PSIO 469 Exam 2 Flashcards
1
Q
A
2
Q
What is the meaning of Depot and IM?
A
Depot is long acting formulation. IM is intramuscular
3
Q
What is the significance of modifications to A and B rings for synthetic androgens?
A
Modifications to A and B rings can maximize anabolic activity and minimize androgenic activity.
4
Q
what does modifications to Carbon-17 determine?
A
determine if oral or depot delivery
5
Q
Explain how the Myotrophic-Androgenic index is calculated in the Hershberger Bioassay in rats.
A
Myotropic factors were measured by the size of the levator ani muscle. Adrogenic factors were measured by the size of the prostate gland or seminal vesicles. Myotrophic and Androgenic activity is calculated by increase in size with steroid of interest divided by increase in weight with control steroid. Index value is Myotrophic activity divided by androgenic activity.
6
Q
Index value of 1 indicates that the anabolic effects of testosterone cannot be divorced entirely from androgenic effects. True or false
A
True
7
Q
index value greater than 1 means what?
A
Some synthetic steroids present remarkable dissociation. Very good anabolic effects and less androgenic. This is what we want!! Ex: Nandrolone decanoate, Stanozolol.
8
Q
Nandrolone has ____ anabolic effects and ____ androgenic effects compared to testosterone.
A
Enhanced, reduced
9
Q
Nandrolone is inactivated by which enzyme?
A
5alpha-reductase
10
Q
Nandrolone has ___ Androgen Receptor affinity than testosterone. This results in increased anabolic activity relative to androgenic activity.
A
less
11
Q
Elevated levels of ___ at hair follicles contribute to male pattern hair loss. Also known as ____.
A
DHT, Alopecia
12
Q
Increased activity of which enzyme leads to higher levels of DHT, contributing to male pattern baldness.
A
5-alpha reductase enzyme
13
Q
Explain the difference between exogenous and endogenous anabolic androgenic steroids and why they are both banned by the world anti-doping agency (WADA)
A
Exogenous are synthetic derivatives of testosterone while endogenous are naturally occurring hormones in the body such as testosterone and epitestosterone. Both are banned due to unfair advantage for the athletes.
14
Q
Explain the significance of epitestosterone and the T/E ratio.
A
Epitestosterone is an epimer of testosterone which is biologically inactive due to its structure. T/E ratio is used to test the testosterone/epitestosterone ratio in the body of athletes and should be 1:1.
15
Q
why is T/E ratio > 4 an adverse finding?
A
Because the ratio increases with administration of exogenous T.
16
Q
why is exogenous epitestosterone propionate used?
A
It can mask the presence of exogenous testosterone by increasing the levels of epitestosterone leading to an increased T/E ratio.
17
Q
what is “the cream”?
A
It is a transdermal preparation containing testosterone and epitestosterone which can artificially balance/adjust the ratio.
18
Q
what are anabolic steroid prohormones?
A
prohormones are compounds that serve as precursors to anabolic steroids in the body. They can mimic the effects of anabolic steroids. Some dietary supplements may contain anabolic steroid prohormones.
19
Q
what did the Leder and co-workers’ 2000 study indicate about androstenedione?
A
Administration of androstenedione at dose 300mg, led to an increase in T by 34% but an increase in E2 by 128%
20
Q
what is one negative side effect of using Androstenedione?
A
feminizing effects (gynecomastia)
21
Q
In which anatomical compartments do the following take place: Oogenesis, hormone production, fertilization, development and maintenance of fetus?
A
Oogenesis: Ovaries
Hormone Production: Ovaries and adrenal gland
Fertilization: Fallopian tube (ampulla)
Development and Maintenance of fetus: In the uterus
22
Q
which oocytes are produced during fetal development and what phase are they remained in?
A
Primary oocytes and are arrested in Prophase I at birth.
23
Q
when is the first meiotic division completed?
A
Just prior to ovulation
24
Q
In what phase will secondary oocyte remain frozen in?
A
Metaphase II until fertilization
25
what are the three cell types of the ovarian follicle?
Granulosa Cells
Theca Cells
Oocyte
26
During prophase I, primary oocytes contain:
46 chromosomes, each consisting of 2 sister chromatids.
27
___ are germ cells and _____ are somatic cells.
Oocytes are germ cells, theca/granulosa are somatic cells
28
what are the functions of the 3 ovarian cells?
Oocytes--- germ cells within the ovarian follicle, undergo meiosis to form mature eggs for fertilization.
Granulosa cells--- surround the oocyte, provide nutrients and hormonal signals for oocyte maturation, produce estrogen, stimulated by FSH.
Theca cells--- Located outside the granulosa cells, involved in transformation of cholesterole to androgens (steriodogenesis), stimulated by LH.
29
Explain the difference between a pre-antral and antral follicle:
Pre-antral follicles are in the early stages and can be classified as primordial, primary or secondary. They lack an antrum. They are gonadotropin-independent (don't need it for development) Not seen on US.
Antral follicles are more advanced, can be classified as graffian follicle. Have an antrum that forms within the granulosa cell layer. They are gonadotropin dependent for development and maturation. Seen on US.
30
what separates the granulosa cells from theca cells?
basal lamina
31
what is the mucopolysaccharide layer surrounding the plasma membrane of the oocyte?
Zona Pellucida
32
Explain the significance of differences in cellular expression of 17 alpha-hydroxylase and aromatase in the biosynthesis of estradiol.
17alpha-hydroxylase is crucial for the production of DHEA and androstenedione which serve as substrates for aromatase. Aromatase is responsible for conversion of testosterone and androstenedione into estrone and estradiol.
33
Name 3 estrogens naturally synthesized by the body and indicate the major site of production for each:
E1--Estrone: Produced after menopause; adrenal glands, intermediate potency.
E2--Estradiol: Granulosa cells; most potent.
E3-- Estriol: rises in pregnancy; placenta; least potent.
34
__ stimulates production and secretion of androgens from cholesterol precursor by __ cells.
LH, Theca
35
__ stimulates estradiol production and secretion by ___ cells.
FSH, Granulosa
36
Theca cells lack ___ enzyme, therefore they are unable to make estradiol from androgens without the help of granulosa cells.
Aromatase
37
which cell releases inhibin?
Granulosa Cells
38
Granulosa cells lack ___ , therefore they need the help of theca cells.
17-alpha-hydroxylase
39
Granulosa cell are similar to which cells of the male reproductive tract?
Sertoli Cells
40
Oogonia (germ cell) in fetal ovary will undergo _____ by 20 weeks gestation.
Mitotic proliferation
41
By 20 weeks, some oogonia are surrounded by single layer of follicular cells to form ____
primordial follicles.
42
what happens during the recruitment stage?
Beginning at birth the pool of primordial follicles give rise to continuous trickle of developing follicles.
43
What happens to developing follicles and the oocytes within them prior to puberty?
Under go atresia due to not enough hormonal support
44
After puberty, a gonadotropin _____ signal causes a select cohort to initiate growth and development each month.
independent
45
In a 20 year old female how many follicles are in the cohort that is recruited?
10-20 follicles
46
In the development stage we get the formation of which layer?
zona pellucida
47
Antral follicle growth and development is gonadotropin _____.
Dependent
48
___ is secreted by granulosa cells into the antrum.
Estradiol
49
How many antral follicles reach the selection stage of oogenesis?
Only one antral follicle (containing one primary oocyte)
50
what induces expression of LH receptors by granulosa cells?
Elevated Estradiol levels
51
what 3 things break down the wall of the ovary to prepare for ovulation?
-prostaglandins
-collagenases
-proteases
52
what endocrine signal will trigger ovulation?
LH surge
53
Endocrine signal triggering ovulation is LH surge which produces 3 major changes:
1. stimulates follicular prostaglandin production
2.Stimulates differentiation of theca and granulosa cells into luteal cells
3.Reinitiates meiosis of the oocyte
54
Once an oocyte is ovulated what cells will surround it?
Cumulus cells (derived from granulosa cells)
55
At what point is the first meiotic division completed?
Prior to ovulation (1st polar body will be observed)
56
Remnants of ruptured follicle undergo process of ___ to form ____
Lutenization, Corpus Luteum
57
Progesterone (and estradiol) secretion will increase as the size of ____ increases.
Corpus Luteum
58
Fate of Corpus Luteum is determined by the balance of some factors, what are they?
1.Luteolysis (degrades after 14 days in non-pregnant females)
2.Luteotropins (prolong the life of CL)- LH stimulates growth in non-pregnant females, hCG stimulates CL after implantation of embryo in pregnant females
59
Lutenized cells have ____ SCC enzyme activity, ___ 17 alpha hydroxylase activity, and ____ aromatase activity.
Increased, Decreased, Decreased
60
Define atresia:
Degeneration of ovarian follicles that do not fully develop for ovulation. Ensures that a limited number of healthy follicles progress for potential ovulation.
61
what process stimulates follicles to resume development?
Process of recruitment
62
what stimulates the initial recruitment of follicles into the developing cohort?
stimulated by cyclic increases in serum gonadotropins, particulary FSH.
63
What causes the dominant follicle to grow faster than the rest of the cohort?
Due to higher levels of estrogens and inhibin produced
64
what accumulates in the antrum?
Various substances, including proteins that promote antrum formation, growth factors and FSH increase the expression of these proteins, contributing to the development of the antral cavity.
65
what happens to the uterine endometrium as follicular estradiol secretion rises?
Walls of uterine will proliferate and thicken to prepare for fertilization. The endometrium fills with fluids and nutrients to nourish a potential embryo.
66
explain why only about 450 oocytes complete the first meiotic division and very few complete the second meiotic division?
-atresia
-oocytes remain arrested in meiosis I until puberty. Only one primary oocyte per month completes meiosis I, and enters meiosis II to be ovulated. Meiosis II is only completed if the oocyte is successfully fertilized.
67
which cells produce AMH?
Granulosa cells in ovarian follicles
68
Higher AMH level indicate?
Larger supply of eggs in the ovaries
69
Production of AMH is highest in ___ and ____ stages of follicle development.
pre-antral and small antral
70
At menopause, when no eggs are left, AMH levels drop to ____
zero
71
what level of AMH is considered low fertility?
Between 0.8-2
72
what is the normal range of AMH level for fertility?
2-6
73
In ovarian luteal phase, theca-lutein cells will produce ____ while granulosa-lutein cells will produce ____ and _____
Progesterone, Progesterone and estradiol
74
___ stimulates corpus luteum to produce progesterone, which is essential for preparing the endometrium for potential implantation.
LH
75
what regulates ovarian steroidogenesis?
Basal LH and FSH secretion
76
In the follicular phase, rising estradiol levels exert ____ feedback on FSH secretion.
Negative
77
Near the end of the follicular phase, rising estradiol causes a shift to a ____ feedback loop, stimulating anterior pituitary to release more FSH and LH.
Positive
78
FSH stimulates ___ cells to produce enzymes like ____ that convert androgens into estrogens.
Granulosa, aromatase
79
Estradiol exerts negative feedback on gonadotropin secretion by acting on ___ Kisspeptin neruons.
ARC
80
After a women goes through menopause, her LH and FSH levels increase. Why?
She has no more follicles in her ovaries, therefore she will not be making estradiol. Without estradiol inhibiting the hypothalamus to stop making GnRH, LH and FSH, the levels will rise.
81
what is human menopausal gonadotropin (hMG) used for? And what is in it?
It contains FSH and LH derived from postmenopausal women's urine. Used for fertility treatment.
82
___ kisspeptin neurons are implicated in driving LH surge through + feedback loop.
AVPV
83
AVPV is sexually ___ females have ___ times greater kiss1 mRNA-expressing neurons than males.
Dimorphic, 25
84
AVPV rises ___ days before ovulation (end life of graafian follicle)
2
85
Why don't males experience an LH surge?
High testosterone levels exert negative feedback on the HPG axis. Testosterone suppresses the release of LH by acting on the hypothalamus and pituitary gland.
86
Rapid GnRH pulses favor ___ Slower GnRH pulses favor ____
LH, FSH
87
What major changes occur in follicle after LH surge?
- Reinitiates meiotic division of oocyte
-stimulates follicular prostaglandin production
-stimulates differentiation of theca and granulosa cells into theca-lutein and granulosa-lutein cells
88
What are the 3 phases of the ovarian cycle?
Follicular, Ovulatory , Luteal
89
___ stimulates development of antral follicle and estradiol.
FSH
90
On roughly what day will one follicle become dominant?
Day 6
91
Late in the follicular phase which cells will express both LH and FSH receptors?
Granulosa Cells
92
Luteal phase must be ___ days long.
14
93
What happens during the luteal phase?
Corpus luteum forms and then degenerates in non-pregnant women.
94
What are the phases in Uterine cycle:
Menstrual, Proliferative, Secretory
95
What happens during the secretory phase of the uterine cycle:
The endometrium prepares to support a potential pregnancy by thickening and secreting chemicals. This includes progesterone stimulating vascularization, glycogen production, and increased amounts of epithelial cell endoplasmic reticulum and mitochondria.
96
What happens during the proliferative phase of the uterine cycle?
Endometrial cells proliferate the lining of the uterus and it thickens.
97
what hormone signaling causes atresia of smaller follicles?
Suppression of FSH by estradiol and inhibin contributes to atresia.
98
LH surge converts follicle from ___to primarily ___ secreting tissue. Inhibin diminishes ___ surge.
Estradiol, progesterone, FSH
99
what does home ovulation predictor kit detect?
It detects LH in urine. It should be used pripr to expected LH surge. Two lines indicate LH surge.
100
which hormone prepares endometrium for implantation?
Progesterone
101
How many days after ovulation will luteolysis begin if implantation of egg does not occur?
10-11 days
102
Lowered ___ permits rise in LH and FSH
prostaglandins
103
Thinness and Thickness of endometrium is based on ____ and less and more vascularization is based on ____.
Estradiol, progesterone
104
What is billings ovulation method?
Female observes changes in cervical secretions to monitor fertility.
105
__, __ secretions facilitate movement of sperm while ___, ___ secretions do not.
Thin and watery.
Thick and sticky.
106
Early cycle -- the cervical mucus is __ and does not ___. Due to ___ E2 and ___ Progesterone.
sticky, low, low
107
Nearing Ovulation-- the cervical mucus extends a little before breaking. Due to ___ E2 and ___ progesterone.
Rising, low
108
Just before ovulation-- the cervical mucus is ___ and ___ and ___. Due to ___E2 and ___ progesterone.
very thin, watery, stretchable. High E2, low P.
109
After ovulation-- the cervical mucus becomes ___. Due to ___ E2, and ___ progesterone.
thick, low E2, Rising P
110
if observing cervical mucus, when is the ideal time to have intercourse?
when the mucus is very thin and watery (E2 high, P is low)
111
Basal Body temp ___ after ovulation in parallel with ____ secretion by corpus luteum.
Rises, progesterone
112
Basal body temp --- Less progesterone = ____ body temp
lower
113
why is elevated basal body temp an indicator, but not predictor, of ovulation?
Because temp rise occurs after formulation of corpus lutem.
114
Primary source of progesterone is from ___
Ovaries
115
what is amenorrhea:
failure to have menstrual cycles, generally associated with annovulation (failure to ovulate)
116
what is the term for failure to ovulate?
Annovulation
117
What is primary Amenorrhea?
Absence of menses in female who have never menstruated. Ex: Turners syndrome
118
what is secondary Amenorrhea?
Cessation of menses in females who has menstruated previously. Example: breastfeeding, poor nutrition
119
What happens in endometriosis?
cyclic growth of endometrial cells in a location other than the uterus.
120
what is luteal phase defect?
when luteal phase is less than 14 days. Treatment can include exogenous progesterone. Defect can cause infertility due to incomplete implantation.
121
How many sperm are deposited in vagina? How many sperm reach uterine cavity?
250 mil
100, 000
122
how many sperm can arrive at distal end of fallopian tube?
50 or less
123
In which region of fallopian tube does the sperm reach occyte?
Ampulla
124
At which stage of oogenesis is the oocyte ovulated?
secondary oocyte stage.
125
The ___ oocyte is released into the ____ during ____ and remains arrested in Metaphase II of meiosis until fertilization occurs.
secondary, fallopian tube, ovulation
126
Oocyte arrested in metaphase II is viable for ___ hrs after ovulation
24 hrs
127
Sperm are viable for ___ days in female reproductive tract.
2-5 days
128
what is sperm capacitation?
Final maturation of sperm does not occur until it is inside the female reproductive tract. Capacitation allows them to undergo acrosomal reaction and fertilize the egg.
129
what is ZP3?
ZP3 is a glycoprotein in zona pellucida that plays a crucial role in sperm-egg binding.
130
put the following in order: fusion of sperm and oocyte membrane, acrosomal reaction, completion of MII, cortical reaction
1.Acrosomal reaction
2.Fusion of sperm and oocyte membrane
3.Corticol reaction
4.Completion of MII.
131
what are the different stages after fertilization takes place?
Zygote---Two cell Stage---Four cell stage---Eight cell Stage--- Morula
132
how many hours post fertilization is 8-cell stage?
49 hrs
133
how many days post fertilization does Morula form?
3-4 days
134
What structure surrounds blastocyst?
zona pellucida
135
what part of blastocyst gives rise to fetus?
Inner cell mass
136
what structure of blastocyst gives rise to placenta?
Trophoblast
137
why is hatching important?
crucial process where the blastocyst breaks out of the zona pellucida to facilitate implantation into the endometrium.
138
What is the first step in implantation and when does it happen?
Implantation begins roughly 6 days after ovulation. Embryo hatches out of the degenerating zona pellucida. Trophoblast contact endometrium and release proteolytic enzymes.
139
what is the second step in implantation?
Some trophoblast fuse and penetrate into the endometrium to form syncytiotrophoblast (multinuclei)
140
What is the third step in implantation?
Layer of endometrium completely surrounds developing fetus by 12 days post-fertilization.
141
What is the Decidua?
Highly vascularized, maternally-derived endometrium of pregnancy.
142
Placenta is derived from both ___ and ____.
Embryonic syncytiotrophoblast and maternal (decidual) tissue.
143
what is the function of the Yolk Sac?
It functions as early extra-embryonic circulatory system before internal circulatory system forms.
144
what are the 3 embryonic germ layers?
Endoderm, Mesoderm, Ectoderm
145
What structure forms within the inner mass and gives rise to the amnion?
Amniotic Cavity
146
The inner cell mass differentiates into ____ which contains cells that will develop into the embryo itself
embryonic disc
147
what does the connecting stalk connect?
Connects the embryonic disc to the trophoblast, facilitating communication between the developing embryo and the placenta.
148
what organs are formed from endoderm?
lining of respiratory tube (including lungs), digestive tube (including liver, gall bladder, pancreas)
149
what organs are formed from mesoderm?
muscles, skeleton, circulatory system, kidneys
150
what organs are formed from the ectoderm?
nervous system, outer layer of skin, hair, nails, tooth enamel
151
what features are derived from inner cell mass?
embryonic disc, amnion, connecting stalk, yolk sac
152
what is the chorion derived from?
Trophoblast
153
what does the chorion separate?
maternal blood from fetal blood
154
___ becomes umbilical cord (connect embryo to chorion)
Connecting stalk
155
which two embryonic features eventually fuse?
Chorion eventually fuses with amnion
156
Roughly how many weeks post-fertilization do we get the fusion of amnion and chorion?
6-7 weeks
157
distinguish between an embryo and a fetus?
1-8 weeks post fertilization is called embryo. 8 weeks and after post-fertilization is considered a fetus.
158
Blood enters the placenta and exchanges oxygen and nutrients with fetal blood through ____
chorionic villi
159
Deoxygenated blood from the fetus is carried to the ____ through the ____
placenta, umbilical arteries
160
Oxygenated blood returns to the fetus via the ____, providing essential nutrients for fetal development.
Umbilical vein
161
what two procedures are done to detect genetic disorders before birth?
-Chorionic Villus sampling (CVS)
-Amniocentesis
162
what is the function of the placenta?
serves as an interface between maternal and fetal circulatory system.
163
Molecules larger at ___ molecular weight cannot diffuse across chorionic villi into fetal blood vessels.
500
164
what is the MW of oxygen, CO2 , Glucose, and amino acids?
32, 44, 180, 75-204
165
which hormone although large in MW can still cross the placenta?
T4 (777 MW) because it is hydrophobic
166
Alcohol and drugs may cross the placenta. Why?
Alcohols MW is 46 and cocaine for example is 303, both are less than 500 MW therefore they can cross the placenta.
167
what are the two protein hormones of endocrine gland?
hCG- human chorionic gonadotropin
CRH- Corticotropin releasing hormone
168
where is hCG produced?
Synthesized by syncytiotrophoblast cells
169
structure of hCG is similar to which other hormones?
LH - Glycoprotein family
170
function of hCG during pregnancy?
Maintains corpus luteum to produce progesterone, signals implantation of embryo, prevents luteolysis.
171
where is CRH produced?
Placenta and hypothalamusw
172
what is the function of CRH in pregnancy?
-suppresses the mother's immune system to prevent rejection of fetus.
-improves blood flow between placenta and fetus
173
when is hCG detectable?
6 days after implantation, peaks at 9-12 weeks
174
why can hCG be used clinically?
it can mimic LH surge in infertile women and induce ovulation.
175
describe the role of progesterone leading up to pregnancy and during pregnancy?
Progesterone rises post ovulation. Initially produced by corpus luteum in ovaries, but later primarily by placenta.
Inhibits uterine contractility (prevent premature labor)
promotes formation of mucus plug (keep foreign chemicals/bacteria out of vagina/cervix)
176
At home pregnancy test can detect up to ___ (units) of hCG
50 IU/ml
177
By about ___ weeks gestation, placental steroidogenesis is sufficient to support pregnancy (corpus luteum to placenta shift)
10-12 weeks
178
for those with luteal phase defect, at what point can they discontinue progesterone supplementation?
10-12 weeks because the placenta can now take over and produce its own progesterone
179
what is the role of estrogen in pregnancy?
-stimulates myometrial growth (increase in size of uterus)
-stimulates gap junction and oxytocin receptors in myometrium ( change responsiveness of uterus for end of pregnancy)
180
Mother cannot make ___ and ___ after demise of corpus luteum. Instead, progesterone is synthesized by ____ and estrogen is synthesized by ____ unti.
progesterone and estrogen. Placenta, feto-placental unit
181
what is the function of sulfation in feto-placental unit?
Sulfation or sulfatase weakens biological activity of androgens. Ex: if fetus will be a female, this will prevent masculinization.
182
which enzyme adds 3rd OH group on estrogen?
16 alpha hydroxylase
183
what is an indicator or a risk factor for premature labor?
elevated levels of placental CRH
184
which hormone plays a role in regulating "placental clock"
CRH
185
what is the term for process of labor and delivery?
Parturition
186
Name the 3 stages of laber?
1.Uterine awakening
2.Active labor
3.Delivery of placenta and uterine involution
187
what is the name of the process that results in the uterus to shrink to pre-pregnancy size?
Uterine involution
188
During the process of uterine awakening, fetal ___ Cortex stimulates an increased in ____ and _____.
adrenal, cortisol and DHEA
189
During the process of uterine awakening, increase in cortisol will cause an increase in pulmonary ___ activation.
Surfactant
190
During the process of uterine awakening, an increase in DHEA causes an increase in all 3 estrogens, which leads to an increase in ____ , ____and ____.
Gap junctions between myometrial cells, oxytocin receptors in myometrium, prostaglandin.
191
Delivery can be induced by what?
Pitocin a synthetic oxytocin
192
Uterine involution takes ____ weeks and is stimulated by rapid decline in ____ and ____.
4-6 weeks, estrogen, progesterone.
193
Uterine involution is facilitated by ___ release in lactating mothers.
oxytocin
194
What is the role of estradiol and progesterone in combination birth control?
Progesterone stimulates thicky and sticky / "hostile" environment which is not good for the sperm. Estrogen helps prevent ovulation and provides better cycle control.
195
Progestogens include natural (___) and synthetic (___) compounds.
Progesterone, progestins
196
How does progestogen effect the cervical mucus?
It decreases the volume and increases the viscosity (stickiness)
197
How does progestogen effect GnRH, FH, and FSH?
Progestogen decrease pulse frequency of GnRH to the point where there can be a decline in both LH and FSH. Decreased FSH inhibits antral follicle development, decreased LH may prevent LH surge and ovulation.
198
what are disadvantages of progestogens?
It can slow the rate of ovum/zygote transport in oviduct by reducing the number of ciliated cells lining oviduct or by reducing the intensity and frequency of cilia action. This may lead to an increase rate of ectopic pregnancy.
199
what is the meaning of ectopic pregnancy?
When embryo implants in a location other than the uterus (often in oviduct)
200
what are advantages of adding estrogen to progesterone in birth control?
inhibits follicular development and helps prevent ovulation. Combination of both leads to better suppression of FSH and LH.
201
what are disadvantages of estrogen in birth control packs?
increases water retention (breast tenderness, bloating), and increases risk of venous thromboembolism (blood clot within an intact vein)
202
what does cycle control mean?
whether female has "intended bleeding pattern" while on hormonal contraception
203
Distinguish between menstrual period, withdrawal bleeding and breakthrough bleeding:
Menstrual period = Endometrium sees estradiol for 14 days before progesterone exposure
Withdrawal bleeding = Results from drop in hormone levels when hormones are stoped, which causes uterine lining to weaken just enough to allow for some bleeding to occur.
Breakthrough bleeding: Bleeding while taking hormone pills (week 1-3).
204
which estrogen is in all combined birth control pills?
Ethinyl estradiol
205
what are 3 combination contraceptives?
-pills
-Nuvaring
-Transdermal patch
206
what are some progesterone-only contraceptives?
-progesterone only pill
-Depo-provera injection
-Nexplanon implant
-Hormonal IUD
207
why do birth control pills need to be taken every 24 hrs?
progesterone and estrogen both have low half-lifes. By hour 24 the concentration in the body is almost zero.
208
what is the difference between hormonal and copper IUDs?
copper has no hormone. Hormonal has levonorgestrel which is a progestogen. Copper ion is toxic to sperm and embryo. Hormonal IUD suppresses gonadotropin secretion (FSH and LH) but doesn't always prevent ovulation.
209
Copper does not interfere with _____ and ____.
follicular development and ovulation
210
Copper IUD produces ____, low-grade ____ response.
local, inflammatory
211
what is the lifespan of copper IUD and hormonal IUD?
copper is 10 years, hormonal is 3-7 years.
212
what are some arguments against monthly menstruation?
-painful
-contributes to anemia, endometriosis
-expensive
-reduce productivity in workplace
213
what are some monthly menstruation differences between prehistoric and modern female?
Modern female have 450 ovulations per life time, prehistoric had 160. Modern female age at menache is 12.5, prehistoric was 16. Number of live breaths for modern female is 2-3, for prehistoric was 6.
214
what are some arguments in favor of monthly menstruation?
-natural
-its not a sickness that needs to be corrected medically
-shedding of endometrium may prevent against cancer
215
Why dont artificial "periods" associated with hormonal contraceptives protect against endometrial cancer?
even with true menstrual bleeding, only the top layer of endometrium is shed, no the basal layer where cancer starts.
216
what does the word emergency emphasize in emergency contraception pills?
emphasizes that treatment is not intended to be used as ongoing method of contraception. (not very reliable, and can be expensive)
217
____ regimen, combined estrogen and progesterone and was associated with nausea and vomiting.
Yuzpe
218
what is the difference between Plan B, and Plan B One-step?
Plan B is 2 0.75 mg doses taken 12 hours apart, while Plan B One-Step is one 1.5mg dose.
219
how effective is Levonorgestrel EC and at what timing?
95% effective if taken within 24 hrs of unprotected sex. 61% effective if taken between 48-72 hours after unprotected sex.
220
The Noe study wanted to see the benefit of LNG-EC benefit in relative to two factors what were they?
1.relative to ovulation
2.relative to unprotected sexual intercourse
221
which blood hormone assays can be used to determine day of ovulation?
LH, Estradiol, Progesterone
222
what does a transvaginal ultrasound show?
endometrial appearance and follicle dimensions.
223
How did Noe and co-worker use probability of conception data from wilcox-cowrokers to estimate the number of females who were at risk of pregnancy in LNG-ECP?
they used the data for probability of clinical pregnancy and cycle days of intercourse.
224
Explain how Noe and co-workers (2011) used the observed number of pregnancies to
draw conclusions about mechanism of LNG-ECP action.
They looked at the number of pregnancies expected and compared to pregnancies observed. Concluded that no pregnancies were seen among those who took LNG-EC prior to ovulation but saw 8 pregnancies among those who took LNG-EC after ovulation.
225
what is the mechanism of action of levonorgesterol EC?
it can prevent follicle maturation and or ovulation if taken at least one day prior to ovulation by supressing LH and FSH. Data do not support role in post-fertilization events.
226
what is the mechanism of action of IUD as contraception?
hormonal IUD may be as effective as copper IUD for emergency contraception. In mid to late follicular phase it may immobilize sperm in luteal phase in can create inflammatory reaction in endometrium and copper is embryotoxic.
