Hellekant Female Repro

Question 1

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

Answer 1

FSH

Question 2

What is the priordial follicle?

Answer 2

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

Question 3

Cyclic recruitment in the female cycle refers to what?

Answer 3

Antral follicles that are rescued from atresia by FSH

Question 4

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

Answer 4

Development of the follicle, and synthesis of LHR

Question 5

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

Answer 5

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

Question 6

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

Answer 6

The become the corpus luteum

Question 7

What hormones are produced by the corpus luteum?

Answer 7

Estrogen and progesterone

Question 8

During the luteal phase, what hormone is predominant?

Answer 8

Progesterone

Question 9

During the follicular phase, what hormones are predominant?

Answer 9

Estrogen

Question 10

Where is GnRH produced?

Answer 10

Arcuate nucleus of the hypothalamus

Question 11

What type of receptor does GnRH bind?

Answer 11

Gq

Question 12

What hormone is critical for inducing ovulation?

Answer 12

LH

Question 13

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

Answer 13

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

Question 14

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

Answer 14

LH receptor

Question 15

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

Answer 15

Alpha subunit

Question 16

LHR binds what?

Answer 16

LH and hCG

Question 17

What type of receptors are LHR and FSHR?

Answer 17

Gs protein coupled

Question 18

What cell does LH act on in the ovary?

Answer 18

Theca cell

Question 19

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

Answer 19

Progesterone, androstenedione, testosterone (androgens)

Question 20

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

Answer 20

They diffuse across the basement membrane to granulosa cells

Question 21

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

Answer 21

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

Question 22

What cell does FSH act on in the ovary?

Answer 22

Granulosa cell

Question 23

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

Answer 23

Androgens from the theca cell are aromatized to 17 beta estradiol

Question 24

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

Answer 24

ER alpha

Question 25

What effect does estrogen have on the endometrium?

Answer 25

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

Question 26

What effects does progesterone have on the endometrium?

Answer 26

Causes secretion from glads, rather than proliferation

Question 27

What produces hCG in early pregnancy?

Answer 27

The chorion - specifically the syncitotrophoblast

Question 28

What hormones does the placenta produce?

Answer 28

Progesterone, estriol, hPL, and inhibin

Question 29

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

Answer 29

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

Question 30

What hormone is required for the maintenance of pregnancy?

Answer 30

Progesterone

Question 31

When is the greatest likelihood for miscarriage? Why?

Answer 31

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

Question 32

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

Answer 32

Etrogen, glucocorticoids, GH

Question 33

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

Answer 33

Estradiol, glucocorticoids, Progesterone and prolactin, placental lactogen

Question 34

What is Lactogenesis II? What hormones are responsible?

Answer 34

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

Question 35

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

Answer 35

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

Question 36

What causes the degradation of the corpus luteum?

Answer 36

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

Question 37

What can be used to promote folliculogenesis or stimulate follicles?

Answer 37

FSH +/- LH;estrogen antagonists

Question 38

What can be used to induce ovulation?

Answer 38

Human chorionic gonadotropin

Question 39

What can be used to control the timing of ovulation?

Answer 39

GnRH agonists/antagonists

Question 40

What can be used for the treatment of uterine fibroids?

Answer 40

GnRH agonists/antagonists

Question 41

What can be used to maintain pregnancy?

Answer 41

Progestins

Question 42

How is folliculogenesis promoted in women with hypothalamic anovulatory function?

Answer 42

Administer both FSH and LH

Question 43

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

Answer 43

Clomiphene citrate - estrogen antagonist; induces FSH secretion

Question 44

What is clomiphene citrate?

Answer 44

Estrogen antagonist

Question 45

What is menotropin?

Answer 45

(Also called pergonal); FSH and LH activity

Question 46

Wht is urofolitropin?

Answer 46

Also called metrodin; only has FSH activity

Question 47

What are the urinary derived human gonadotropins?

Answer 47

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

Question 48

What are the recombinant human gonadotropins?

Answer 48

Follitropin a and follitropin b; both FSH analogs

Question 49

What is ovarian hyperstimulation syndrome?

Answer 49

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

Question 50

What is clomiphene citrate?

Answer 50

Estrogen antagonist

Question 51

Where does clomiphene act?

Answer 51

Blocks ER signaling in hypothalamus and anterior pituitary

Question 52

What effect does clomiphene have on HPO axis?

Answer 52

Blocks ER signaling, resulting in release of GnRH and gonadotropins

Question 53

What is used to mimic LH surge and induce ovulation?

Answer 53

HCG

Question 54

What is leuprolide?

Answer 54

Synthetic GnRH

Question 55

What is Goserelin?

Answer 55

Synthetic GnRH

Question 56

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

Answer 56

GnRH

Question 57

What are the uses for GnRH agonists?

Answer 57

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

Question 58

What are the GnRH antagonists?

Answer 58

Ganirelix, Cetrorelix

Question 59

When are GnRH antagonists used?

Answer 59

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

Question 60

What is Ganirelix?

Answer 60

GnRH antagonist

Question 61

What is cetrorelix?

Answer 61

GnRH antagonist

Question 62

What is ethinyl estradiol?

Answer 62

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

Question 63

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

Answer 63

Estrogens increase synthesis; androgens decrease synthesis

Question 64

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

Answer 64

17 alpha substitution

Question 65

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

Answer 65

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

Question 66

What is medroxyprogesterone acetate?

Answer 66

C21 progestin

Question 67

What is norethindrone?

Answer 67

Progestin that is a 19 nor testosterones; estrane

Question 68

What is levonorgestrel?

Answer 68

Progestin in 19-nor testosterone class; gonane

Question 69

What is desogestrel?

Answer 69

Progestin in the 19-nor testosterone class; gonane

Question 70

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

Answer 70

Medroxyprogesterone acetate

Question 71

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

Answer 71

Norethindrone

Question 72

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

Answer 72

Levonorgestrel, desogestrel

Question 73

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

Answer 73

Gonanes

Question 74

What is mifepristone?

Answer 74

Progesterone antagonist; but also an analog to 19-nortestosterone

Question 75

What is ulipristal acetate?

Answer 75

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

Question 76

What emergency contraception works up to 5d after intercourse?

Answer 76

Ulipristal acetate

Question 77

What is mifepristone used for?

Answer 77

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

Question 78

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

Answer 78

Mifeprisonte (large dose) and misoprostol (prostaglandin)