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exam 1 Flashcards

1
Q

Ovary

A

site of ovum production & release

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2
Q

Uterine/fallopian tube

A

transport & site of fertilization for ovum

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3
Q

uterus

A

site of implanttion & growth of developing embryo

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4
Q

3 parts of uterus

A

fundus, body & cervix

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5
Q

vagina

A

site of delivery of sperm

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6
Q

GnRH is released from

A

hypothalamus

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7
Q

GnRH acts on

A

anterior pituitary to release LH and FSH

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8
Q

FSH and LH cause

A

growth of follicles & ovaries to secrete estrogen & progesterone

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9
Q

phases of the ovarian cycle

A

follicular & luteal phases

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10
Q

follicular phase

A
  • FSH & LH inc.
  • Growth of primordial follicles->primary->antral->vesicular
  • high [estrogen]
  • positive feedback between LH and estrogen
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11
Q

ovulation is caused by

A

a surge in LH

- follicle ruptures & ovum is discharged

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12
Q

luteal phase

A
  • remaining follicles-> lutein cells->corpus luteum

- estrogen & progesterone secreted by corpus luteum have feedback inhibition on ant. pit & decrease FSH & LH

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13
Q

corpus luteum secretes

A
  • progesterone>estrogen

- inhibin which <FSH

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14
Q

if fertilization occurs ___ maintains the corpus luteum

A

hCG

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15
Q

what causes involution of the corpus luteum?

A

< in estogen & progesterone & >inhibin which remove the feedback inhibition & FSH/LH increase & initiate growth of new follicles

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16
Q

most potent naturally occurring estrogen

A

17beta-estradiol (followed by estrone & estriol)

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17
Q

steroidal estrogens arise from androstenedione by aromatization catalized by

A

aromatase which is localized in ovarian granulosa cells

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18
Q

FSH/LH increase activity of

A

aromatase & facilitate the transport of cholesterol into the cells that synthesize estrogens

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19
Q

estrogen=

A

proliferation

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20
Q

progesterone=

A

pro-gestational=secretion

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21
Q

progesterone decreases

A

frequency & intensity of contractions

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22
Q

endometrial cycle is associated with

A

monthly production of estrogen & progesterone; change in endometrial lining

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23
Q

phases of the endometrial cycle

A
  • proliferative: preovulatory: follicular
  • secretoy: postovulatory: luteal
  • menses: desquammation of the endometrium
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24
Q

blood supply to the endometrium

A

spiral arteries of the functional zone restored during secretory phase

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25
GnRH, LH, FSH are ____ & bind to ____
polar peptides; cell membrane receptors (GPCR)
26
estrogen & progesterone are ___ & bind to ____
lipophilic; cytoplasmic steroid receptors
27
when ovaries are no longer responsive to gonadotropins:
menopause occurs; estrogen & progesterone no longer produced by ovaries-> high levels of FSH/LH
28
gonadotropins
FSH & LH
29
most potent estrogen
estradiol but has poor oral bioavailability
30
circulating estrogens
estrone: 60-80% estradiol: 10-20% estriol: 10-20%
31
ethinyl estradiol & mestranol
ethinyl substitution on C17 & increases oral potency by <1st pass metabolism
32
estradiol esters
ester allows for longer duration of action with IM administration
33
conjugated estrogens
from prego mares (Equilin)
34
estrogen & progesterone is ___ protein bound
highly
35
pregnanes
medroxyprogesterone acetate
36
estrane
19-nortestosterone
37
gonanes
norgestrel; no estrogenic effect, diminished androgenic activity
38
in prego, progesterone
suppresses menstruation & uterine contraction
39
in CNS, progesterone
induces ~0.6*C increase in body temp & drowsiness
40
metabolic effects of progesterone
decreases insulin EFFECTS and enhances fat deposition
41
what increases amount of cervical mucous?
estrogen
42
what causes a thickening of cervical mucous?
progestins
43
some progestins show limited bioavailability due to
rapid first pass metabolism
44
mini pill
progestin only 28 days of active hormone micronor, nor-QD: norethindrone
45
combination oral contraceptives work
before fertilization to prevent conception
46
progestin actions
thickens mucous, slows tubal transport, endometrial alterations, suppress LH surge
47
Estrogen actions
stabilizes endometrial lining; suppresses FSH (no dominant follicle)
48
extended cycle OCs
84 +7 placebo
49
continuous cycle OCs
active pills throughout the year. 21 + 4-7days very low dose estrogen & progestin
50
blood clot symptoms
ACHES
51
ACHES
* A- abdominal pain (thrombosis in liver) * C-chest pain (MI/PE) * H-HA(vascular spasm/stroke) * E- eye problems (stroke, HTN, retinal artery thrombosis) * S- swelling/severe leg pain (DVT)
52
noncontraceptive benefits: increase
menstrual regularity & [Hgb]
53
ethinyl estradiol is metabolized by
CYP 3A4
54
chewable OC
femcon FE
55
quick start method
preferred | start the day of office visit & use back up for 7 days
56
managing breakthrough bleeding
- first make sure patient compliance | - can switch from a multiphasic to a monophasic or vise versa or can increase EE >20mcg
57
yasmin/ yaz hormone
drospirenone
58
drospirenone
no estrogenic effects & < andogenicity; similar structure to spironolactone; monitory serum K+
59
benefits of drospirenone
PMDD & acne
60
the "new" yaz
beyaz & safyral
61
beyaz
EE 0.0.2mg, drospirenone 3mg & levomefolate calcium 0.451mg | levomefolate0.451mgX 4 days
62
safyral
EE 0.03mg, drospirenone 3mg, levo 0.451mg | levo 0.451X 7days
63
yasmin
EE 0.03mg, drospirenone 3mg- 7 inactive tabs | generic: ocella
64
yaz
EE 0.02mg, drospirenone 3mg- 4 inactive | generic: gianvi
65
2 studies reported that there is a greater risk of __ associated with drospirenone
VTE (2-6X greater than with levonorgestrel)
66
injectable
depo-provea (DMPA) & depo-subQ provera
67
implantable
implanon & nexplanon
68
intrauterine
mirena & paragard
69
transdermal
ortho evra
70
intravaginal
nuvaring
71
postcoital
emergency contraception
72
depo-provera
- progestin only (DMPA 150mg) - IM X3 months - fertility does not return for 10-12 months
73
dep-subQ provera
- medroxyprogesterone acetate 014mg - SQX3 months - less hormone but as efffective
74
implantable contraceptives aka
long-acting reversible contraceptives (LARC)
75
mirena
intrauterine levonorgestral - prevents ovulation & thickens mucous
76
paragard T380A
intrauterine releases copper - interferes with sperm transport & prevents implantation
77
implanon
implantable | etonorgestrel
78
nexplanon
implantable | etonorgestrel
79
ortho-evra
estrogen 20mcg & norelgestromin 150mcg - abs, butt, upper torso, upper outer arm - higher rates of failure in women >90kg
80
nuva ring
EE 15mcg & etonogestrel 120mcg | - insert on of before day 5 of cycle
81
plan B & next choice
levonorgestrel 1.5mg
82
2013
no age restriction on planB
83
2014
generic can be OTC as long as same labeling
84
ella
emergency contraception ulipristal acetate 30mg RX only may be taken 5 days after
85
YuzpE method
200mcg EE+ 1mg levonorgestrel or 2 mg norgestrel in 2 divided doses (both estrogen & progestin)
86
>35
should use < cancer risk & vasomotor symptoms | - bone mineral density benefits
87
smoking
>15 cigs- CI OCS>50mcg EE associated w/ MI - progestin ONLY should be considered
88
HTN
progestin only (does not > BP)
89
dyslipidemia
- estrogens remove LDLs, > HDL & >TGs slightly - progestins: >LDL &
90
Diabetes
OK for OCs if non-smoker, <35 & no associated vascular disease
91
progestins may alter
carb metabolism & insulin, glucose & glucagon release | EXCEPT levonorgestrel
92
migraines
use progestin only, IUD or barrier method
93
breast cancer
can consider if no disease for >5 years
94
thromboembolism
use DMPA & levonorgestrel IUD | - greater risk w/ transdermal contraception
95
estrogens increase production of
factors 8, 10 & fibrinogen
96
Lupus
-antiphospholipid antibodies: progestin only
97
sickle cell
use DMPA

Reproduction (12 decks)

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