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Patient > Hormones and reproduction > Flashcards

Hormones and reproduction Flashcards

1
Q

primary response in transcriptional response to steroids, is mediated by

A

oestrogen response elements in gene promotors

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2
Q

secondary transcription factors include….. where?

A

progesterone

in the endometrium

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3
Q

estrogen hormone production is ______ progesterone production?

A

BEFORE

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4
Q

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

A

nothing

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5
Q

what is the corpus luteum?

A

part of the ovary from where ovulation has recently occurred

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6
Q

LH maintains the corpus luteum for how long?

A

a week

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7
Q

after a week the CL _____ respond to LH

A

doesn’t

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8
Q

the decline In oestrogen and progesterone causes?

A

mensturation

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9
Q

physiological features of mensturation?

A

vasoconstriction
tissue hypoxia
connective tissue breakdown
fragmentation

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10
Q

how is blood loss kept local?

A

coagulation factors

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11
Q

what does an continuous supply of exogenous sex steroids prevent?

A

mensturation

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12
Q

what is endometriosis?

A

establishment and growth of endometrial tissue outside the uterus

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13
Q

TF: endometriosis can cause infertility

A

true

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14
Q

how does most cases endometriosis arise?

A 
reflux mensturation (endometrial tissue fragments shed at menses) 
fragments aren't lost at mensturation
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15
Q

what’s other more rarer forms of endometriosis?

A

at remote sites where the tissues couldn’t get to

denovo from progenitor cells in ectopic tissues

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16
Q

why do women get endometriosis?

A

not clear
predisposition
family history is a risk factor

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17
Q

symptoms of endometriosis?

A

pelvic pain

infertility

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18
Q

how can lesions be removed in endometriosis?

A

surgery

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19
Q

treatment of endometriosis?

A

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

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20
Q

where does fertilisation usually occur?

A

upper Fallopian tube

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21
Q

stages of fertilisation

A

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

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22
Q

pre implantation development lasts?

A

6 days

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23
Q

what is the embryonic phase where implantation takes place?

A

blastocyst

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24
Q

how can contraception influence this embryonic development?

A

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

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25
Q

TF: the baby sits in the cavity of the uterus

A

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

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26
Q

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

A

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

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27
Q

when is hCG produced?

A

from the hatched blastocyst stage and onwards

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28
Q

where is hCG produced?

A

the placenta

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29
Q

hCG is the same family as ___

A

LH

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30
Q

Where is hCG detected?

A

in measurable quantities in the blood and urine

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31
Q

what does hCG do?

A

rescues the corpus luteum- so progesterone continues to rise

32
Q

hCG effect on progesterone?

A

INCREASES

33
Q

if implantation occurs too late what happens?

A

the CL will regress and pregnancy fails

34
Q

what does lack of timely appearance of hCG mean?

A

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

35
Q

how does hCG change during pregnancy

A

peaks at about 8 weeks and declines

36
Q

how does progesterone and oestrogen change during pregnancy?

A

increase steadily

37
Q

effects of progesterone?

A

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

38
Q

progesterone ______ uterine lining spring pregnancy.

A

sustains

39
Q

why is progesterone inhibiting myometrial contractility important?

A

important to suppress this muscle contracting- LABOUR

40
Q

TF: CL has a unlimited lifeaspan in pregnancy?

A

FALSE- limited

41
Q

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

A

yes but the placenta is the major source

42
Q

what is the luteoplacental endocrine switch?

A

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

43
Q

when does the luteoplacental endocrine switch occur?

A

7-9 weeks

44
Q

when is a common time of miscarriage?

A

7-9 weeks when the luteoplacental endocrine switch occurs

45
Q

the placenta relies on the ____ for steroids

A

fetus

46
Q

TF: aromatase is present in the placenta

A

true

47
Q

when can ultra sound imaging be done transvaginally?

A

5 weeks post last menstural period

48
Q

when can ultrasound imaging be done transabdominally?

A

6 weeks post last menstural period

49
Q

ways of terminating pregnancy?

A

surgically or medically

50
Q

the law permits terminating pregnancy up to….

A

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

51
Q

mifepristone mechanism of action?

A

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

52
Q

do maternal and feral blood mix?

A

NO

53
Q

What is the disidua?

A

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

54
Q

the placenta is an _____ organ

A

endocrine

55
Q

what does the placenta release?

A

progesterone
oestrogen
hCG
other secretory substances

56
Q

what does human placental lactogen (hPL) do?

A

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

57
Q

how long does gestation (pregnancy) last?

A

38 weeks

58
Q

how many trimesters does gestation consist of?

A

3

59
Q

embryonic stage of development time frame and what occurs?

A

up to 10 weeks

formation of major organs

60
Q

fatal stage of development time frame and what occurs?

A

10-38 weeks

maturation, development and growth

61
Q

what are CAPs

A

contraction associated proteins

62
Q

where is oxytocin released? what is it

A

from the posterior pituitary

peptide hormone

63
Q

oxytocin levels _____ in the last trimester.

A

rise

64
Q

myometrial receptors increase when?

A

around week 36

65
Q

what can oxytocin and progesterone analogues be used for?

A

inducing labour

66
Q

what is given when induction of labour is planned?

A

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

67
Q

how would drugs given in pregnancy reach the foetus?

A

most drugs diffuse across the placenta and enter fatal circulation

68
Q

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

A

weakly basic
lipophilic
unionsed
smaller

69
Q

what can valproate do to a foetus?

A

fetal valporate syndrome: birth defects

lifelong alterations to learning and behaviour

70
Q

what is preterm labour defined as?

A

<37 weeks gestation

71
Q

___% of births are premature

A

5-10%

72
Q

tocolytics prolong pregnancy for how long?

A

only 48 hours

73
Q

e.g. of tocolytic drugs

A

ritodrine
nifedipine
atosiban

74
Q

does ritodrine cross the placenta?

A

yes

75
Q

does nifedipine cross the placenta?

A

no

76
Q

does atosiban cross the placenta?

A

no

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