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COM - Repro > Female Repro Physio - 2/23 Lopez > Flashcards

Female Repro Physio - 2/23 Lopez Flashcards

1
Q

What part of the ovary do neurovascular elements run?

A

Medulla

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2
Q

What is the cortex of the ovary composed of?

A

Dense cellular stroma

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3
Q

What resides inside the cellular stroma?

A

Ovarian follicle

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4
Q

Primary oocytes are arrested in what phase of meiosis?

A

Diplotene stage of prophase I

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5
Q

How do follicle cells stimulate oocyte growth?

What does it bind?

A

Release of c-kit ligand (stem cell factor)

c-KIT receptor

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6
Q

The appearance of what signals a primary follicle?

A

Cuboidal granulosa cells

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7
Q

Pre-antral follicles fail to complete meiosis and the oocyte begins to grow. What does it secrete?

What is the fx of the secretion?

A

ZP1, 2, 3

Species-specific binding site for sperm during fertilization

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8
Q

How do Granulosa cells and oocyte maintain contacts?

A

Gap junctions

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9
Q

Thecal cells are analogous to what?

Major product?

A

Leydig cells

Androstenedione

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10
Q

Early natural follicles are depended upon what for normal growth?

A

FSH

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11
Q

What do mural Granulosa cells form?

Where are they located?

What happens to them?

A

Outer wall of follicle

Close to thecal layers

Become highly steroidogenic and remain in ovary after ovulation to differentiate into the CL

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12
Q

The innermost layer relative to the oocyte of cumulus cells maintains contact how?

A

Gap junctions and adherens junction

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13
Q

Larger antral follicles have meiotic competence but are still arrested until when?

Via what mechanism?

A

Mid cycle LH surge

elevated cAMP levels in mature oocyte

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14
Q

What converts androgens to estradiol-17B?

A

Mural Granulosa cells

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15
Q

What stimulates proliferation of Granulosa cells?

What else does it induce?

A

FSH

Expression of CYP19-aromatase

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16
Q

Mural Granulosa cells of large antral follicles producing increasing amounts of what?
When?

A

Inhibin B

Early follicular phase

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17
Q

When does the process of follicle selection occur?

A

Early follicular phase

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18
Q

What converts androstenedione to estrone?

A

Aromatase (CYP19)

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19
Q

Aromatase converts testosterone to what?

A

Estradiol-17B

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20
Q

What receptors do thecal cells express?

What do they produce?

A

LH

Androgens

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21
Q

What receptors do Granulosa cells express?

What is present in granulosa cells And what does it do?

A

FSH AND LH receptors

Aromatase which converts androgens to estrogens

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22
Q

What is the periovulatory period?

Lasts how long?

A

Onset of LH surge to ovulation

32-36 hours

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23
Q

The CL is made how and of what?

A

Biogenesis from remaining thecal and mural Granulosa cells

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24
Q

Main product of CL?

Secondary product?

A

Progesterone

Estrogen

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25
Q

Before ovulation, the follicle presses against the wall of the ovary forming what?

A

Bulge called the stigma

26
Q

LH surge induces release of what?

A

Inflammatory cytokines and hydrolytic enzymes from Theca and Granulosa cells

27
Q

As an indirect response to LH surge what does the oocyte release?

What does this do?

What do these products do?

A

GDF9

Hyaluronic acid and other extracellular matrix components

Expansion of the oocyte complex, making it easier for sperm to locate

28
Q

What are some angiotensin factors the Granulosa cells produce to increase blood supply to the new CL?

A

VEGF, angiopoietin-2, bFGF

29
Q

What converts androstenedione to testosterone?

A

17B-HSD

Major thing that does this

30
Q

What happens during lute ionization of the Granulosa cells?

A

Inhibits Aromatase and estrogen formation

Causes vascularization of Granulosa cells increasing LDL receptor expression

31
Q

CL lives how long?

Saved by what?

A

14 days

hCG from implanted embryo

32
Q

When does progesterone production increase?

When does it peak?

A

After onset of LH surge

Peaks midluteal phase

33
Q

What does estrogen do after LH surge?

A

Decreases but then peaks at midluteal phase

34
Q

What happens to FSH and LH levels during the Luteal phase?

Why?

A

DEC

Negative feedback from progesterone and estrogen

35
Q

What do Granulosa lutein cells secrete?

What does this do?

A

Inhibin A

Suppress FSH

36
Q

What is thelarche?

A

Breast development

37
Q

What does the follicular phase coincide with?

Luteal phase?

A

Proliferative

Secretory

These are endometrial phases

38
Q

Granulosa cells increase production of what to stimulate endometrial growth and maturation?

A

Estrogen estradiol

39
Q

What 2nd messenger does GnRH work through?

A

Gq -> PLC -> PKC, DAG, IP3

40
Q

How is GnRH released?

High levels of what, typical of the late follicular phase sensitize gonadotrophs to GnRH?

A

Rhythmic pulses

Estradiol

41
Q

What do activins stimulate?

Made from where?

A

FSH release

Granulosa cells

42
Q

What are inhibins composed of?

Activins?

A

Alpha beta heterodimers

Beta A and B Heterodimers

43
Q

When do estrogens exert negative feedback control?

Progestins?

A

High and low [ ]’s

ONLY high [ ]’s

44
Q

Where are estrogens derived from in the female?

A

Ovary
Adrenal gland
Peripheral conversion in adipose

45
Q

How does estrogen affect basal body temperature?

When?

A

Lowers it

Pre-ovulation

46
Q

How do high levels of progesterone affect basal body temperature?

When?

A

Raise it

After ovulation

47
Q

When is the endometrium restored after menstruation?

What proliferates?

A

Day 5

Basal stromal cells
Epithelial cells from uterus

48
Q

How does progesterone act in accordance with estrogen?

What does it inhibit/stimulate?

A

Opposes its action on endometrium and functions as anti estrogen

Inhibits epithelial cells proliferation but promotes proliferation of endometrial stroma

Stimulates 17B-HSD and sulfotransferase

49
Q

What promotes the differentiation from of stromal cells into predicdual cells?

A

Progesterone

50
Q

What do oral contraceptive pills suppress?

A

FSH and LH

51
Q

How do progestin-only OCP work?

A

Cause the cervical mucus to thicken and become sticky and insufficient

52
Q

What are oligomenorrhea and amenorrhea due to?

A

Dysfunction or cessation of the HPA ovarian axis

53
Q

What is menorrhagia?

A

Loss of greater than 80mL of blood

54
Q

What is endometriosis?

What tissue is most commonly involved?

Clinical presentation?

A

Tissue that normally grows inside the uterus grows outside it

Ovaries, bowel or tissue lining the pelvis

Pelvic pain, dysmenorrhea, dyspareunia, constipation, infertility

55
Q

What is most common infertility in women?

Caused by what?

A

PCOS

Hyperandrogenism, anovulation, polycystic ovary

56
Q

Enlarged polycystic ovaries are associated with what?

Presentation?

A

DHEA

Young, obese, infertility, oligomenorrhea, insure females

57
Q

Describe the following levels in PCOS:
LH
FSH
Testosterone

A

Elevated
Low
Elevated

58
Q

Turner syndrome due to what?

What are the external and internal genitalia like?

Clinical presentation?

A

Congenital hypogonadism

Female

Webbed neck, short, low-set ears, shout 4th metacarpals, sexual infantilism

59
Q

Menopausal women have what kind of levels of FSH and LH?

Why?

A

High

Low levels of estrogen and Inhibin -> no (-) feedback

60
Q

What are some signs of peri menopause?

A 
Irregular periods
Hot flashes
Vaginal dryness
Night sweats
Mood problems
Etc
61
Q

What is considered part of the female reproductive system?

A

Ovaries, breasts, reproductive tract

COM - Repro (15 decks)

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