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#DAY4_OBSTETRICS/GYNECOLOGY > Menstrual Physiology and Amenorrhea > Flashcards

Menstrual Physiology and Amenorrhea Flashcards

1
Q

Which menstrual cycle days is the narrow window of endometrial receptivity to blastocyst implantation?

A

Days 20-24

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2
Q

Which cell secretes small amount of progesterone that cause LH release?

A

Granulosa cells

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3
Q

Inhibin B inhibits what hormone?

A

FSH release

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4
Q

Inhibin B is produced by the

A

Granulosa cells

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5
Q

What cell produces androstenediol?

A

Theca cells

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6
Q

What promotes theca cells to produce androstenedione?

A

LH

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7
Q

Drop in FSH is due to

A

Inhibin B and rise in estradiol

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8
Q

The drop in FSH leads to

A

Failure of other follicles to develop

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9
Q

Primary oocyte is formed when?

A

5th month AOG

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10
Q

The primary oocyte divides and arrested in what stage until the onset of puberty?

A

Prophase

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11
Q

The primary oocyte will complete the 1st meiotic division during

A

The onset of puberty

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12
Q

What does the granulosa cell secrete?

A

Progesterone and inhibin B

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13
Q

What oocyte is formed upon completion of meiosis 1?

A

Secondary oocyte

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14
Q

Release of the first polar body occurs during

A

Ovulation

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15
Q

Secondary oocyte is arrested in what phase until fertilization

A

Metaphase 2

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16
Q

This hormone level rises in parallel to the growth of a dominant follicle

A

Estrogen

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17
Q

Site of FSH receptor expression

A

Granulosa cells

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18
Q

Increase in FSH during what phase stimulates in increase in FSH receptors to convert androstenedione into estradiol

A

Late luteal phase

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19
Q

This hormone induces remodeling of the ovarian extracellular matrix to allow release of the mature oocyte

A

LH

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20
Q

Corpus luteum regresses how many days after ovulation?

A

9-11 days

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21
Q

Secondary rise in estrogen and progesterone peak occurs during what phase

A

Mid luteal phase

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22
Q

The most biologically potent naturally occurring estrogen secreted by the granulosa cells

A

17 B estradiol

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23
Q

What progesterone receptors are involved in subnuclear vacuole formation?

A

PR A

PR B

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24
Q

Phase in the endometrial cycle that consists of striaght to slightly coiled tubular glands that are lined by pseudostratified columnar epithelium

A

Proliferative phase

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25
Which layer is shed and regenerated in the endometrium?
Functionalis layer
26
What day of menses is the woman in when the epithelial surface of the endometrium has been restored
Day 5 of menses
27
This period in the proliferative phase is where there are longer curving glands and numerous mitotic figures
Midproliferative phase
28
Mid proliferative phase corresponds to what days in the menstrual cycle?
Day 8-10
29
In late proliferative phase this layer has more crowded glands and denser stroma
Basalis
30
This phase occurs when there are COILED glands and the endometrium is lined by simple columnar
Early secretory phase
31
This phase has serrated, dilated glands and lined by short columnar cells
Late secretory
32
Dating of the early secretory phase is based on what structure
Glandular epithelium
33
1st signs of ovulation in the early secretory phase
Presence of subnuclear vacuoles and pseudostratification
34
On Day 17, glycogen accumulates in what part of the endometrium?
Basal portion
35
On day 18, the vacuoles move to what portion of the endometrium
Apical
36
Dating of mid to late secretory phase is based on this structure
Endometrial stroma
37
What days in the menstrual cycle is also known as the window of implantation
Days 21-24
38
These are luminal protrusions on the apical cell surface that appears in preparation for blastocyst implantation
Pinopodes
39
Chemotactic activating factor for neutrophils seen in late premenstrual phase endometrium
IL-8
40
Invading leukocytes activate these proteases from the MMP family that produces intense vasoconstriction and endometrial changes the promote endometrial destruction
MMP 1 and 3
41
This hormone(?) substance promotes vasoconstriction, myometrial contractions and up regulation of proinflammatory responses
Prostaglandins
42
This prostaglandin promotes vasoconstriction of the spiral arteries
PGF2- alpha
43
Specialized, highly modified endometrium of pregnancy and is a function of hemochorial placentation
Decidua
44
Blastocyst implantation phase where there is initial contact of blastocyst to uterine wall
Apposition
45
Blastocyst implantation phase where there is increased physical contact of blastocyst to uterine wall
Adhesion
46
Blastocyst implantation phase where there is penetration and invasion of syncitiotrophoblast and cytotrophoblast into the endometrium, 1/3 of myometrium and uterine vasculature
Invasion
47
Decidual layer directly beneath the blastocyst implantation
Decidua basalis
48
Decidual layer that overlies the enlarging blastocyst and initially separates it from the uterine cavity
Decidua capsularis
49
Decidua capsularis is prominent during what month of pregnancy?
2nd
50
Decidua vera is the combination of which layers of the decidua?
Capsularis and parietalis
51
At what AOG is the gestational sac completely filling the uterine cavity
14-16 weeks AOG
52
Decidual later where spiral arteries persists Layer that is responsive to vasoactive agents
Decidua parietalis
53
Layer where spiral arteries are invaded by cytotrophoblasts
Decidua basalis
54
Earliest sign of puberty
Breast budding | Thelarche
55
This hormone affects LH pulsatility and restore menstrual cycle
Leptin
56
Cut off age to investigate if no thelarche yet
13 years old
57
Stage of breast growth where there is breast budding
Stage 2
58
Stage of breast growth where there is enlargement without separation of breast contours
Stage 3
59
Stage of breast growth where there is secondary mound
Stage 4
60
Stage of pubic hair growth where there is labial hair present
Stage 2
61
Stage of pubic hair growth where there is spread over mons pubis
Stage 3
62
Stage of pubic hair growth where there is slight lateral spread
Stage 4
63
Term that describes no menses due to anatomic disorders interfering with the outflow of menses
Cryptomenorrhea
64
Primary amenorrhea occurs when there are no menses by the age of _____ or no menses within how many years of breast development
No menses by 15 years old or 5 years after breast development
65
Secondary amenorrhea occurs when skipped menses are occurring longer than
6-12 months
66
Hypogonadotrophic hypogonadism where there is inadequate GnRH synthesis that leads to anosmia, increased growth in long bones and greater wingspan to height ratio but normal height
Kallmann syndrome
67
What is the first thing to do when a patient comes to you with no breast development?
Measure FSH and LH
68
What is the first thing to do when a patient comes to you with breast development but with no menses?
Ultrasound of uterus
69
This enzyme is deficient so no synthesis of sex steroid develops and the female external genitalia develop
17 alpha hydroxylase or 17,20 desmolase
70
Most common non-PRL secreting neoplasm causing hypoestrogenic amenorrhea
Chromophobe adenoma
71
Non neoplastic pituitary cell destruction due to hypotensive episode during pregnancy
Sheehan
72
Non neoplastic pituitary cell destruction unrelated to pregnancy
Simmonds
73
Menopause before age 40
Premature ovarian failure
74
Disease where there is obliteration of the endometrial cavity leading to intrauterine adhesions or synechiae mosr often due to endometrial curretage
Asherman syndrome
75
Also called stein-leventhal syndrome
PCOS

#DAY4_OBSTETRICS/GYNECOLOGY (22 decks)

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