reductase?

A

DHT

52
Q

What and where is testosteorne excreted as?

A

Urine as 17-ketosteroid

53
Q

How many isoforms of testosterone exist?

A

Two

54
Q

Where is 5-alpha reductase produced?

Five locations

A
  1. Skin
  2. Seminal vesicles
  3. Prostate
  4. Epididymis
  5. Brain
55
Q

What are the four consequences of 5-alpha reductase deficiency?

A
  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
Q

Where is sex hormone binding globulin synthesised?

A

Liver

57
Q

Where is the gene for SBHG located?

A

Chromosome 17

58
Q

Are SHBG levels higher in women or men?

A

Women

59
Q

What four things can increase SHBG levels?

A
  1. Oestrogen
  2. Tamoxifen
  3. Phenytoin
  4. Thyroid hormone
60
Q

What 6 factors decrease SHBG?

A
  1. Exogenous androgens
  2. Progestin
  3. Glucocorticoids
  4. Growth Hormone
  5. Hypothyroidism
  6. Obesity

MRCOG Part 1 (8 decks)

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