Intro to women's health

Question 1

vestibular glands

Answer 1

Skene and bartholin glands secretions are responsible for sexually stimulated vaginal lubrication

Question 2

female differentiation dependent on

Answer 2

genetics (46xx), proteins, hormones (estrogens, androgens), ovaries

Question 3

gonad development

Answer 3

early gonadal ridge differentiates into ovaries (influence of germ cells) germ cells migrate to ovaries and differentiate into oocytes

Question 4

paramesonephric duct (mullerian)

Answer 4

contact of bilateral tubules with urogenital sinus causes differentiation ducts. lower ends fuse and become uterus, cervix, upper vagina. upper ends stay separated as fallopian tubes. mesonephric/wollfian regresses in females

Question 5

external genitalia development

Answer 5

urogenital sinus, when contact mullerian ducts develops into lower vagina.

Question 6

menarche

Answer 6

first menstrual cycle, first bleeding average age 12

Question 7

follicular phase of menstrual cycle

Answer 7

begins with onset of menses and ends on the day of LH surge/ovulation. average is 14 days. FSH increases (follicular growth of oocytes, emergence of dominant follicle) estradiol maintains endometrium and starts low, increases near end to critical level

Question 8

ovulation

Answer 8

positive feedback from estradiol causes LH surge which triggers ovulation. oocyte released from ovary. follicle becomes corpus luteum.

Question 9

luteal phase

Answer 9

predominance of progesterone (corpus luteum) estradiol secretion. suppresses FSH and LH from pituitary.

Question 10

fertilization

Answer 10

implanted zygote releases human chorionic gonadotropin (hCG) which sustains corpus luteum until 9-10 weeks gestation (then placenta takes over)

Question 11

no fertilization

Answer 11

corpus luteum involutes after 9-10 days. withdrawal of progesterone results in increase in FSH to begin a new cycle

Question 12

menstruation

Answer 12

first few days of follicular phase. duration 3-7 days. blood and desquamated superficial endometrial tissue. prostaglandins from secretory endometrium produce contractions of uterine vasculature and musculature, endometrial ischemia and uterine cramping. caused by involution of corpus luteum and decrease in progesterone and estrogen

Question 13

oogenesis

Answer 13

increase in FSH stimulates oogenesis. several primary oocytes begin to grow. unequal division produces secondary oocytes. primary follicle develops several layers of granulosa cells around oocyte and becomes secondary follicle. develops into corpus luteum.

Question 14

endometrium

Answer 14

follicular phase=proliferative phase.
rise in estrogen stimulates endometrial cell growth, glands become elongated. ovulation: endometrium at maximum thickness. luteal phase=secretory phase. progesterone converts endometrium into loose and edematous stroma and tortuous blood vessels and glands. menstruation: withdrawal of progesterone, endometrium sloughs off

Question 15

primary vs secondary amenorrhea

Answer 15

primary: no menstruation by age 13 without secondary sexual development. by age 15 with secondary sexual development.
secondary: absence of menstruation for 3-6 months in a menstruating female.

Question 16

metorrhagia

Answer 16

irregular menstrual bleeding, usually between cycles

Question 17

menorrhagia

Answer 17

excessive menstrual bleeding at regular intervals

Question 18

anovulation

Answer 18

failure to ovulate. can cause abnormal uterine bleeding, oligomenorrhea, amenorrhea. constant (noncyclic) estrogen levels stimulate growth of endometrium . irregular bleeding, unpredictable amounts as endometrium outgrows its blood supply and sloughs off.

Question 19

hirsutism

Answer 19

male pattern hair growth caused by excess androgens and treated with OCPs (combination) or antiandrogens.

Question 20

turners syndrome causes

Answer 20

45XO genetics.

Question 21

symptoms of turners syndrome

Answer 21

few ovarian follicles, gonadal dysgenesis, no gonadal sex hormone production, primary amenorrhea, delayed puberty, small stature, webbed neck, coarctation of aorta, poor breast dev, widely spaced nipples, wide carrying of the arms, multiple pigmented nevi, renal anomalies, liver dysfunction, ocular and auditory deficiencies.

Question 22

treatment turners syndrome

Answer 22

growth hormone early to max height. estrogen at puberty to optimize peak bone mass, genital tract maturation, menstruation, breast dev. progestins later to protect endometrium