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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
Q

Which layer is shed and regenerated in the endometrium?

A

Functionalis layer

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26
Q

What day of menses is the woman in when the epithelial surface of the endometrium has been restored

A

Day 5 of menses

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27
Q

This period in the proliferative phase is where there are longer curving glands and numerous mitotic figures

A

Midproliferative phase

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28
Q

Mid proliferative phase corresponds to what days in the menstrual cycle?

A

Day 8-10

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29
Q

In late proliferative phase this layer has more crowded glands and denser stroma

A

Basalis

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30
Q

This phase occurs when there are COILED glands and the endometrium is lined by simple columnar

A

Early secretory phase

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31
Q

This phase has serrated, dilated glands and lined by short columnar cells

A

Late secretory

32
Q

Dating of the early secretory phase is based on what structure

A

Glandular epithelium

33
Q

1st signs of ovulation in the early secretory phase

A

Presence of subnuclear vacuoles and pseudostratification

34
Q

On Day 17, glycogen accumulates in what part of the endometrium?

A

Basal portion

35
Q

On day 18, the vacuoles move to what portion of the endometrium

A

Apical

36
Q

Dating of mid to late secretory phase is based on this structure

A

Endometrial stroma

37
Q

What days in the menstrual cycle is also known as the window of implantation

A

Days 21-24

38
Q

These are luminal protrusions on the apical cell surface that appears in preparation for blastocyst implantation

A

Pinopodes

39
Q

Chemotactic activating factor for neutrophils seen in late premenstrual phase endometrium

A

IL-8

40
Q

Invading leukocytes activate these proteases from the MMP family that produces intense vasoconstriction and endometrial changes the promote endometrial destruction

A

MMP 1 and 3

41
Q

This hormone(?) substance promotes vasoconstriction, myometrial contractions and up regulation of proinflammatory responses

A

Prostaglandins

42
Q

This prostaglandin promotes vasoconstriction of the spiral arteries

A

PGF2- alpha

43
Q

Specialized, highly modified endometrium of pregnancy and is a function of hemochorial placentation

A

Decidua

44
Q

Blastocyst implantation phase where there is initial contact of blastocyst to uterine wall

A

Apposition

45
Q

Blastocyst implantation phase where there is increased physical contact of blastocyst to uterine wall

A

Adhesion

46
Q

Blastocyst implantation phase where there is penetration and invasion of syncitiotrophoblast and cytotrophoblast into the endometrium, 1/3 of myometrium and uterine vasculature

A

Invasion

47
Q

Decidual layer directly beneath the blastocyst implantation

A

Decidua basalis

48
Q

Decidual layer that overlies the enlarging blastocyst and initially separates it from the uterine cavity

A

Decidua capsularis

49
Q

Decidua capsularis is prominent during what month of pregnancy?

A

2nd

50
Q

Decidua vera is the combination of which layers of the decidua?

A

Capsularis and parietalis

51
Q

At what AOG is the gestational sac completely filling the uterine cavity

A

14-16 weeks AOG

52
Q

Decidual later where spiral arteries persists

Layer that is responsive to vasoactive agents

A

Decidua parietalis

53
Q

Layer where spiral arteries are invaded by cytotrophoblasts

A

Decidua basalis

54
Q

Earliest sign of puberty

A

Breast budding

Thelarche

55
Q

This hormone affects LH pulsatility and restore menstrual cycle

A

Leptin

56
Q

Cut off age to investigate if no thelarche yet

A

13 years old

57
Q

Stage of breast growth where there is breast budding

A

Stage 2

58
Q

Stage of breast growth where there is enlargement without separation of breast contours

A

Stage 3

59
Q

Stage of breast growth where there is secondary mound

A

Stage 4

60
Q

Stage of pubic hair growth where there is labial hair present

A

Stage 2

61
Q

Stage of pubic hair growth where there is spread over mons pubis

A

Stage 3

62
Q

Stage of pubic hair growth where there is slight lateral spread

A

Stage 4

63
Q

Term that describes no menses due to anatomic disorders interfering with the outflow of menses

A

Cryptomenorrhea

64
Q

Primary amenorrhea occurs when there are no menses by the age of _____ or no menses within how many years of breast development

A

No menses by 15 years old or 5 years after breast development

65
Q

Secondary amenorrhea occurs when skipped menses are occurring longer than

A

6-12 months

66
Q

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

A

Kallmann syndrome

67
Q

What is the first thing to do when a patient comes to you with no breast development?

A

Measure FSH and LH

68
Q

What is the first thing to do when a patient comes to you with breast development but with no menses?

A

Ultrasound of uterus

69
Q

This enzyme is deficient so no synthesis of sex steroid develops and the female external genitalia develop

A

17 alpha hydroxylase or 17,20 desmolase

70
Q

Most common non-PRL secreting neoplasm causing hypoestrogenic amenorrhea

A

Chromophobe adenoma

71
Q

Non neoplastic pituitary cell destruction due to hypotensive episode during pregnancy

A

Sheehan

72
Q

Non neoplastic pituitary cell destruction unrelated to pregnancy

A

Simmonds

73
Q

Menopause before age 40

A

Premature ovarian failure

74
Q

Disease where there is obliteration of the endometrial cavity leading to intrauterine adhesions or synechiae mosr often due to endometrial curretage

A

Asherman syndrome

75
Q

Also called stein-leventhal syndrome

A

PCOS

#DAY4_OBSTETRICS/GYNECOLOGY (22 decks)

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