Hormonal control of female reproduction Flashcards
Concerning amenorrhea, select the false statement
A fall in oestrogen levels is associated with amenorrhoea
Raised prolactin is a cause of amenorrhea
The first investigation for secondary amenorrhea is to assess FSH and LH levels.
Secondary amenorrhoea is an absence of menstruation for, usually, 3-6 months in a women who has previously menstruated
Amenorrhoea may be caused by emotional stress
The first investigation for secondary amenorrhea is to assess FSH and LH levels.
Reason: Primary amenorrhoea is the term given to a girl who has not menstruated by 16 years old. The first investigation for secondary amenorrhea is pregnancy (hCG test); hence the third statement was the incorrect one.
Concerning cyclical changes of the endometrium which of the following statements is true.
The endometrium begins to proliferate after ovulation.
The uterine glands secrete a fluid that is rich in glycogen in response to oestrogens
Approximately 30 ml of blood is lost during menstruation
The entire endometrium is shed in menstruation
The spiral arteries become more elaborate and coil during the secretory phase; this enables secretory activity
The spiral arteries become more elaborate and coil during the secretory phase; this enables secretory activity
(Proliferation commences after menstruation under the influence of oestrogen)
A 50 year old woman presents with menorrhagia and fibroids are diagnosed. Which of these statements is correct?
A fibroid is a common, benign tumour also called leiomyoma.
Fibroids form in the endometrium.
They grow mainly in the presence of progesterone.
They can progress into endometrial carcinomas.
They worsen after menopause.
A fibroid is a common, benign tumour also called leiomyoma.
They don’t worsen after menopause- As oestrogen levels fall, they regress and menorrhagia is no longer a problem
Select the correct statement. The granulosa cells of the Graafian follicle
are columnar cells surrounding the oocyte.
are stimulated by LH only.
produce oestradiol.
produce oestrone from testosterone.
produce cholesterol from pregnenolone .
produce oestradiol
granulosa cells are principally stimulated by FSH
Select the false statement concerning the hormonal changes in a normal menstrual cycle.
hCG rises during the luteal phase of the cycle
LH makes the follicular cells yellow after ovulation
LH stimulates the synthesis of progesterone
Low levels of oestrogen inhibit FSH and LH secretion
Oestrogen rise during mid cycle stimulates gonadotrophin release.
hCG rises during the luteal phase of the cycle
Disruption of the hypothalamic – pituitary portal system will lead to
ovulation, followed by raised progesterone levels
enhanced follicular development as a result of increased circulating prolactin
high circulating levels of prolactin, low FSH and LH and ovarian atrophy
excessive androgen production by the ovaries
a reduction in ovarian inhibin followed by increased FSH levels
high circulating levels of prolactin, low FSH and LH and ovarian atrophy
Reason: there will be reduced dopamine (which inhibits prolactin secretion). Also, GNRH will not stimulate FSH and LH and hence ovarian stimulation will not occur.
A 51 year old woman is beginning menopause. Which statement is true?
She is quite late starting the menopause.
If she desires HRT, oestrogen should be given alone.
Taking HRT would lower the risk of fracture of the neck of femur.
HRT is associated with increased risk of cardiovascular disease.
At this stage, her gonadotrophin levels are probably reduced.
Taking HRT would lower the risk of fracture of the neck of femur.
(Gonadotrophin levels are raised at this early stage of menopause due to lack of feedback by oestrogen.Oestrogen of HRT reduces the risk of osteoporosis.)
Select the correct statement concerning oestrogen.
acts via a cell surface receptor on target cells
It is not secreted in the luteal phase
It acts on the posterior pituitary gland to have variable effects on LH and FSH secretion
Decreases Fallopian tube secretions, motility and cilial actions
It is essential for the normal pubertal growth of external female genitalia
It is essential for the normal pubertal growth of external female genitalia
(Feedback is normally negative but becomes positive before ovulation however on the ANTERIOR pituitary. Oestrogen is essential for the normal development of external female)
Increased progesterone during the post-ovulatory period is associated with
endometrial proliferation
enhanced Graafian follicle development
regression of the corpus luteum
basal body temperature rise of 0.5 to1.0°C
increased FSH secretion
basal body temperature rise of 0.5 to1.0°C
(The corpus luteum secretes progesterone; hence, regression would lower progesterone levels. The correct answer is rise in basal body temperature.)
Select the false statement regarding progesterone.
blood levels are low between menstruation and ovulation
raises basal body temperature
is a complex steroid hormone, synthesised in two steps from cholesterol
inhibits uterine secretion
decreases Fallopian tube secretion
inhibits uterine secretion
progesterone, acting on oestrogen primed cells, reduces Fallopian tube secretion
Which statement is correct regarding female puberty?
ovulation occurs at menarche
pubic hair development is the first sign
puberty is dependent upon the maturation of the pituitary
absence of menarche and secondary sexual characteristics can be caused by imperforate hymen.
if puberty occurs early can lead to short stature
if puberty occurs early can lead to short stature- oestrogen causes early fusion of epiphyseal plates.
Select the correct statement.Consider the Leydig (interstitial cells) and Sertoli cells of the testes:
The Leydig and Sertoli cells are separated by a basement membrane forming the blood-testis barrier.
Sertoli cells produce testosterone under the influence of LH.
Testosterone is produced from oestrogen.
Leydig and Sertoli cells have receptors for LH and FSH, respectively.
Leydig and Sertoli cells have receptors for LH and FSH, respectively.
Select the correct statement.The theca interna cells of the Graafian follicle
produce androgens from cholesterol
produce testosterone from oestradiol
produce inhibin
are located deep to the basement membrane of the Graafian follicle
are avascular
produce androgens from cholesterol
(Theca internal cells are superficial; granulosa cells are deep to the basement membrane. The theca interna cells produce androgens from cholesterol.)
