Hormones and reproduction

Question 1

primary response in transcriptional response to steroids, is mediated by

Answer 1

oestrogen response elements in gene promotors

Question 2

secondary transcription factors include….. where?

Answer 2

progesterone

in the endometrium

Question 3

estrogen hormone production is ______ progesterone production?

Answer 3

BEFORE

Question 4

effects of progesterone if the cells weren’t first exposed to oestrogen?

Answer 4

nothing

Question 5

what is the corpus luteum?

Answer 5

part of the ovary from where ovulation has recently occurred

Question 6

LH maintains the corpus luteum for how long?

Answer 6

a week

Question 7

after a week the CL _____ respond to LH

Answer 7

doesn’t

Question 8

the decline In oestrogen and progesterone causes?

Answer 8

mensturation

Question 9

physiological features of mensturation?

Answer 9

vasoconstriction
tissue hypoxia
connective tissue breakdown
fragmentation

Question 10

how is blood loss kept local?

Answer 10

coagulation factors

Question 11

what does an continuous supply of exogenous sex steroids prevent?

Answer 11

mensturation

Question 12

what is endometriosis?

Answer 12

establishment and growth of endometrial tissue outside the uterus

Question 13

TF: endometriosis can cause infertility

Answer 13

true

Question 14

how does most cases endometriosis arise?

Answer 14

reflux mensturation (endometrial tissue fragments shed at menses) 
fragments aren't lost at mensturation

Question 15

what’s other more rarer forms of endometriosis?

Answer 15

at remote sites where the tissues couldn’t get to

denovo from progenitor cells in ectopic tissues

Question 16

why do women get endometriosis?

Answer 16

not clear
predisposition
family history is a risk factor

Question 17

symptoms of endometriosis?

Answer 17

pelvic pain

infertility

Question 18

how can lesions be removed in endometriosis?

Answer 18

surgery

Question 19

treatment of endometriosis?

Answer 19

blocking hormonal cycle:
aromatase inhibitor- enzyme which catalysis formation of oestrogens
COC
GnRH modulators

Question 20

where does fertilisation usually occur?

Answer 20

upper Fallopian tube

Question 21

stages of fertilisation

Answer 21

1- sperm binds to zona pellucida
2- contents of the acrosome are released by exocytosis
3- the hydrolytic enzymes release helps he sperm burrow through the zona pellucid, and enables binding and fusion of the sperm with the egg
4- the sperm nucleus enters the egg cytoplasm

Question 22

pre implantation development lasts?

Answer 22

6 days

Question 23

what is the embryonic phase where implantation takes place?

Answer 23

blastocyst

Question 24

how can contraception influence this embryonic development?

Answer 24

stop the embryo developing to the blastocyst phase- they must be at this phase for implantation to take place

Question 25

TF: the baby sits in the cavity of the uterus

Answer 25

F: the embryo buries down into the surface and sits in the uterus tissues

Question 26

if you implant after day 10 (roughly) what will happen.

Answer 26

will probably mensturate due to decline in P and E so you won't get pregnant

Question 27

when is hCG produced?

Answer 27

from the hatched blastocyst stage and onwards

Question 28

where is hCG produced?

Answer 28

the placenta

Question 29

hCG is the same family as ___

Answer 29

LH

Question 30

Where is hCG detected?

Answer 30

in measurable quantities in the blood and urine

Question 31

what does hCG do?

Answer 31

rescues the corpus luteum- so progesterone continues to rise

Question 32

hCG effect on progesterone?

Answer 32

INCREASES

Question 33

if implantation occurs too late what happens?

Answer 33

the CL will regress and pregnancy fails

Question 34

what does lack of timely appearance of hCG mean?

Answer 34

probably accounts for the 'closure' of the receptive period for implantation- has implanted too late so CL regresses and pregnancy fails

Question 35

how does hCG change during pregnancy

Answer 35

peaks at about 8 weeks and declines

Question 36

how does progesterone and oestrogen change during pregnancy?

Answer 36

increase steadily

Question 37

effects of progesterone?

Answer 37

regulates the rate of transport of the egg through the Fallopian tube prepares the uterus to receive the implanting blastocyst sustains uterine lining throughout pregnancy inhibits myometrial contractility

Question 38

progesterone ______ uterine lining spring pregnancy.

Answer 38

sustains

Question 39

why is progesterone inhibiting myometrial contractility important?

Answer 39

important to suppress this muscle contracting- LABOUR

Question 40

TF: CL has a unlimited lifeaspan in pregnancy?

Answer 40

FALSE- limited

Question 41

does the CL produce steroids in pregnancy? is it the major source?

Answer 41

yes but the placenta is the major source

Question 42

what is the luteoplacental endocrine switch?

Answer 42

when the placenta takes over as the dominant production of oestrogen and progesterone

Question 43

when does the luteoplacental endocrine switch occur?

Answer 43

7-9 weeks

Question 44

when is a common time of miscarriage?

Answer 44

7-9 weeks when the luteoplacental endocrine switch occurs

Question 45

the placenta relies on the ____ for steroids

Answer 45

fetus

Question 46

TF: aromatase is present in the placenta

Answer 46

true

Question 47

when can ultra sound imaging be done transvaginally?

Answer 47

5 weeks post last menstural period

Question 48

when can ultrasound imaging be done transabdominally?

Answer 48

6 weeks post last menstural period

Question 49

ways of terminating pregnancy?

Answer 49

surgically or medically

Question 50

the law permits terminating pregnancy up to....

Answer 50

14 weeks, but most are done before the 13th week

Question 51

mifepristone mechanism of action?

Answer 51

abortifacient for the first half of pregnancy- can also be a contraceptive (less common) antagonises the progesterone receptor blocks preparation of the endometrium for pregnancy, counteracts the suppressive effect of progesterone on myometrial contractility

Question 52

do maternal and feral blood mix?

Answer 52

NO

Question 53

What is the disidua?

Answer 53

endometrial that's been exposed to progesterone for a longer period than in the cycle (1 week) uterine lining in pregnancy- sheds at the end

Question 54

the placenta is an _____ organ

Answer 54

endocrine

Question 55

what does the placenta release?

Answer 55

progesterone oestrogen hCG other secretory substances

Question 56

what does human placental lactogen (hPL) do?

Answer 56

modulates intermediary metabolism by changing the level of insulin like growth factor (IGF) in turn this increases glucose and amino acids available to the foetus

Question 57

how long does gestation (pregnancy) last?

Answer 57

38 weeks

Question 58

how many trimesters does gestation consist of?

Answer 58

3

Question 59

embryonic stage of development time frame and what occurs?

Answer 59

up to 10 weeks | formation of major organs

Question 60

fatal stage of development time frame and what occurs?

Answer 60

10-38 weeks | maturation, development and growth

Question 61

what are CAPs

Answer 61

contraction associated proteins

Question 62

where is oxytocin released? what is it

Answer 62

from the posterior pituitary | peptide hormone

Question 63

oxytocin levels _____ in the last trimester.

Answer 63

rise

Question 64

myometrial receptors increase when?

Answer 64

around week 36

Question 65

what can oxytocin and progesterone analogues be used for?

Answer 65

inducing labour

Question 66

what is given when induction of labour is planned?

Answer 66

glucorticoid treatment to mature the fatal lungs- controversial how much to give and how long

Question 67

how would drugs given in pregnancy reach the foetus?

Answer 67

most drugs diffuse across the placenta and enter fatal circulation

Question 68

what types of drugs have more chance of reaching the fetal circulation?

Answer 68

weakly basic lipophilic unionsed smaller

Question 69

what can valproate do to a foetus?

Answer 69

fetal valporate syndrome: birth defects | lifelong alterations to learning and behaviour

Question 70

what is preterm labour defined as?

Answer 70

<37 weeks gestation

Question 71

___% of births are premature

Answer 71

5-10%

Question 72

tocolytics prolong pregnancy for how long?

Answer 72

only 48 hours

Question 73

e.g. of tocolytic drugs

Answer 73

ritodrine nifedipine atosiban

Question 74

does ritodrine cross the placenta?

Answer 74

yes

Question 75

does nifedipine cross the placenta?

Answer 75

no

Question 76

does atosiban cross the placenta?

Answer 76

no