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Finals > REB Endocrine 2 > Flashcards

REB Endocrine 2 Flashcards

1
Q

What main gonadal hormones are produced by males

A

DHT and testosterone

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2
Q

What main gonadal hormones are produced by females

A

Estrogen and progesterone

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3
Q

There are several types of Estrogens produced by woman. What is the primary oestrogen in woman

A

estradiol

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4
Q

GNRH is released from the hypothalamus through

A

Pulsatile secretions

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5
Q

GNRH causes the release of what is hormones from the anterior pituitary?

A

Gonadotropins FSH and LH

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6
Q

Where does FSH go after being released by the anterior pituitary and what does it stimulate? (female)

A

Ovary
Estrogen production
Follicular development

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7
Q

When is LH released? (female)

A

After ovulation

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8
Q

What is the function of LH (female)

A

causes the secretion of progesterone and oestrogen production from the corpus luteum
maintains structure and secretory function of corpus luteum

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9
Q

high frequency pulse of GnRH causes the release of

A

FSH

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10
Q

low frequency pulse of GnRH causes the release of

A

LH

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11
Q

what is the function of progesterone?

A

converts endometrium to it’s secretory stage, prepares uterus for implantation

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12
Q

what cells secrete inhibin? where are these cells located?

A

granulosa cells

ovary

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13
Q

what does inhibin inhibit?

A

FSH secretion

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14
Q

what are the stages of the menstrual cycle?

A
  1. menses
  2. follicular phase
  3. ovulation
  4. luteal phase
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15
Q

what is menses

A

shedding of endometrium

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16
Q

important events of follicular phase

A

ovum maturation
endometrium proliferation (thickening)
increased estrogen levels

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17
Q

during the ovulation phase, there is a surge of

A

LH

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18
Q

the surge of LH during the ovulatory phase causes

A

rupture of follicle and small surge in FSH

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19
Q

in the luteal phase, there is an increase in

A

progesterone secretion

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20
Q

the increase of progesterone secretion in the luteal phase causes inhibition of release of

A

gonadotropins (by negative feedback)

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21
Q

what happens if there is no implantation in the luteal phase

A

progestesterone secretion stops

induces menses

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22
Q

what happens if there is implantation in the luteal phase

A

corpus luteum persists and continues to secrete progesterone
maintains pregnancy

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23
Q

what are the changes of body temperature observed after ovulation? what is the importance of this?

A

increased by 0.3°C

increases the chance of conceiving

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24
Q

FSH has a positive relationship with ___

LH has a positive relationship with ___

A

estrogen

progesterone

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25
Q

when do inhibin levels peak

A

after ovulation

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26
Q

what is the relationship between inhibin and estrogen levels

A

inversely proportional

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27
Q

what hormone aids in the development and maintenance of sex characteristics in females

A

estrogen

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28
Q

what are some common sex characteristics of females

A 
breasts
body hair 
sweat glands
thigh muscles behind femur 
low hip-waist ratio 
more fat around butt, thigh, hips
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29
Q

what hormone controls ovarian and uterine cycles

A

estrogen

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30
Q

what hormone stimulates linear bone growth (puberty)

A

estrogen

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31
Q

what are the types of estrogens produced and in what quantity (%). in what stage of a female’s life is each type released

A

estrone - (E1) - 10% - menopause
estradiol - E2 - 80% - NORMAL
estriol - E3 - 10% - during pregnancy

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32
Q

estradiol regulates what phase of the menstrual cycle

A

follicular phase

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33
Q

estradiol is regulated by what hormone

A

FSH

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34
Q

other than ovaries, where is estrogen produced

A

adipose tissue

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35
Q

adipose tissue estrogen through what type of reaction. what enzyme catalyses this reaction?

A

aromatization

aromatase - CYP19a1

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36
Q

what type of estrogen is made in adipose tissue

A

estrone - E1

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37
Q

estrone is made from what hormone

A

androstenedione

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38
Q

what type of estrogen is made in ovaries

A

estradiol - E2

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39
Q

estradiol is made from what hormone

A

testosterone

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40
Q

what is the purpose of aromatase inhibitors

A

used to prevent estrogen from forming cancers in post-menopausal women

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41
Q

how does estrogen aid in fertility control

A

ovum maturation and development

the timing of the follicular phase is controlled by E2

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42
Q

how does estrogen aid in the preparation of the uterine wall

A

proliferation of the endometrial lining and induction of progesterone receptors to allow for progesterone sensitivity in the luteal phase

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43
Q

how does estrogen inhibit FSH release

A

by negative feedback on the ant pit

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44
Q

what is the metabolic action of estrogen

A

similar to mineralocorticoids

retention of Na+ and water

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45
Q

what is the action of estrogen on lipids

A

increases HDL in plasma

decreasing LDL and cholesterol concentration

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46
Q

estrogen increases blood coagulability by

A

increase in the number of clotting factors

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47
Q

what is the effect of estrogen on bone, skin and blood vessels

A

maintains bone density and elasticity of skin and blood vessels

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48
Q

progesterone is secreted by the ____ during the cycle and by ____ during pregnancy

A

corpus luteum

placenta

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49
Q

what is the function of progesterone

A

supports gestation and embryogenesis

maturation of the endometrium

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50
Q

gonadotropins are produced and secreted by

A

gonadotropes in the ant pit

or by the chorion and placenta during pregnancy

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51
Q

what are the gonadotropins produced

A

FSH
LH
HCG

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52
Q

what type of hormones are gonadotropins

A

glycoprotein

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53
Q

what subunits are in gonadotropins and what is their significance

A

alpha and beta
alpha is common
beta is different
LH and HCG have similar beta –> same target tissue –> same response (increase progesterone)

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54
Q

why can LH and HCG act on the same target tissue

A

similar B group

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55
Q

LH and HCG both increase the secretion of what hormone

A

progesterone

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56
Q

what controls the secretion of FSH and LH

A

GnRH and GnIH

negative feedback form androgens and estrogens

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57
Q

describe the pulses of GnRH in males and females

A

females - low f - FSH
high f - LH
male - constant pulses

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58
Q

describe GnRH activity in children

A

very low and is activated at puberty

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59
Q

what ant pit hormones do both males and females produce

A

FSH

LH –> ICSH

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60
Q

what is the function of FSH in males

A

targets sertoli cells to promote spermatogenesis

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61
Q

what is the function of ICSH or LH in males

A

causes secretion of testosterone and other androgens

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62
Q

testosterone is the precursor of

A

DHT

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63
Q

testosterone has negative feedback to the

A

AP and Hypothalamus

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64
Q

what is the result of too much testosterone

A

infertility

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65
Q

what is testosterone produced by

what hormone stimulates its release

A

interstitial cells

ICSH

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66
Q

interstitial cells convert testosterone to

what enzyme is used

A

DHT

5 alpha reductase

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67
Q

DHT is present at ___ the concentration of testosterone in plasma

A

1/10th

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68
Q

androstenedione is produced by the

A

adrenal cortex

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69
Q

the adrenal cortex produces androstenedione

what else does it produce

A

DHEA

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70
Q

what hormones are formed from testosterone and in what amounts (%)

A

DHEA (10%)
estradiol (0.3%)
Inactive metabolites (90%)

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71
Q

is androstenedione less potent than testosterone?

A

YUP

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72
Q

what hormone is a major source of androgens in females?

A

androstenedione

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73
Q

what are the common secondary sexual characteristics in males

A 
muscles in thigh at front of femur 
shoulder wider than hips 
heavier skull and bones 
higher waist-hip ratio 
enlargement of larynx for deeper voice
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74
Q

what is the result of a 5 alpha reductase deficiency

A

no synthesis of DHT

  • -> boys born with ambiguous external genitalia but will have normal ducts and internal structures
  • things still develop normally at puberty
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75
Q

what is the importance of DHT in males

A

formation of male external genitalia during embryogenesis

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76
Q

CAH is a deficiency in

A

21OH and 11B-OH

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77
Q

what is the result of CAH

A

increased androgen production

  • electrolyte imbalance
  • salty urine
  • early puberty in boys, ambiguous genitalia in girls
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78
Q

explain how hormones aid in the maintenance of the endometrial lining in pregnancy (start from the beginning of the cycle)

A

FSH –> estrogen –> estrogen burst –> increased LH –> ovulation –> corpus luteum –> estrogen and progesterone

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79
Q

after ovulation, the ovum is picked up by the ______ and enters the ______

A

fimbriae of fallopian tube

oviduct

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80
Q

where does fertilisation of the ovum occur

A

ampulla in the upper 1/3 of it

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81
Q

how long after ovulation can fertilisation occur?

A

24 hours

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82
Q

how long does sperm last in a female

A

48 hrs-5 days

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83
Q

how much sperm (%) gets to the uterus and how much gets to the ampulla

A
  1. 1%

0. 001%

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84
Q

the ovum is surrounded by how many layers?

A

2

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85
Q

what the layers surrounding the ovum? describe them

A
  1. corona radiata - yellow layer of follicular cells

2. zona pellucida - matrix of glycoproteins

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86
Q

fertilization occurs when the sperm binds to a ____ in the zona pellucida

A

sugar group

** ZP3 receptor

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87
Q

describe the steps of fertilization

A
  1. fertilizing sperm penetrates the corona radiata using enzymes found on its head and binds to the ZP3 receptor on the zona pellucida
  2. binding of sperm to the receptor triggers acrosome reaction where enzymes located in acrosome of sperm are released on the zona pellucida and digests it
  3. once the sperm reaches the ovum, the plasma membranes of the 2 cells fuse allowing the sperm nucleus into to the ovum cytoplasm
  4. the sperm stimulates release of CA2+ stored in cortical granules in the ovum which in turn inactivates ZP3 receptor, blocking sperm
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88
Q

what is the effect of the binding of sperm to the ZP3 receptor

A

triggers acrosome reaction where enzymes located in acrosome of sperm are released on the zona pellucida and digests it

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89
Q

in fertilisation, what mechanism prevents the binding of additionals sperm after the binding of the 2 nuclei

A

sperm stimulates release of CA2+ stored in cortical granules in the ovum which in turn inactivates ZP3 receptor, blocking sperm

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90
Q

to prevent the binding of additional sperm nuclei, the sperm which fertilised the ovum releases Ca2+. where is this Ca2+ stored?

A

cortical granules

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91
Q

3-4 days after fertilisation, the zygote remains in the ampulla and undergoes _____ to form a ____

A

mitotic divisions

morula

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92
Q

in the early stages of development, what stimulates the release of glycogen from the endometrium?
what is the function of this glycogen?

A

rising progesterone levels from the corpus luteum

fxn - energy source for embryo

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93
Q

in the early stages of development, what is the effect of rising progesterone levels from the corpus luteum

A

stimulates the release of glycogen from the endometrium

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94
Q

at what stage of development (DAYS) does the morula enter the uterus

A

3-4 days after ovulation

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95
Q

6-7 days after ovulation, what hormone prepares for implantation

A

progesterone

96
Q

what is the importance of progesterone 6-7 days after ovulation

A

to prepare for implantation

97
Q

when is the endometrium suitable for implantation?

A

1 week after fertilization

98
Q

the morula becomes a

A

blastocyst

99
Q

what is the inner and outer cell mass of the blastocyst

A

inner - embryo

outer - trophoblast

100
Q

what is the importance of trophoblasts?

A 
making fuel (from glycogen) and drawing materials from the embryo 
they also release enzymes to penetrate the endometrium (deucida) before degenerating its plasma membrane to form the fetal part of the placenta
101
Q

what forms the fetal part of the placenta

A

degeneration of the plasma membrane of the trophoblast cells

102
Q

at day ____, the embryo is embedded within the decidua

A

12

103
Q

after implantation, the. trophoblastic layer is now __ layers thick and is called the ____

A

2

chorion

104
Q

what does the chorion form

A

blood supply using maternal blood, forming placental villi

105
Q

does maternal and fetal blood mix?

A

NOPE

106
Q

what forms the placenta

A

interlocking of chorionic and decidual tissue

107
Q

importance of placenta

A

does all the work of the digestive, respiratory, etc systems
although fetus has the necessary structures

108
Q

secretion of hormones by the placenta is based on

A

stage of pregnancy

109
Q

is the secretion of hormones by the placenta subject to extrinsic control?

A

NOPE

110
Q

what hormones are secreted by the placenta?

A

estrogens
progesterone
HCG
HPL

111
Q

what hormone increases the size of the uterus

A

estrogen

112
Q

what hormone increases uterine blood flow

A

estrogen

113
Q

what hormone induces the formation of uterine receptors for progesterone and oxytocin

A

estrogen

114
Q

what hormone promotes development of ducts within mammary glands

A

estrogen

115
Q

what hormone is essential for maintaining uterus and embryo

A

progesterone

116
Q

what hormone inhibits myometrial contractions

A

progesterone

117
Q

what is the importance of inhibiting myometrial contractions

A

to prevent miscarriage

118
Q

what hormone is responsible for the formation of a mucus plug at the cervix?

A

progesterone

119
Q

what is the importance of the formation of the mucus plug at the cervix?

A

prevent vaginal contaminants from entering uterus

120
Q

what hormone suppresses immunological responses to fetal antigens?

A

progesterone

121
Q

what hormone stimulates development of milk glands in preparation for lactation

A

progesterone

122
Q

what hormone stimulates and maintains the corpus luteum, preventing it from degenerating?

A

HCG

123
Q

what hormone prevents the blastocyst from being flushed out in the menstrual flow?

A

HCG

124
Q

what hormone increases progesterone production by trophoblasts?

A

HCG

125
Q

what hormone stimulates precursor leydig cells in the male fetus to secrete testosterone for masculinisation of the developing reproductive tract?

A

HCG

126
Q

what hormone is eliminated from the body through urine and produces a positive pregnancy test

A

HCG

127
Q

HCG levels are maximal at

A

week 10

128
Q

HPL is maximal at

A

week 35

129
Q

what hormone has lactogenic and GH-like actions?

A

HPL

130
Q

what hormone promotes cell specialisation in mammary gland (less potent than prolactin and GH)?

A

HPL

131
Q

what is the MAIN function of HPL?

A

ensure adequate fuel supply for fetus metabolism

132
Q

the placenta cannot produce estrogen until

A

fetal adrenal cortex is secreting DHEA in the blood

133
Q

what molecule, provided by the mother, is used by the fetus to make DHEA

A

cholesterol

134
Q

fetal DHEA travels to the placenta where it is converted into

A

estriol

135
Q

the level of what hormone is used to assess viability of fetus

A

estriol

136
Q

the placenta synthesizes small amounts of progesterone after implantation. what is the relationship between progesterone synthesis and weight of placenta?

A

progesterone synthesis is proportional to weight of the placenta

137
Q

there is a notable increase in progesterone synthesis at what month in pregnancy?

A

3rd

138
Q

what are the stages of labour? describe them

A
  1. longest - cervical dilation to 10cm (up to 24 hours)
  2. delivery of baby - begins when cervical dilation is complete (30-90 minutes)
  3. delivery of placenta - second wave of uterine contractions separates placenta from myometrium. - shortest stage - 15-30 minutes after baby
139
Q

what is the significance of the baby being born head first?

A

to ensure sufficient pressure at cervix for dilation

140
Q

during labour, what is the importance of the the second wave of uterine contractions?

A

separates placenta from myometrium

141
Q

what is the role of progesterone in labour

A

inhibits uterine contractions to prevent miscarriage

142
Q

what alters the effective concentration of progesterone?

A

rise in placental progesterone-binding protein

decline in the number of myometrial progesterone receptors

143
Q

what is the role of estrogen in labour (3) comment on the levels

A
  1. levels rise dramatically and promote the synthesis of connexons within uterine smooth muscle cells
  2. dramatic increase of oxytocin receptors for positive feedback on contractions
  3. promotes the production of prostaglandins which contribute to cervical ripening and increases responsiveness to oxytocin
144
Q

what is the role of prostaglandins in labour?

A

contribute to cervical ripening and increases responsiveness to oxytocin

145
Q

what is the role of oxytocin in labour? comment on the levels

A
  • circulating levels of oxytocin remains constant prior to onset of labour
  • leads to more frequent and stronger contractions until fetus has passed
  • stimulates prostaglandin release
146
Q

what is the role of relaxin in labour and where is it produced?

A

produced by corpus luteum and decidua

assists in permitting passage of fetus through cervix and increases oxytocin receptors

147
Q

what hormones increase oxytocin receptors?

A

estrogen

relaxin

148
Q

cervical stretch stimulates the release of what hormone?

A

oxytocin

149
Q

when is labour initiated? (in relation to oxytocin levels)

A

labour is initiated when myometrial responsiveness to oxytocin reaches critical threshold

150
Q

the breast is an ____ gland which provides nutrients and immunity

A

exocrine

151
Q

what are the layers of the breast tissue? (with functions)

A

inner - lobular luminal epithelial cells which produce milk

outer - myoepithelial cells which provides structural support to lobules and assists in milk secretion

152
Q

what layer of breast tissue is responsible for milk production

A

inner - lobular luminal epithelial cells

153
Q

what layer of breast tissue provides structural support and assists in milk secretion

A

outer - myoepithelial cells

154
Q

what do the layers of the breast tissue form

A

tubuloalveolar glands organised into lobes

155
Q

each lobe drains into a _______ that dilates into a _______ onto the areola

A

lactiferous duct

lactiferous sinus

156
Q

trace the passage of milk from production to the areola

A

RER –> golgi –> secretory vesicles –> alveolar lumen –> lactiferous duct –> lactiferous sinus –> areola

157
Q

what is the breastfeeding recommendation

A

feeding up to 6 months

mixed until 2 years

158
Q

what is the principal hormone responsible for lactation

A

prolactin

159
Q

PRL secretion is stimulated by

A

TRH
PRH
progesterone
suckling (positive feedback)

160
Q

PRL secretion is inhibited by

A

PIH

dopamine

161
Q

comment on the levels of prolactin during pregnancy

A

increases gradually throughout pregnancy with increased nighttime secretion

162
Q

prolactin inhibits what hormones

what is the overall result of this?

A

FSH
LH
inhibiting ovulation

163
Q

hyperprolactinemia can be due to ____

why?

A

hypothyroidism

low feedback of TH on TRH –> increased TRH secretion, increased PRL secretion

164
Q

what is the effect of hyperprolactinemia

A

infertility

galactorrhea (inappropriate lactation)

165
Q

what are the 3 phases of maternal breast changes

A
  1. mammogenesis
  2. Lactogenesis I, II and III
  3. galactogenesis
166
Q

what changes occur during mammogenesis

A

development of ducts and alveolar systems by pregnancy hormones

167
Q

what hormones are involved in mammogenesis and what are their functions

A

prolactin –> milk production (completes cellular differentiation and lactogenic capacity)
estrogen –> duct formation
progesterone –> completes alveolar systems of mammogenesis
insulin –> required for multiplication of epithelial cells and lobular structure

168
Q

what is the main occurrence in lactogenesis

how many phases are there?

A

milk secretion - this occurs on 3 phases

169
Q

describe lactogenesis I

A

mid pregnancy until 30 hours after birth - capable of lactogenesis but high progesterone levels inhibit release

170
Q

describe lactogenesis II

A

30 hours –> 2-3 months

delivery of placenta decreases progesterone, estrogen and HPL levels and increase milk production and secretion

171
Q

what is the effect of placenta delivery on hormones

A

delivery of placenta decreases progesterone, estrogen and HPL levels

172
Q

describe lactogenesis III

what type of regulation is this?

A

from 2-3 months of age
as long as milk is being secreted (suckiling), milk will be produced
autocrine regulation

173
Q

describe the synthesis of milk.

what is it catalysed by and where is this enzyme found?

A

2 glucose molecules needed
1 becomes UDP glucose and then UDP galactose
the other remains unchanged
it is catalysed by Lactose Synthase which is found in the mammary glands

174
Q

what is lactose synthase composed of and what is the importance of eacg

A
  1. galactosyl transferase - catalytic component

2. alpha lactalbumin - regulatory component - increases PRL

175
Q

what changes occur in galactogenesis

A

milk let down caused by activation of neurosensory reflex

176
Q

what stimulates the release of oxytocin from the posterior pit

A

suckling

cortical inputs eg. baby crying

177
Q

fxn of oxytocin

A

contraction of myoepithelial cells

178
Q

what are the components of human milk

A

carbs - lactose and oligosaccharides
milk fat - TGs
proteins - casein, whey proteins, secretory IgA, alpha lactalbumin
others - growth factors

179
Q

what components of human milk is not found in formula?

A

lactoferrin protein, growth factors, lipase and polyunsaturated fats

180
Q

instant formula is from cow milk but the _______ balance is altered and ______ is added.
there is also replacement of dairy fat with _____

A

protein
immune fortification

vegetable fat

181
Q

what is colostrum and comment on its components

A

yellow liquid produced which is low in fat and high in carbs and proteins
it has a high concentration of antibodies (especially IgA)

182
Q

what is the importance of a high concentration of antibodies in colostrum

A

important in preventing jaundice

183
Q

after colostrum, __________ is produced for a few days before becoming mature

A

transitive milk

184
Q

what is weaning?

A

reduction of breast milk and/or replacement with solid food

185
Q

how long before the introduction of cow’s milk should formula be used?

A

12 months

186
Q

what is the mechanism of action of synthetic estrogen

A

steroid hormones –> intracellular receptors ERalpha and ERbeta

187
Q

how can synthetic estrogen be given

A

orally
IM
IV
etc etc

188
Q

stilbestrol is an example of

A

synthetic estrogens

189
Q

mestranol is an example of

A

synthetic estrogens

190
Q

ethinyl estradiol is an example of

A

synthetic estrogens

191
Q

do natural estrogens degrade more rapidly than synthetics

A

YUP

192
Q

what are the main clinical uses of synthetic estrogen

A

contraceptives and replacement therapy due to primary ovarian failure or secondary ovarian failure

193
Q

as a contraceptive, estrogen is usually given with

A

progesterone

194
Q

what is secondary ovarian failure

A

menopause

195
Q

what is an example primary ovarian failure

A

turner syndrome

196
Q

what are the side effects of taking synthetic estrogens

A

edema (increased water retention)
increased Bp
increased thromboembolism
increased cancer

197
Q

tamoxifen is an example of

A

antiestrogen

198
Q

what is the use of tamoxifen

A

combat estrogen-dependant tumours and reduces fractures (affected by cancer)

199
Q

clomifene is an example of

A

antiestrogen

200
Q

what is the use of clomifene

A

induce ovulation

fertility treatment

201
Q

if an individual is a heavy smoker, what synthetic hormone should they not take

A

synthetic estrogen

202
Q

other than heavy smokers, individuals with what other medical conditions should not use synthetic estrogen?

A

tumors
liver disease
history of thromboembolism

203
Q

can natural progesterone be taken orally?

A

nope

204
Q

what are progestogens

A

derivatives such as testosterone derivatives are used

**they give androgen activity

205
Q

desogestrel is an example of a

A

progestogen

**testosterone derivative

206
Q

desogestrel has less side effects but has an increased risk of

A

thromboembolism

207
Q

what are some clinical uses of progestogens

A

contraception
hormone replacement therapy
endometriosis (prepares endometrium for implantation)

208
Q

mifepristone is an example of

A

antiprogestogens

209
Q

what is the function of mifepristone

A

acts as a competitive antagonist or as a partial agonist (in the absence of progesterone) used to terminate uterine pregnancies

210
Q

what are the common types of oral contraceptives (4)

A
  1. combined pill
  2. progestogen-only pill
  3. long-acting progestogen
  4. emergency post-coital contraception
211
Q

what is the combined pill? when is it taken?

A

it has estrogen and a progestogen

taken for 21 consecutive days and 7 days without

212
Q

how does the combined pill work?

A

estrogen inhibits FSH release and development of the ovarian cycle
progestogen will inhibit LH release and prevent ovulation and makes mucous inhospitable to sperm
progestogen withdrawal for 21 days will cause menstruation

213
Q

what are some side effects of the combined pill

A 
weight gain 
nausea
mood changes 
pigmentation 
** LIMITED TO THE FIRST FEW CYCLES
214
Q

which hormone in the combined pill inhibits FSH release and development of the ovarian cycle

A

estrogen

215
Q

which hormone in the combined pill will inhibit LH release and prevent ovulation and makes mucous inhospitable to sperm

A

progestogen

216
Q

what is the progestogen only pill and how often is it taken?

A

norethisterone

taken everyday, no interruption

217
Q

how does the progestogen only pill work?

A

makes cervical mucus inhospitable to sperm, hinders implantation, inhibits LH and ovulation

218
Q

is the progestogen-only pill more or less reliable than the combined pill?

A

very slightly less reliable

219
Q

which pill can be taken as an oral contraceptive if the patient has an estrogen contraindicatio?

A

progestogen only pill

220
Q

what are the side effects associated with the progestogen only pill?

A

irregular menstruation

risk of ovarian cyst

221
Q

how is long-acting progestogen given to a patient?

A

injectable

subdermal implant

222
Q

how does the injectable long-acting progestogen work and how often is it taken? are there any side effects?

A

slowly released into systemic circulation following IM injections
taken every 3 months and is effective
menstrual irregularities are common

223
Q

Can the injectable long-acting progestogen be taken long term? why?

A

NOPE
causes reduction on bone mineral density
also affects mucus hospitality and ovulation

224
Q

how does the subdermal long-acting progestogen implant work and how often is it taken?

A

implanted subcutaneously and released over 3 years

225
Q

side effects of the subdermal long-acting progestogen implant

A

irregular bleeds

headaches

226
Q

what is the mechanism of action of emergency post-coital contraception

A

if taken in the:

  1. first half of cycle - prevents ovulation
  2. second half of cycle - delays movement of edd and thickens cervical mucus
227
Q

can emergency post-coital contraception be used in an established pregnancy?

A

NOPE

228
Q

what are the types of emergency post-coital contraception?

A
  1. progestin-only pill

2. 5-day pill

229
Q

when should the progestin-only pill be taken?

what are some common side effects

A

must be taken within 72 hours
**efficacy decreases over time

side effects
nausea
weight gain

230
Q

what is the 5-day pill

A

prevents pregnancy up to 5 days after

it is a progesterone receptor modulator

231
Q

ulipristal acetate (ella one) is an example of

A

5-day pill

232
Q

differentiate between
progesterone
progestogen
progestin

A

progesterone - natural hormone
progestogen - synthetic hormone
progestin - in the “day after”pill

233
Q

what can cause contraceptive failure?

A

change in absorption or in clearance

234
Q

what enzyme metabolises OCP

A

CYP450

235
Q

Rifa-x is a

A

CYP enzyme-inducing antibiotics

236
Q

what should the patient do of they experience vomiting and diarrhea while taking OCPs

A

7 day rule

Finals (17 decks)

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