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Hormone in GYN Flashcards

1
Q

Natural GnRH is a _____ peptide

A

Decapeptide

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2
Q

T 1/2 of GnRH

A

3-4 mins

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3
Q

Kallmann syndrome

A

Failure of neuronal migration in olfactory placode.
X- linked recessive
M:F = 6:1
Hypothalamic failure + anosmia +/- Colour blindness in male.
Height of pt is normal

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4
Q

Complaints of Kallmann syndrome

A

Delayed puberty
primary amenorrhea
Infertility

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5
Q

Example of Hypogonadotropic Hypogonadism

A

Kallmann syndrome.

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6
Q

Mutated gene in Kallmann syndrome

A

Kal 1 gene

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7
Q

Neurotransmitter that decrease when hypothalamus is active

A

GABA and neuropeptides

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8
Q

Neurotransmitter that increase when hypothalamus is active

A

LPG - Leptin , Kisspeptin and Glutamate.

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9
Q

Low pulse freq of GnRH produces

A

FSH

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10
Q

HIgh pulse freq of GnRH produces

A

LH

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11
Q

Synthetic GnRH

A

Leuprolide
Triptorelin
Goserelin
Nafarelin

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12
Q

Leuprolide
Triptorelin
Goserelin
Nafarelin

A

Synthetic GnRH

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13
Q

Synthetic GnRH

A

HIgh first pass metabolism - not Given orally

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14
Q

Pulsatile synthetic GnRH is given in

A

Acts like normal GnRH

Delayed puberty and ovulation induction

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15
Q

Continuous synthetic GnRH is given in

A

Dec LH and FSH and in turn reduces Estrogen

Given in Hyperestrogenic conditions

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16
Q

Add back therapy

A

If GnRH is given for more than 6 months - Estrogen levels are very low - so causes menopause like symptoms
So E + P are given to counter it

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17
Q

LH receptors are present on

A

Females - Theca and granulosa cells

males - Leydig cells

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18
Q

FSH receptors are present on

A

Females - Granulosa cells

Males - Sertoli cells

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19
Q

T 1/2 of LH

A

20 mins

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20
Q

T 1/2 of FSH

A

3-4 mins

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21
Q

Receptor type of FSH, LH, GnRH, HCG

A

G protein coupled receptors

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22
Q

Receptor type of Progesterone and Estrogen

A

Nuclear receptor present in cytoplasm.

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23
Q

Synthetic LH and FSH

A

HMG - human menopausal gonadotropin
75 IU of FSH and 75 IU of LH
used for ovulation induction.

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24
Q

S/E of HMG

A

Multifetal pregnancy

OHSS

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25
Natural Estrogen is
C18
26
Natural Progesterone is
C19
27
Synthetic progesterone is
C21
28
Androgens are
C21
29
MC estrogen in reproductive age
E2
30
MC estrogen in Menopause
E1
31
MC estrogen in pregnancy
E2
32
Most specific estrogen in Pregnancy
E3
33
Ratio of E2:E1
2:1
34
Ratio of E2:E1 in PCOS
1:2
35
Potency of natural estrogens
2>1>3>4
36
Least androgenic Effects are seen in which Gen of Progesterone
3rd gen
37
Anti androgenic effects are seen in which gen of progesterone
4th
38
Reason for Androgenic effects of Synthetic progesterone
Both are C21
39
3rd gen Synthetic Progesterone
Desogestrel Norgestimate Gestodene
40
4th gen Synthetic progesterone
Drospirenone | Cyproterone acetate
41
____ binds to SHBG
Estrogen
42
Progesterone does not bind to
SHBG
43
Sources of progesterone
Granulosa cells, Corpus luteum, Placenta
44
Sources of Estrogen
Granulosa and theca cells, Corpus luteum and Placenta
45
SHBG Inc by
Estrogen
46
SHBG dec by
AI PG C | Androgens, Insulin, Progestin, GH, Cortisol
47
Effects of Estrogen
Growth of non pregnant uterus | Proliferates endometrium
48
Effects of Progesterone
Pregnant uterus support Stops proliferation Decidualization - Secretion and support
49
IF Progesterone given for long time -
Endometrial atrophy.
50
Endometrial biopsy in 1st half shows
Short Simple cystic tubular glands.
51
Endometrial biopsy in 2nd half shows
Coiled - corkscrew or sawtooth appearance | filled with secretions.
52
Endometrial biopsy @ ovulation shows
Subnuclear vacuoles
53
Appearance of subnuclear vacuoles indicates
Ovulation
54
1st sign of Ovulation on endometrial biopsy
Appearance of subnuclear vacuoles
55
Cervical Mucus on day 8 appears as
Ferning
56
Spinnbarkeit
Thin, water, copious, elastic appearance of Cervical mucus.
57
Causes for ferning of cervical mucus
Inc Na, Cl, And estrogen
58
Scanty or tacky appearance of cervical mucus is seen in
2nd phase of menstruation.
59
Ferning disappears by
Day 18
60
Estrogen predominates _____ cells in vaginal epithelium
Superficial cells
61
____ cells are predominant under no hormonal stage
Basal or parabasal cells
62
Progesterone predominant cells in vaginal epithelium are
Intermediate cells
63
Sample for hormonal study should be taken from
Lateral wall of vagina - upper 2/3rd
64
Sample for cytological study should be taken from
Posterior wall of vagina
65
Maturation index
Parabasal/basal : Intermediate : superficial cells
66
Maturation index at pregnancy
0:95:5
67
Maturation index at postpartum
100:0:0
68
Maturation index at menopause
100:0:0
69
Maturation index at secretory phase
0:70:30
70
Maturation index at pre-ovulatory phase
0:40:60
71
Karyotypic index aka
cornification index = Number of cornified squamous cells.
72
Cardioprotective hormone
Estrogen
73
OCP are contraindicated in
Thromboembolism, Stroke and CAD
74
Billings method of family planning
looking at cervical mucus thickness to determine ovulation.
75
Appearance of Endometrium on USG in proliferative phase
thin white line
76
Appearance of Endometrium on USG at ovulation
Trilaminar appearance
77
Trilaminar appearance of Endometrium on USG
@ time of ovulation.
78
Appearance of Endometrium on USG in Secretory phase
Thick white endometrium with a posterior enhancement .
79
SERM
Selective estrogen receptor modulator drugs
80
SERM example
Clomiphene citrate, Raloxifene, Tamoxifen, Ormeloxifene.
81
Tamoxifen action on breast
Antagonistic action. | DOC for RX of Estrogen Receptor + Breast cancer
82
DOC for RX of ER + Breast cancer
Tamoxifen
83
Raloxifene action on breast
Antagonistic action. | DOC for Prophylaxis in Estrogen Receptor + Breast cancer.
84
DOC for Prophylaxis in ER + Breast cancer.
Raloxifene
85
Antagonistic action of Tamoxifen is seen in
Breast
86
Antagonistic action of Raloxifene is seen in
Breast and uterine endometrium
87
Raloxifene action on uterine endometrium
Antagonistic action | S/E - hot flushes.
88
SERM are contraindicated in
Thrombosis, stroke, and CAD
89
new combination to treat osteoporosis and hot flashes.
Bazedoxifene and estrogen
90
Estrogen antagonists
Progesterone > continuous gnrh > Danazol > Gestrinone > Letrozole.
91
Letrozole - MOA
aromatase inhibitor.
92
Danazol - C/I
Not to be used in young female- S/E - Hirsutism
93
Smoking inhibits
Aromatase
94
SPRM
Selective progesterone receptor modulator
95
SPRM - Example
Ulipristal
96
ELLA -
Ulipristal - SPRM
97
Progesterone Antagonist
Mifepristone.
98
Uses of Ulipristal
Emergency contraception - Single dose - 30mg | Fibroids.
99
RU486
Mifepristone.
100
Drug used in Mx of Endometriosis
Mifepristone - | Brings about endometrial atrophy.

GYN (19 decks)

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