HD1 Flashcards
The single follicle that reaches full maturity during this process of follicular phase is referred to as theWHAT follicle (the oocyte develops within this)?
The single follicle that reaches full maturity during this process of follicular phase is referred to as the Graafin follicle (the oocyte develops within this)?
label A-C
A: luteal phase
B: follicular phase
C: ovulation
what differnce occurs in the menstrual cycle if fertlisation occurs? [4]
- If an ovum is fertilised it produces hCG which is similar in function to LH.
- hCG prevents degeneration of the corpus luteum (resulting in the continued production of progesterone).
- Continued production of progesterone prevents menstruation.
22. The placenta eventually takes over the role of the corpus luteum (from 8 weeks gestation).
label A-D
A: FSH
B: Estradoil
C: LH
D: Progesterone
what is the inside lining of the uterus called? [1]
what are the two layers of the uterus? [2]
which one is shed during menstruation? [1]
what is the inside lining of the uterus called? [1]
endometrium
what are the two layers of the uterus? [2]
functional layer
basal layer
which one is shed during menstruation? [1]
functional layer (this grows thicker in response to oestrogen and is shed during menstruation)
what are the three stages of the uterine cycle? (simple) [3]
proliferative, secretory and menstrual phases.
what is happenind during the proliferative phase of uterine cycle?
the endometrium is exposed to increasing levels of oestrogen as a result of FSH and LH stimulating its production.
Oestrogen stimulates repair and growth of the functional endometrial layer allowing recovery from the recent menstruation (increasing endometrial thickness, vascularity and the number of secretory glands).
what is happening during the secretory phase of uterine cycle?
The secretory phase begins once ovulation has occurred.
This phase is driven by progesterone produced by the corpus luteum and results in the secretion of various substances by the endometrial glands, making the uterus a more welcoming environment for an embryo to implant.
explain the menstrual phase of menstrual cycle
At the end of the luteal phase, the corpus luteum degenerates (if no implantation occurs).
The loss of the corpus luteum results in decreased progesterone production.
The decreasing levels of progesterone cause the spiral arteries in the functional endometrium to contract.
The loss of blood supply causes the functional endometrium to become ischaemic and necrotic.
As a result, the functional endometrium is shed and exits through the vagina as menstruation.
how does the combined pill work? (which hormones?
oestrogen and progesterone
Inhibits LH and FSH: prevents ovulation
Thickens cervical mucus: natural sperm barrier
Thins endometrium: prevents implantation
the combined pill is a combination of which two hormones? [2]
oestrogen and progesterone
what is the mode of action of progesterone only pill? [3]
Thickens cervical mucus –> natural sperm barrier
Thins endometrium –> prevents implantation
Inhibits ovulation (97% desogestrel, 60% others)
how does emergency contraception work?
Oral
Mode of action: Delay ovulation
Levonelle. Levonorgestrel 1.5mg single dose. Licensed up to 72 hours post-UPSI. Pregnancy rate 0.6 – 2.6%
EllaOne. Ullipristal acetate 30mg single dose. Licensed up to 120 hours post-UPSI. Pregnancy rate 1 – 2%
how does IUD work? [4]
- Inhibits fertilisation by direct toxicity
- Affects implantation by causing endometrial inflammation
- Overall pregnancy rate <0.1%
- Licensed up to 5 days after UPSI / earliest possible ovulation
which type of contraception works by being spermicidal?
IUD
combined pill
progesterone only pill
copper coil
pull out method
which type of contraception works by being spermicidal?
IUD
combined pill
progesterone only pill
copper coil
pull out method
what is natural family planning / rhythm method / fertility awareness MoA? [4]
charting of various indicators of female fertility including:
- Temperature
- Consistency of cervical mucus
- Position of cervix
- Day of cycle
what is MoA of female sterilisation?
Typically, laparoscopic bilateral tubal occlusion with clips/ligation/rings/diathermy
Can be done under local or general anaesthetic
male sterilisation MoA? [1]
Ligation/diathermy/excision of vas deferens bilaterally
how does emergency contraception work with IUD?
The intrauterine device (IUD) is a small, T-shaped plastic and copper device that’s put into your womb (uterus) by a doctor or nurse. It releases copper to stop the egg implanting in your womb or being fertilised.
- Inhibits fertilisation by direct toxicity
- Affects implantation by causing endometrial inflammation
- Overall pregnancy rate <0.1%
- Licensed up to 5 days after UPSI / earliest possible ovulation
the emergency pill causes a big bleed because of an increased level of:
LH
FSH
oestrogen
progesterone
ADH
the emergency pill causes a big bleed because of an increased level of:
LH
FSH
oestrogen
progesterone
ADH
which patient populations would not be advised to have the combined pill? [3]
if already have blood clots [1]
if suffer from migraines [1]
already have high BP [1]
what is the dosing regimen for combined pill? [1]
what is the dosing regimen for pop? [1]
what is the dosing regimen for combined pill? [1]
3 weeks on, 1 week off
what is the dosing regimen for pop? [1]
everyday
explain the mechanism of pregnancy tests working?
Pregnancy testing relies upon the detection of the beta subunit of human chorionic gonadotrophin in the mother’s urine after overnight concentration. The test is usually positive from the first day of the last missed period.
With the advent of monoclonal antibodies, pregnancy tests are now more specific and sensitive
the women must dip the hCG urine stick into a small pot of her urine and allow it to travel up the stick. Free monoclonal antibodies specific to hCG, which is a glycoprotein, are conjugated to an enzyme that changes the colour of a dye22, and a second set of monoclonal antibodies will be immobilised to the dye substrate<strong>2</strong>2. If there is hCG present in the urine, it will interact with both sets of monoclonal antibodies, causing the enzyme that changes the colour of the dye to interact with its substrate and change the colour of the stick. There is also a control due to a third set of monoclonal antibodies, and these bind to any unattached enzyme-linked antibodies.
what can cause false postivies in pregnancy test? [1]
False positive results can occur if pituitary gonadotrophin levels are elevated in the urine, for example, in older women when ovulation is failing and the pituitary excretes more gonadotrophins to stimulate the failing ovary
False negatives can occur if the test is done too early in pregnancy since their is insufficient chorionic gonadotrophin.
