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HRM Final Exam > Hellekant Female Repro > Flashcards

Hellekant Female Repro Flashcards

1
Q

Primary oocytes complete meiosis I under the influence of what hormone?

A

FSH

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2
Q

What is the priordial follicle?

A

Primary oocyte surrounded by follicular cells (granulosa and theca cells)

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3
Q

Cyclic recruitment in the female cycle refers to what?

A

Antral follicles that are rescued from atresia by FSH

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4
Q

In the mature hypothalamic pituitary ovarian axis, FSH promotes development and synthesis of what?

A

Development of the follicle, and synthesis of LHR

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5
Q

Why do we get an LH surge, but not FSH surge?

A

Inhibit released from the granulosa cell has a neg feedback on FSH but not LH

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6
Q

After ovulation, what happens to the granulosa and theca cells?

A

The become the corpus luteum

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7
Q

What hormones are produced by the corpus luteum?

A

Estrogen and progesterone

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8
Q

During the luteal phase, what hormone is predominant?

A

Progesterone

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9
Q

During the follicular phase, what hormones are predominant?

A

Estrogen

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10
Q

Where is GnRH produced?

A

Arcuate nucleus of the hypothalamus

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11
Q

What type of receptor does GnRH bind?

A

Gq

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12
Q

What hormone is critical for inducing ovulation?

A

LH

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13
Q

During the first trimester what is secreting progesterone and estrogen? What is maintaining this?

A

Corpus luteum secretes progesterone and estrogen; hCG maintains the corpus luteum

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14
Q

What receptor does hCG stimulate in order to maintain the corpus luteum?

A

LH receptor

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15
Q

What subunit is identical in FSH, LH, TSH, and hCG?

A

Alpha subunit

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16
Q

LHR binds what?

A

LH and hCG

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17
Q

What type of receptors are LHR and FSHR?

A

Gs protein coupled

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18
Q

What cell does LH act on in the ovary?

A

Theca cell

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19
Q

When LH acts on the theca cell, what is produced?

A

Progesterone, androstenedione, testosterone (androgens)

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20
Q

What happens to the androgens made in the theca cell due to LH response?

A

They diffuse across the basement membrane to granulosa cells

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21
Q

What happens to the androgens that diffuse across into the granulosa cells?

A

Under the action of FSH, the are aromatized to 17 beta estradiol

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22
Q

What cell does FSH act on in the ovary?

A

Granulosa cell

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23
Q

When FSH acts on the granulosa cell, what is the response?

A

Androgens from the theca cell are aromatized to 17 beta estradiol

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24
Q

What type of estrogen receptor mediates the HPO axis responses to estrogen?

A

ER alpha

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25
Q

What effect does estrogen have on the endometrium?

A

Thickening and proliferation; glands develop, stromal and vessel growth occurs, uterine lining increases

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26
Q

What effects does progesterone have on the endometrium?

A

Causes secretion from glads, rather than proliferation

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27
Q

What produces hCG in early pregnancy?

A

The chorion - specifically the syncitotrophoblast

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28
Q

What hormones does the placenta produce?

A

Progesterone, estriol, hPL, and inhibin

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29
Q

What are the different types of estrogen produced during pregnancy? Where do they come from?

A

17 beta estradiol from the corpus luteum; estriol from the placenta

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30
Q

What hormone is required for the maintenance of pregnancy?

A

Progesterone

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31
Q

When is the greatest likelihood for miscarriage? Why?

A

End of 1st trimester; when pregnancy transitions from being dependent on ovarian hormones to placental hormones

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32
Q

What hormones are responsible for development of the epithelial ductal tree in breasts?

A

Etrogen, glucocorticoids, GH

33
Q

What hormones are responsible for lobular-alveolar growth in breasts?

A

Estradiol, glucocorticoids, Progesterone and prolactin, placental lactogen

34
Q

What is Lactogenesis II? What hormones are responsible?

A

Post-partum onset of copious milk secretion; comes with fall in progesterone; prolactin dependent

35
Q

What hormone is required for maintenance of lactation? Milk let down? Involution?

A

Prolactin for maintenance; oxytocin for let down; involution due to lack of prolactin

36
Q

What causes the degradation of the corpus luteum?

A

If no pregnancy, prostaglandin F alpha causes corpus luteum to degrade

37
Q

What can be used to promote folliculogenesis or stimulate follicles?

A

FSH +/- LH;estrogen antagonists

38
Q

What can be used to induce ovulation?

A

Human chorionic gonadotropin

39
Q

What can be used to control the timing of ovulation?

A

GnRH agonists/antagonists

40
Q

What can be used for the treatment of uterine fibroids?

A

GnRH agonists/antagonists

41
Q

What can be used to maintain pregnancy?

A

Progestins

42
Q

How is folliculogenesis promoted in women with hypothalamic anovulatory function?

A

Administer both FSH and LH

43
Q

How is folliculogenesis promoted in women with endogenous estrogen activity and normal hypothalamic-pituitary-ovarian function?

A

Clomiphene citrate - estrogen antagonist; induces FSH secretion

44
Q

What is clomiphene citrate?

A

Estrogen antagonist

45
Q

What is menotropin?

A

(Also called pergonal); FSH and LH activity

46
Q

Wht is urofolitropin?

A

Also called metrodin; only has FSH activity

47
Q

What are the urinary derived human gonadotropins?

A

Menotropin (LH and FSH activity) and urofolitropin (FSH activity only)

48
Q

What are the recombinant human gonadotropins?

A

Follitropin a and follitropin b; both FSH analogs

49
Q

What is ovarian hyperstimulation syndrome?

A

Shift of vascular fluids to abdominal and thoracic cavity; due to SE of folliculogenesis stimulation

50
Q

What is clomiphene citrate?

A

Estrogen antagonist

51
Q

Where does clomiphene act?

A

Blocks ER signaling in hypothalamus and anterior pituitary

52
Q

What effect does clomiphene have on HPO axis?

A

Blocks ER signaling, resulting in release of GnRH and gonadotropins

53
Q

What is used to mimic LH surge and induce ovulation?

A

HCG

54
Q

What is leuprolide?

A

Synthetic GnRH

55
Q

What is Goserelin?

A

Synthetic GnRH

56
Q

The drugs that end in -relin are synthetic analogs of what?

A

GnRH

57
Q

What are the uses for GnRH agonists?

A

Shut down HPO axis; reduce symptoms from uterine fibroids; control hormone dependent prostate and breast cancers

58
Q

What are the GnRH antagonists?

A

Ganirelix, Cetrorelix

59
Q

When are GnRH antagonists used?

A

Fertility to prevent endogenous LH surge; prostate and breast cancer; benign uterine disease (fibroids)

60
Q

What is Ganirelix?

A

GnRH antagonist

61
Q

What is cetrorelix?

A

GnRH antagonist

62
Q

What is ethinyl estradiol?

A

Hormonal contraceptive estrogen with addition at C-17 to reduce metabolism and make orally available

63
Q

What effects do estrogen and androgens have on the synthesis of SHBG?

A

Estrogens increase synthesis; androgens decrease synthesis

64
Q

What is added to oral progestins to decrease 1st pass metabolism?

A

17 alpha substitution

65
Q

Progesterone binds to what binding globulin? 19-nor progestins bind to what binding globulin?

A

Progesterone binds cortisol binding globulin; 19-nor progestins bind SHBG

66
Q

What is medroxyprogesterone acetate?

A

C21 progestin

67
Q

What is norethindrone?

A

Progestin that is a 19 nor testosterones; estrane

68
Q

What is levonorgestrel?

A

Progestin in 19-nor testosterone class; gonane

69
Q

What is desogestrel?

A

Progestin in the 19-nor testosterone class; gonane

70
Q

Of the synthetic progestins, which are in hte progestanes class?

A

Medroxyprogesterone acetate

71
Q

In the synthetic progestins, what drugs are in the estranes class?

A

Norethindrone

72
Q

In the synthetic progestins, which drugs are in the gonanes?

A

Levonorgestrel, desogestrel

73
Q

What synthetic progestins are more potent and able to be used at lower doses?

A

Gonanes

74
Q

What is mifepristone?

A

Progesterone antagonist; but also an analog to 19-nortestosterone

75
Q

What is ulipristal acetate?

A

Progesterone antagonist or agonist; not sure how it works, can be used to prevent pregnancy

76
Q

What emergency contraception works up to 5d after intercourse?

A

Ulipristal acetate

77
Q

What is mifepristone used for?

A

Small doses - emergency contraception by preventing/delaying ovulation; larger doses - terminate early pregnancy (< 49 days), used with misoprostol

78
Q

To terminate a pregnancy at < 49 days, what drugs are used?

A

Mifeprisonte (large dose) and misoprostol (prostaglandin)

HRM Final Exam (21 decks)

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