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Endocrinology -- Freedman > Final Exam- Hormones of Reproduction Pt 2 > Flashcards

Final Exam- Hormones of Reproduction Pt 2 Flashcards

1
Q

What converts testosterone into 17beta-estradiol? What cells does this occur in?

What stimulates this enzyme?

A

aromatase (in granulosa cells in ovaries)

FSH

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2
Q

What are the two enzymes the ovaries have that are important?

A
  1. 17beta-hydroxysteroid dehydrogenase

2. Aromatase

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3
Q

What convertes androstenedione to testosterone in the ovaries? What other organs have this enzyme?

A

17beta-hydroxysteroid dehydrogenase

testes

(adrenal lack it)

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4
Q

What is the major ovarian estorgen?

A

17beta-estradiol

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5
Q

What does aromatase do in the ovaries? Can the testes produce this?

A

converts testosterone into 17beta-estradiol

testes produce a little too

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6
Q

What do the Theca cells of the ovaries produce and secrete?

A

progesterone

as well as androstenedione

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7
Q

What does androstenedione produced and secreted by Theca cells do?

A

diffuses from theca cells to granulosa cells –> which in presence of 17Beta hydroxysteroid dehydrogenase is converted into testosterone

which in presence of aromatase is converted to 17beta-estradiol

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8
Q

What stimulates cholesterol desmolase in theca cells in the ovaries?

A

LH

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9
Q

What stimulates aromatase in granulosa cells in the ovaries?

A

FSH

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10
Q

What are the two major functions of the ovaries? What are both of these functions controlled by?

A
  1. oogenesis
  2. synthesis/secretion of female sex hormones

hypothalamic-pituitary axis

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11
Q

Where is GnRH secreted from? What will it stimulate when it is delivered to the Ant. Pit. in high concentrations?

A

from hypothalamus

stimulates pulsatile secretion of FSH/LH which act on the ovaries

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12
Q

What is the effect of FSH/LH on the ovaries?

A
  • follicular development–> leads to ovulation

- synthesize/secretion of progesterone and 17beta-estradiol

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13
Q

How long is the menstrual cycle?

A

28 day cycle

follicular development–> ovulation–> formation and degeneration of corpus luteum

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14
Q

What is the first 14 days of the menstrual cycle called? What is the midpoint of the cycle? What is the last 14 days called?

A

Follicular phase

ovulation

Luteal phase

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15
Q

What occurs during the Follicular phase? What hormone dominates?

A

development of follicle

estrogen (17beta-estradiol)–> gets uterus ready for pregnancy

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16
Q

What occurs during the luteal phase?

A

dominated by corpus luteum

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17
Q

What are the only ovarian cells with FSH receptors? What does FSH stimulate of these cells?

A

Granulosa cells –> FSH stimulates growth of them in primary follicles–> stimulates estradiol synthesis

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18
Q

What supports the trophic effect of FSH on granulosa cells?

A

estradiol

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19
Q

What initiates ovulation?

A

LH

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20
Q

What occurs just prior to ovulation?

A

just prior to ovulation LH rises sharply and causes rupture of the mature follicle (ovulatory surge)

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21
Q

What stimulates the formation of the corpus luteum? What else does this hormone do?

A

LH

maintains progesterone production by the corpus leuteum during the luteal phase

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22
Q

What maintains progesterone production by the corpus leuteum during the luteal phase?

A

LH

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23
Q

During the menstrual cycle, what two levels does feedback occur at?

A
  1. Anterior pituitary

2. Hypothalamus

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24
Q

What hormone is the main product in the Follicular phase?

What is the main hormone in the Luteal phase?

A

17beta-estradiol

Progesterone

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25
Q

During the Follicular phase, what effect will 17beta-estradiol have on the Anterior pituitary and hypothalamus?

A

inhibitory effect (negative feedback)

therefore less FSH/LH secretion

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26
Q

During midcycle of the menstrual cycle, what effect will 17beta-estradiol have on the Anterior pitutitary and hypothalamus?*

A

stimulatory effect (positive feedback)

therefore increase in GnRH release and therefore increase in FSH/LH

= ovulatory surge

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27
Q

During the Luteal Phase, what effect with progesterone have on the anterior pituitary and the hypothalamus?

A

inhibitory effect (negative feedback)

therefore less secretion of FSH/LH

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28
Q

What is required for maintenance of pregnancy?

A

progesterone

keeps uterus “quite” during pregnancy

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29
Q

Which precedes what in the course of the menstrual cycle…estrogen or progesterone?

A

estrogen precedes progesterone

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30
Q

What effect will estrogen have on progesterone receptors in target tissues?

A

it up regulates them

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31
Q

What effect does progesterone have on estrogen receptors in some target tissues?

A

down regulates them

therefore decreases responsiveness to estrogen

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32
Q

In general what is the ratio like b/w estrogen and progesterone?

A

much higher progesterone to estrogen levels (150:1)

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33
Q

When estrogen dominants over progesterone, what is this due to?

A

due to progesterone levels FALLING (not so much due to estrogen levels rising)

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34
Q

What effect does estrogen have on the uterus?

What about progesterone?

A

estrogen–> causes cell proliferation, cell growth, and increase contractility

progesterone–> increase secretory activity and decrease contractability

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35
Q

What effect does estrogen have on the uterine tubes?

What about progesterone?

A

estrogen–> + ciliary activity and contractility (aids movement of sperm towards uterus)

progesterone–> increase secretory activity and decrease contractility

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36
Q

What effect does estrogen have on the cervix?

What about progesterone?

A

estrogen–> causes cervical mucous–> copious, watery, elastic

progesterone–> decreases quantity of cervical mucous and become thick, non elastic

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37
Q

What effect does estrogen have on the vagina?

What about progesterone?

A

estorgen–> + proliferation of epithelial cells

progesterone–> + differentiation but inhibits proliferation of epithelial cells

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38
Q

What is useful as a marker of ovarian reserve and can predict reproductive lifespan for a female?

A

Anti-Mullerian hormone

is a good measure of fertility

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39
Q

What happens to Anti-Mullerian hormone with age?

A

declines with age, as egg supply diminishes

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40
Q

What hormone does development of mammary glands require?

A

estrogen

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41
Q

What does estrogen stimulate in mammary glands?

A
  • growth of lobular ducts
  • enlargement of areola
  • increase amount of adipose tissue
42
Q

What works synergistically with estrogen to stimulate secretory activity in lobular ducts of mammary glands?

A

progesterone

43
Q

What are lobular ducts of mammary glands lined with?

A

milk-secreting epithelium

44
Q

When do the highest levels of estrogen and progesterone occur?

A

during pregnancy

45
Q

When is the period of highest progesterone output by the corpus luteam occur?

A

day 5 after ovulation

46
Q

At what days does the following occurs?1

  1. fertilization
  2. entrance of blastocyte into uterus
  3. implantation
  4. attachment of endometrium
  5. secretion of HCG
  6. HCG rescue of corpus luteum
A
  1. day 1
  2. day 4
  3. day 5
  4. day 6
  5. day 8
  6. day 10
47
Q

What two things does the blastocyst consist of?

A
  1. inner mass of cells–> become fetus

2. outer mass of cells–> trophoblast (contributes to fetal portion of placenta

48
Q

What does the trophoblasts part of the blastocyst do?

A

invades endometirum and attaches and will contribute to the fetal portion of the placenta –> will begin secreting HCG ~ day 8

49
Q

What will take over/ maintain the function of the Corpus Luteaum during pregnancy?

A

HCG; from the trophoblasts (outer rim of cells of the blastocyst) invading endometrium and contributing to fetal part of placenta

50
Q

What would happen to the Corpus Luteum without HCG?

A

it would regresses (day 12) and menses occurs

51
Q

What hormone increases dramatically during the first weeks of pregnancy and is the basis of pregnancy tests? What day is it detectable in the urine?

A

HCG

day 9

52
Q

Describe the fluctuation of HCG in the first trimester of pregnancy? What is its interaction with the Corpus Luteum?

A

increases sharply and peaks ~ wk 9 and then decreases

rescues corpus luteum; and stimulates Corpus luteum to produce Estrogen and Progesterone

53
Q

What does HCG stimulate the Corpus Luteum to produce?

A

Estrogen and progesterone

54
Q

What has happened to HCG during the second and third trimesters of pregnancy?

A

has fallen off

55
Q

What takes over production of steroid hormones during pregnancy?

A

placenta

56
Q

What is the major estrogen during pregnancy? What does its production require?

A

Estriol

cholesterol from mother and both fetal adrenal cortex and fetal liver

(requires mother, placenta, and fetus)

57
Q

What happens to the levels of Estriol during pregnancy?

A

levels rise throughout until parturition

58
Q

What accounts for the steep rise of estriol in maternal blood during last weeks of pregnancy?

A

fetal dehydroepiandrosterone-sulfate (DHEA-5)

59
Q

What does progesterone require during pregnancy to be made? How do the levels change throughout pregnancy?

A

cholesterol from mother (requires mother and placenta only–NOT fetus)

levels rise until parturition

60
Q

What is the precursor for progesterone?

A

pregnenolone (and precursor for that is cholesterol)

61
Q

What is produced by the anterior pituitary throughout pregnancy?

A

Prolactin

62
Q

What hormone stimulates prolactin? How do the levels of prolactin change throughout pregnancy?

A

estrogen

levels gradually and steadily rise

63
Q

What is the hormone of highest concentration during the last half of pregnancy?

A

Prolactin

64
Q

What suppresses lactation during pregnancy? Why does lactation begin at parturition?

A

Estrogen and progesterone suppress lactation

lactation begins at parturition when Estrogen and progesterone levels drop

65
Q

What drives the fetal pituitary-adrenal axis to produce significant amounts of cortisol? Where is this hormone produced?

A

Corticotropic Releasing Hormone (CRH)–> produced by placenta

66
Q

What is an important function to cause maturation of the lungs of the fetus to allow them to produce surfactant?

A

cortisol

67
Q

What hormone from the placenta stimulates the formation of both PGF-2alpha and PGE (prostagladins) during pregnancy?

A

Corticotropic Releasing Hormone (CRH)

68
Q

What week does delivery of the fetus normally occur?

A

week 40

69
Q

What happens to the myometrium and cervix during parturition?

A

myometrium–> forceful coordinated contractions

cervix–> softens and becomes distensible

70
Q

B/w estrogen and progesterone, which becomes dominant during parturition?

A

estrogen becomes dominate due to decreases in progesterone

71
Q

What are 5 important hormones during parturition?

A
  1. Cortisol
  2. Estrogen
  3. Relaxin
  4. Prostaglandins
  5. Oxytocin
72
Q

What will fetal cortisol cause near parturition?

A

increase estrogen/progesterone ration (estrogen dominate due to drop in progesterone)

there increases sensitivity of uterus to contractile stimuli

73
Q

What hormone stimulates the production of PGE-2 and PGF-2alph during parturition?

A

Estrogen (estriol)

74
Q

What is produced by the corpus luteum and relaxes the pubic ligament and softens the cervix?

A

relaxin

75
Q

What hormones cause rupturing of fetal membrane and softening of the uterine cervix and contraction of myometrium?

A

Prostaglandins (both PGF-2alpha and PGE)

76
Q

What stimulates both placental production and fetal production of CRH –> ACTH –> cortisol?

A

Prostaglandins

```
CRH = Corticotropin releasing hormone
(ACTH = Adrenocorticotropic hormone)
~~~

77
Q

What hormone is used clinically to induce labor?

A

oxytocin

78
Q

What stimulates powerful slow and prolonged contractions of the uterine myometrium at the end of pregnancy?

A

Oxytocin

79
Q

T/F. Oxytocin is the physiologic trigger for parturition?

A

FALSE– it is NOT the physiologic trigger for parturition–> levels don’t increase until after labor has begun

80
Q

What is oxytocin secreted in response to?

A

as a neuroendocrine reflex in response to stretching of uterus

81
Q

What protects against hemorrhage after expulsion of the fetus?

A

Oxytocin

82
Q

T/F. no signle even appears to initiate parturition.

A

true

83
Q

What happens to progesterone levels after loss of placenta?

What about its effect prior to parturition?

A

they DO NOT decline

there is a decrease in progesterone effectiveness prior to parturition

84
Q

After delivery of the placenta, all hormone concentrations return to their pre-pregnant levels except which one?

A

prolactin–> which will remain high if mother breast-feeds infant

85
Q

How is lactation maintained?

A

by suckling

86
Q

What does suckling stimulate the secretion of?

A

both oxytocin and prolactin

87
Q

What hormone induces milk “let down”? What hormone stimulates milk production?

A

“let down” = oxytocin

produciton = prolactin

88
Q

What suppresses ovulation after birth? What does this hormone inhibit?

A

prolactin release form continuing lactation by baby suckling breasts

prolactin inhibits GnRH and FSH/LH

89
Q

T/F. Breast feeding is a method of contraception.

A

FALSE–not 100% effective

90
Q

What hormones are Oral Contraceptives the combination of?

A
  1. Estrogen and Progesterone

2. Progesterone alone

91
Q

What will an Oral Contraceptive of a combination of Estrogen and Progesterone cause?

A

Causes:

  • negative feedback on pituitary gland and inhibits FSH/LH
  • cervical mucous to be hostile env. for sperm
  • decrease motility of uterine tubes
92
Q

What will an Oral Contraceptive of Progesterone alone cause?

A

Progesterone alone:

  • effects on cervical mucous
  • altered tubal motility
93
Q

What is the name for the Morning After Pill? (maybe what drug is used) What does it contain a higher dose of?

A

Postcoital

  • higher does of estrogen/progesterone (interferes with implantation)
  • Mifepristone–> antagonist to progesterone receptor–> prevents implantation
94
Q

What does Menopause mean and what age does this occur?

A

cessation of menstrual cycle

age 50

95
Q

What occurs several years prior to menopause?

A

anovulatory cycles are common (Perimenopause)

– decrease number of functioning ovarian follicles

96
Q

What are the signs and symptoms of menopause due to?

A

lack of estrogen

its secretion gardually decreases and eventually ceases

97
Q

What are signs and symptoms of menopause?

A
  • thinning of vaginal epithelium
  • decrease vaginal secretions
  • decrease breast mass
  • increase bone loss
  • vascular instability (“hot flashes”)
  • emotional lability
98
Q

Who tend to be less symptomatic during menopause, obese women or non-obese women? why?

A

obese women—-> due to androgenic precursors and aromatase present in adipose tissue

99
Q

What are benefits of hormone replacement therapy? Is this still routinely recommended for women in menopause?

A
  • relief of menopausal symptoms
  • protection against osteoporosis
  • decrease risk of colorectal cancer

(NOT longer routinely recommended for menopausal symptoms)

100
Q

What are risk factors for hormone replaement therapy?

A

increase risk of:

  • heart disease*
  • breast CA*
  • stroke
  • blood clots
  • abnormal mammograms, false positives
  • = only seen in women taking estrogen along with progestin
101
Q

What is it called when the father experiences physical symptom’s during mates pregnancy?

A

Couvade syndrome “sympathetic pregnancy”

  • may have indigestion, weight gain, constipation/diarrhea, HA
102
Q

Can male hormone levels be affected by their mates pregnancy? If so, how (what increases and what decreases)?

A

yes

  • in last trimester testosterone decrease by 33%, and
  • prolactin increases by 20%

–> prolactin will stimulate connections in brain for paternal behavior and decrease sex drive

Endocrinology -- Freedman (14 decks)

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