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ENDO/REPRO-1 Exam Two > Exam Two - high yield for Montemayor > Flashcards

Exam Two - high yield for Montemayor Flashcards

1
Q

SRY gene

A

Sex-determining region on the Y chromosome; promotes development of the testes via protein action of TDF

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2
Q

5-alpha-reductase (type 2)

A

Responsible for the conversion of testosterone to DHT

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3
Q

Leydig cells

A

Cells of the testes that produce testosterone

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4
Q

_____ can be substituted for LH in clinical attempts to stimulate spermatogenesis in oligospermic men due to its increased availability. hCG is structurally most similar to LH and binds LH receptors

A

hCG

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5
Q

DHT (details)

A

Required for external male genitalia and prostate

Binds the same androgen receptor as testosterone, with greater affinity

If deficient, default female external pattern will develop

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6
Q

What happens in the absence of DHT in a genetic male?

A

Development of female eternal genitalia (outer vagina, labia major/minora, clitoris)

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7
Q

What is required for Wolffian duct structures to develop?

A

testosterone “action”

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8
Q

What are the Wolffian duct structures?

A

Epididymis, vas deferens, ejaculatory duct and seminal vesicles

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9
Q

Breast development in a male can occur with…?

A

Peripheral conversion of testosterone to estradiol

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10
Q

Which enzyme converts androgens to estrogens?

A

CYP19-aromatase

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11
Q

What is required for pubertal hair growth?

A

DHT action

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12
Q

What hormone is thought to be responsible in initiating puberty?

A

GnRH (pulsatile release)

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13
Q

Circulating testosterone is found in which forms?

A

Majority is bound to SHBG (45-60%)

Minority is free (2-5%)

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14
Q

What protein is responsible for maintaining adequate testosterone concentration in the testes?

A

ABP (androgen-binding protein)

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15
Q

Why must testosterone be concentrated in the testes?

A

It is required to maintain adequate spermatogenesis (high concentration)

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16
Q

Know the Tanner stages of puberty

A

1 —> 5

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17
Q

Hypogonadotropic hypogonadism (details)

A

Congenital (Kallman syndrome: decreased or absent GnRH secretion, anosmia), idiopathic or acquired causes

Plasma LH, FSH, and testosterone levels are low

Testes are immature and have no sperm

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18
Q

What is eunuchoidism?

A

Gonadal failure before puberty results in the absence of secondary sex characteristics

19
Q

What stimulates LH and FSH secretion?

A

Pulsatile hypothalamic GnRH release

20
Q

T concentration in peripheral circulation is diluted to about 100-fold less than T level in the ___________ ___________

A

seminiferous tubules

21
Q

When do hCG levels peak during pregnancy?

A

about 10 weeks

22
Q

Estriol levels….

A

are unique to pregnancy and can be used as a indicator of fetal health

23
Q

What is determined by the date of the last menstrual period?

A

The LMP determines *pregnancy duration (the mean is 40 wks total (gestational age) or 38 weeks from ovulation (embryonic/fetal age)

24
Q

What is the “luteal-placental shift”?

A

When the placenta takes over hormone synthesis from the corpus luteum (P+E levels may decrease during transition)

25
Q

What is thought to be the cause for morning sickness (aka hyperemesis gravidarum)?

A

pt’s response to hCG

26
Q

hCG binds to what receptors with high affinity?

A

LH receptors (can also bind to FSH and TSH receptors with lower affinity)

27
Q

What is absolutely required to maintain pregnancy?

A

Progesterone (reduces smooth m. activity and promotes quiescent myometrium)

28
Q

Can progesterone be used as an indicator of fetal health?

A

No

29
Q

Estriol production requires what hormone from the adrenal glands of the fetus?

A

DHEA-S (androgen)

30
Q

What hormone levels are directly proportional to placental growth?

A

human placental lactogen (hPL)

31
Q

What is the main action of hPL?

A

To promote adequate glucose availability to the fetus (by antagonizing insulin, inhibiting maternal glucose uptake, “diabetogenicity of pregnancy”)

32
Q

What type of hormones do syncytriotrophs produce?

A

peptide and steroid hormones

33
Q

What are the five described endocrine functions of the placenta?

A

xx

34
Q

Endocrine changes in the pregnant mother:

A

Increased prolactin levels
Increased pituitary size (x2+, can cause Sheehan’s)
Decrease in LH and FSH production (negative feedback from estrogens and progesterone)
ADH “set point” changed…released with lower osmolality
Increased size of thyroid and total T3 and T4 (hCG weakly binds TSH, estrogen promotes increased TBG too)
Increased cortisol
Increased aldosterone (due to estrogen’s ability to increase liver secretion of angiotensinogen (causes increased Ang II), however this does not cause hypernatremia, hypokalemia, or hypertension due to progesterones ability to blunt aldosterone’s action and due to ADH’s lower set point)

35
Q

For a women with a normal BMI, what is the average (normal) weight gain with pregnancy?

A

about 25-35 lbs.

36
Q

Main cardiovascular changes during pregnancy:

A

Increase in blood volume
Increase in plasma volume (increase in aldosterone, lower set point for ADH)
Decrease in hematocrit (“physiological anemia”… RBC production does not meet increase in plasma volume, contributes to reduction in TPR)
Increase in CO
Decreased TPR
Decreased or Same MAP (increased CO, decreased TPR, MAP = CO x TPR)

37
Q

Where is the blood pumped by the increased CO directed to?

A

15% goes to uterus (non-pregnant % is 1%)
40% goes to kidneys
(then skin, heart, and breasts)
(no change = brain, gut, skeleton)

38
Q

What are the changes in Starling forces during pregnancy (causing edema)?

A

Increased capillary hydrostatic pressure (increased venous pressure in LE’s due to compression on IVC by fetus and increased venodilation due to hormones) (increased in)

Decreased capillary colloid osmotic pressure (increased liver productions of proteins can’t keep up with increased plasma volume) (decreased out)

39
Q

Changes in the respiratory system during pregnancy:

A

Increase in alveolar ventilation
Progesterone induced changes to fascia…resulting in elevation of diaphragm
Increased 02 demand and CO2 production
Increased sensitivity and response to CO2, ***causing reduction of PCO2 (~40 –> 32 mmHg)

Response of kidneys to the respiratory alkalosis = increased secretion of HCO3-

40
Q

Renal changes during pregnancy:

A

Increased RBF and GFR ( ~ 50% due to increased blood volume and CO)
Increased plasma renin, Ang II, and aldosterone
Increased sodium retention
Increased H20 intake and retention
Decreased serum Na+ (due to ADH set point effects)

41
Q

GI changes during pregnancy:

A

due to progesterone: reflux, constipation, etc. (slowing)

42
Q

What are the three important nutrients during pregnancy?

A

protein, iron and folate

43
Q

Three stages of parturition?

A

xx

44
Q

do the

A

practice questions for male BSC

ENDO/REPRO-1 Exam Two (5 decks)

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