Female Reproductive Physiology

Question 1

luteal phase

Answer 1

elevated progesterone and low estrogen

secretory endometrium forms

Question 2

follicular phase

Answer 2

FSH elevated
-proliferation of granulosa cells

increased estrogen secretion in follicles

Question 3

theca cells

Answer 3

LH stimulation

form androgens

Question 4

granulosa cells

Answer 4

FSH stimulation

increased aromatase - androgen to estrogen

Question 5

estrogen

Answer 5

acts locally on granulosa cells - increased proliferation and sensitivity to FSH

rising level of estrogens - follicular phase

Question 6

inhibin B

Answer 6

from granulosa cells

inhibits secretion of FSH by pituitary

Question 7

estrogen effect

Answer 7

endometrial cell - increased rate of mitotic divions

cervical mucus thin and watery

Question 8

very high estrogen

Answer 8

no longer inhibit LH and FSH

start positive feedback - LH surge and very high FSH

Question 9

LH surge

Answer 9

induction of ovulation

removed restraint upon meiosis
prophase 1 to metaphase 2
first polar body lost

Question 10

production of progesterone

Answer 10

decreased activity of aromatase and decreased estrogen production

from luteal cells -that were formerly granulosa and theca cells

Question 11

progesterone effect

Answer 11

endometrial to become secretory

thickens cervical mucus

thermogenic - increased body temp

negative feedback on LH

Question 12

menstruation

Answer 12

due to lack of gonadal sex steroids

Question 13

to monitor menstrual cycle

Answer 13

look at sex steroids in urine

Question 14

early follicular phase

Answer 14

low progesterone

low but slowly rising estrogen

Question 15

follicular phase

Answer 15

low progestone and rapidly rising estrogens

Question 16

luteal phase and pregnancy

Answer 16

elevated progesterone

Question 17

potency estrogens

Answer 17

estradiol > estrone > estriol

Question 18

amenorrhea

Answer 18

lack of menstrual bleeding

Question 19

length of follicular phase

Answer 19

more variable

Question 20

increased DHEA

Answer 20

PCOS

Question 21

hirsutism caused by ovarian source of adrenal source

Answer 21

measure DHEA

dexamethasone suppression test

Question 22

most common cause of ovarian androgen excess

Answer 22

PCOS

Question 23

ectopic pregancy

Answer 23

failure of pick up of ovum by fimbrae

Question 24

fertilization

Answer 24

upper end of oviduct

Question 25

first step in infertility evaluation

Answer 25

semen analysis

Question 26

implantation

Answer 26

5-7 days after fertilization

at blastocyst stage

Question 27

hCG

Answer 27

from trophoblast cells of fetus

has LH activity

test for pregnancy

rescues corpus luteum

Question 28

peak of hCG

Answer 28

first three months of pregnancy

Question 29

marker of corpus luteum function

Answer 29

17-hydroxyprogesterone

secreted by CL and not placenta

Question 30

relaxin

Answer 30

from CL

Question 31

third month

Answer 31

placenta secretes enough progesterone and estrogen to maintain uterus

not controlled by hCG anymore

Question 32

placental progesterone secretion limited by

Answer 32

cholesterol delivered by LDL to placenta

Question 33

index of placental function and fetal well being

Answer 33

estriol levels

Question 34

estrogen secretion during pregnancy

Answer 34

involves transfer of steroids from fetal adrenal cortex and fetal liver to placenta
-then to maternal circulation

fetal adrenal cortex - secrete DHEA and DHEAS

fetal liver and placenta - convert these to estrogens - enter maternal circulation

Question 35

hPL

Answer 35

from placenta
-aka hCS

during latter half of pregnancy

actions similar to GH

maternal energy more available to fetus

Question 36

second trimester

Answer 36

pregnancy becomes hyperinsulinemic state with peripheral resistance to metabolic effects of insulin

reserves glucose for fetal needs

mother - FA for energy

modest fasting - ketosis

Question 37

maternal compensation to pregnancy

Answer 37

CV/renal
-CO increases with peripheral resistance decrease

no HTN

BP decline first trimester - then rises

GFR increase and renal threshold decrease

glucose in urine

Question 38

endocrine maternal changes during pregnancy

Answer 38

anterior pituitary enlarges

Question 39

postpartum pituitary necrosis

Answer 39

sheehan
-preced by obstetric hemorrhage

failure to lactate

Question 40

relaxin

Answer 40

from ovary

pubic symphysis, cervix, vagina increased distensibility

Question 41

induce contractions

Answer 41

oxytocin

but normal pregnancy - oxytocin not elevated until fetus enters birth canal

so does not initiate rhythmic uterine contractions characteristic of onset of labor

does cause uterus to contract immediately after fetus expelled - to limit blood flow and loss

Question 42

prostaglandins

Answer 42

act locally on myometrium - contraction

increased with oxytocin

Question 43

dead fetus

Answer 43

increased prostaglandins - initiates contractions - miscarriage

Question 44

induce abortion

Answer 44

prostaglandins

Question 45

mammary tissue grwoth

Answer 45

stimulated by estrogen and progesterone

also need PRL, GH, and cortisol

Question 46

milk synthesis

Answer 46

occurs with high PRL

at birth - estrogen drops - withdraws block on milk synthesis

Question 47

to maintain lactation

Answer 47

suckling necessary

afferent to magnocellular nucleus of hypothalamus
-synthesize oxytocin

oxytocin to post pituitary

• causes contraction of myoepithelial cells
• milk ejection

anterior pituitary - PRL - milk synthesis

Question 48

dopamine

Answer 48

prolactin inhibiting factor

this is inhibited by suckling - allowing PRL secretion to increase

Question 49

suckling

Answer 49

inhibits GnRH, FSH, and LH release

follicular growth, estrogen secretion, and menses stop

Question 50

women who doesn’t want to breastfeed

Answer 50

high dose

inhibits lactation

Question 51

contraceptive effect

Answer 51

breast feeding