Lect 7: Female Repro CASES

Question 1

Menopause
marks the end of a woman’s reproductive cycles

is due to lack of primary ovarian follicles to produce steroids in response to pituitary gonadotrophins

is associated with increased risk of cardiovascular disease and osteoporosis

is associated with hot flashes, night sweats, and vaginal atrophy

Answer 1

all of the above

Question 2

Symptoms of menopause are primarily due to

Answer 2

lack of estrogen production by the ovaries

Question 3

menopause is typically diagnosed by

Answer 3

typically diagnosed by a rise in circulating FSH; 17X increase in FSH production bc of lack of estrogen inhibition

Question 4

HRT (HRT=combination estrogen + progesterone)

Answer 4

reduces the symptoms assoc with menopause; is controversial bc of increased cardiovascular, stroke and breast cancer risk, is bring displaced byt the development or selective estrogen receptor modulators (SERMs) which mimic the effects of estrogen on bone, but not the detrimental effects on uterus and breast

Question 5

Puberty is characterized by:

Answer 5

pulsatile GnRH secretion initially at night and then also during the day.

Question 6

After puberty hypothalamic secretion can be diminished by

Answer 6

significant weight loss, exercise and stress

Question 7

Polycystic ovary syndrome: A diagnosis of hypothalamic amennorhhea is obtained by

Answer 7

increased FSH and LH release after injection of exogenous GnRH

Question 8

In polycystic ovary syndrome

Answer 8

no dominant follicle emerges and ovulation does not occur

Question 9

PCOS is characterized by

Answer 9

by reduced estrogen production by the granulosa cells, reduced progesterone production by granulosa and thecal cells, continued production of androgen by the thecal cells throughout the cycle→acne & male secondary sex characteristics; irregular or completely absent menses.

Question 10

Treatment for PCOS includes

Answer 10

Treatment options for polycyctic ovarian syndrome include: combination birth control pills (estrogen and progesterone) to restore regular menstrual periods; clomiphene to restore ovulation; 5 alpha reductase inhibitors to block conversion of testosterone to dihydrotestosterone; weight loss to control abnormal blood glucose and diminished insulin sensitivity

Question 11

Endometriosis occurs when

Answer 11

tissue from the uterine endometrium spreads to peritoneal cavity, often around the ovaries

Question 12

theory behind endometriosis is

Answer 12

retrograde menstruation

Question 13

Treatment for endometriosis may involve

Answer 13

oral contraceptive therapy to regulate hormonal balance and pelvic pain, OTC pain relievers as needed; surgical removal of ectopic tissue

Question 14

Ectopic pregnancy: many occur

Answer 14

in the fallopian tube which stretches and may spontaneously rupture. The most dangerous region for rupture that places the patient at risk for massive hemorrhage is: the interstitial area which generally ruptures at 12-16 weeks gestation It is the closest to the blood vessels. The bigger it is the most dangerous it is.

Question 15

treatment of endometriosis may include

Answer 15

o Treatment may involve a single dose of methotrexate to inhibit rapidly dividing cells, especially in early cases, Methotrexate series and laproscopy and salpingectomy; they can still get pregnant because they have another tube

Question 16

Characteristics of an ectopic pregnancy often include:

Answer 16

abnormal fetal development

Question 17

Many ectopic pregnancies occur in the fallopian tube, which stretches and may spontaneously rupture. The most dangerous region for rupture that places the patient at risk for massive hemorrhage is:

Answer 17

the interstitial area which generally ruptures at 12-16 weeks gestation