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Physiology II > Pregnancy and Menopause > Flashcards

Pregnancy and Menopause Flashcards

1
Q

What are the five hormones of pregnancy?

A

1) Progesterone
2) Prolactin
3) hCG and 4) hPL
5) Estrogens (E3)

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2
Q

___ is responsible for the preservation of the corpus luteum

A

hCG

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3
Q

The early blastocyst is composed of ____ (gives rise to embryo) and external layer (protects and nurtures the embryo)

A

Blastocyst
a) inner cell mass - embryo
b) trophoblast

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4
Q

What two layers do the trophoblasts further differentiate into?

A

1) Syncitiotrophoblasts
2) Cytotrophoblasts

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5
Q

Which is responsible for the invasion of the endometrium and production of hCG and hPL?

A

Syncitiotrophoblasts

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6
Q

___ is secreted by the syncitiotrophoblasts layer of the blastocyst and enters both the maternal and fetal circulations.

Also thought to be responsible for morning sickness

A

hCG

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7
Q

hCG can be measure in the maternal plasma as early as ___ days after fertilization

A

6 to 8 days

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8
Q

When do hCG levels peak?

A

8th week of gestation
- following this, it decline to low plateau for rest of pregnancy

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9
Q

True or False: hCG belong to family of pituitary glycoproteins that includes: FSH, LH, and TSH

A

True

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10
Q

How does hCG prevent degeneration of corpus luteum?

A

hCG binds to LH receptors on luteal granulosa cells

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11
Q

The corpus luteum survives until the ___ can take over synthesis of estrogen and progesterone (~8th wk of pregnancy)

A

placenta

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12
Q

True or False: hCG is crucial throughout pregnancy for correct development/growth of placenta (favors angiogenesis)

A

True

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13
Q

How is hCG important in males?

A

hCG is important for fetal male reproductive development

  • hCG interacts with LH receptor on Leydig cells of male fetus, promoting testosterone synthesis
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14
Q

What diagnosis would you suspect if hGC was very low?
Very high?

A

Very low
- Ectopic
-Spontaneous abortion

Very high
- Down Syndrome

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15
Q

What is the likely reason that elevated hCG has been linked to some cancers?

A

Blocks apoptosis
Favors invasion
Vascularization

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16
Q

For the first 8 weeks of pregnancy, progesterone is secreted by the ____ (stimulated by hCG). After these 8 weeks, the ___ becomes capable of making progesterone

A

corpus luteum; placenta

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17
Q

The amount of progesterone secreted is proportional to ______ and does NOT provide any indication of ______

A

placental weight; fetal health

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18
Q

Placental progesterone secretion requires ___ from maternal circulation. However, it is still independent of outside regulatory factors (NOT regulated by maternal FSH/LH)

A

cholesterol

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19
Q

The progesterone: estrogen throughout pregnancy is ___ than 1. At the end of pregnancy, this is reversed.

A

Greater than 1

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20
Q

Six effects of progesterone during pregnancy?

A

1) Decrease myomet contractions; increase thick cervical mucus; suppress immune response
2) breast dev
3) more ventilation
4) less prostaglandin made
5) increases appetite
6) reduces deamination of AA (elevates AA for fetal use)

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21
Q

____ will become part of the placenta and will generate the chorionic villi

A

Synchtiotrophoblast

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22
Q

True or False: placenta can make progesterone from its enzymes alone

A

True

23
Q

What is the estrogen of pregnancy?

A

E3

24
Q
A
25
Q

True or False: Progesterone must be higher
than estrogen to maintain pregnancy

A

True

26
Q

True or False: the placenta does not have all the enzymes required for the synthesis of estrogens

A

True

27
Q

Measure of ___ levels in maternal urine gives information on health status of the
fetus

A

estriol

28
Q

Synthesis of estrogens (E3) requires enzymes produced by the ___ and
____ of the fetus.

A

liver; adrenal gland

29
Q

Advantage of having elevated E3 in pregnancy?

A

E3 is as potent as E2 in maintaining utero-placental blood flow, but it is way less likely to stimulate contractility

30
Q

___ is secreted by anterior pituitary and is controlled by two hypothalamic hormones: 1) ___ and 2) _____

A

Prolactin
1)

31
Q

The placenta produces ____

Fetal adrenal gland converts it into ___
(via___)

Fetal liver modifies it to ___
(via ____).

A

pregnenolone
DHEA-S; 17α-hydroxylase

16α-DHEAS-S; 16α-hydroxylase

32
Q

The placenta has the enzymes required for completing synthesis of estrogens.

1) _____
2) _____

A

1) 3β-hydroxylase
2) aromatase

33
Q

True or False: Progesterone stimulates protein synthesis in the liver

A

False - estrogen does (clotting factors, binding proteins)

34
Q

__ secretes prolactin

A

anterior pituitary

35
Q

___ inhibits release of prolactin

_____ favors release of prolactin

A

Dopamine = inhibits prolactin secretion

PRH/TRH = favors prolactin release

36
Q

Normally, secretion of prolactin by AP is continually and robustly suppressed by ___

A

dopamine

37
Q

Prolactin secretion by anterior pituitary is enhanced by ____, leads to hyperplasia of prolactin-secreting cells in the pituitary.

A

estrogen

38
Q

True or False: As estrogen concentration rises during pregnancy, so does plasma prolactin concentration

A

True

39
Q

What two molecule lead to structural breast development and synthesis of enzymes and proteins of milk?

A

1) Prolactin
2) Human placental lactogen (hPL)

40
Q

What are the two primary physiological effects of prolactin?

A

1) structural breast development
2) stimulates synthesis of enzymes involve in milk production

41
Q

What induces post-partum (lactational) amenorrhea?

A

High concentrations of prolactin inhibit GnRH in hypothalamus

42
Q

___ belongs to same family as growth hormone

A

human placental lactogen

43
Q

___ secretion is proportional to placental size and peaks during last month of pregnancy

A

hPL (human placental lactogen)

44
Q

___ inhibits insulin-stimulated glucose uptake in maternal target tissues

A

Prolactin
- in other words: it elevated glucose in mom (can cause gestational diabetes)

45
Q

How does prolactin effect lipolysis and proteolysis in the mom?

A

1) Elevates plasma fatty acids (to be used by mom for fuel)
2) Stimulates proteolysis (amino acids become substrate for fetal growth)

46
Q

During menopause, there is peripheral conversion of ___ into ___

A

androgens into estrogens

47
Q

Why do plasma concentrations of testosterone and androstenedione not decline much after menopause?

A

Stromal cells (non follicular) keep making androgens, under influence of LH

48
Q

In menopause, ___ and ___ are converted to their respective estrogens by aromatase, in which two peripheral tissues?

A

testosterone + androstenedione
- adipose tissues / muscles

49
Q

Main estrogen of menopause?

A

E1

50
Q

The characteristic post-menopausal plasma concentrations of estrone and E2 result from peripheral conversion of ____ and ___ androgens

A

peripheral conversion of ovarian (testosterone and androstenedione)

and

adrenal (androstenedione) androgens

51
Q

4 characterisitcs of post-menopause?

A

1) E1>E2
2) Less E2
3) Elevated FSH/LH; FSH>LH (no longer suppressed by inhibin)
4) Plasma androgen (androstenedione and testosterone) concentrations decline - but remain close to pre-menopause level

52
Q
A
53
Q
A
54
Q
A

Physiology II (23 decks)

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