Repro

Question 1

What does the mnemonic pro 1, meta 2 mean?

Answer 1

At birth the ovaries are stuck in prophase of meiosis 1; at puberty ovaries then freeze in metphase of meiosis 2, the cell will continue through meiosis 2 at fertilization!

Question 2

Leydig cells
- What / where are they?
- What do they look like?
- When do they start producing what they produce

Answer 2

• Leydig cells are interstitial cells between the seminiferous tubules
• Look: round cells
• Produce testosterone at 7th week gestation

Question 3

Sertoli Cells
- What / where are they?
- What do they look like?
- When do they start producing what they produce

Answer 3

• What / where are they?: Cells in the seminiferous tubules that aid in spermatogenesis by nourishing developing sperm as it progresses through diff. stages
• What do they look like?: Different stages of spermatocytes
• When do they start producing what they produce: they produce inhibin & ABP
  –> Inhibin: inhibits FSH
  —> ABP: Concentrates testosterone in the seminiferous tubules

Question 4

Menstrual cycle
- 4 phase approximating day ranges:
(1) Day 1 - 4:
(2) Day 5 - 13:
(3) Day 13 - 16:
(4) Day 16 - 28:

Answer 4

(1) Day 1 - 4: Menstrual Cycle
- Shedding of uterine lining, specifically decidua functionalis
(2) Day 5 - 13: Follicular and proliferative phase
(3) Day 13 - 16: Ovulatory phase
(4) Day 16 - 28: Secretory Phase

Question 5

Follicular phase
*What is the point?
*Main hormone
*What does the anterior pituitary release & what does it do?
*What happens to the uterus? And what hormone causes these changes?

Answer 5

*What is the point?: to choose an ovarian follicle that will be fertilized or shedded

*Main hormone: Estridiol

*What does the anterior pituitary release & what does it do?: Releases FSH –> rises & recruits ovarian follicle ; FSH also causes granulosa cell proliferation (granulosa cell starts to produces estrogen) ; FSH also ^ LH receptor expression ;

*What happens to the uterus? And what hormone causes these changes?:
- Estrogen stimulates endometrial growth & causes endometrial cells to produce progesterone receptors
- Estrogen causes endometrium to produce mucus, vagina’s acidity is lowering all to create a healthy environment for sperm to penetrate + fertilize the egg
- Estrogen continues to rise & reaches peak prior to LH surge (right before ovulation)

Question 6

What does LH do? (3 main things)
- What cells does it work on?

Answer 6

LH induces (1) androgen synthesis (2) stimulates proliferation/differentiation/secretion of follicular theca cells (3) Increases LH receptor expression on granulosa cells

*LH works on theca cells

Question 7

LH surge occurs before what? What is released from where?

Answer 7

*LH surge occurs just before ovulation
*Secondary Oocyte moves into the fallopian tube

Question 8

Clomiphene
*MOA
*Used for?

Answer 8

*MOA: inhibits estrogen receptors in the hypothalamus to stop negative feedback on GnRH and increase FSH & LH release from pituitary
*Used for PCOS

Question 9

Secretory/Luteal Phase
*What is the point?
*Main hormone
*If fertilization occurs what happens to uterus?
*If fertilization doesn’t occur what happens to uterus?

Answer 9

*What is the point?: Follicle no longer contains an oocyte + corpus luteum will begin to secrete progesterone to

*Main hormone: Rise in estrogen + progesterone

*What do the hormones do?: progesterone inhibits the release of FSH & LH from the pituitary

*If fertilization occurs what happens to uterus?:
- progesterone remain high and the decidua functionalis remains

*If fertilization doesn’t occur what happens to uterus?:
- progesterone levels drop, spiral arteries recoil, decidua functionalis becomes ishemic and sloughs off

Question 10

Estrogen’s role during menstrual cycle
*Breast:
*Uterus
*Cervix

Answer 10

*Breast: stimulates ductal growth (fibrous tissue, can cause fibroadenoma)

*Uterus: Stimulates growth of decidua functionalis

*Cervix: Estrogen plays a role in thinning cervical mucus so sperm can get into uterus

Question 11

Oral Contraceptives
*MOA
*Different types

Answer 11

*MOA: Provides negative feedback in the hypothalamus + pituitary, dec. freq. pulsatile GnRH = dec. LH & FSH
*Different types: progesterin-only pills or combination

Question 12

Mifepristone
*What?:
*MOA

Answer 12

*Abortificant
*MOA: Progesterone antagonist w/ strong affinity for progesterone receptor, causes necrosis + expulsion of products of conception

Question 13

Menopause
*What is it?
*When does it happen?
*Diagnosis based on what levels?

Answer 13

*Process where ovary stops producing estrogen
*Can occur anywhere between 45 - 55 years of age
*Diagnosis based on FSH levels

Question 14

Pergonal

Answer 14

Mix of FSH & LH

Question 15

Hirutism occurs via…
*Tx’s

Answer 15

PCOS & Adrenal Hyperplasia
*Tx’s
- Spironolactone: anti-androgenic effects
- Flutamide: blocks testosterone receptors
- Finasteride: 5-alpha-reductase inhibitor

Question 16

Polycystic Ovarian Syndrome (PCOS)
*What?
*Abnormalities
*What hormone is elevated?
*Findings

Answer 16

*What?: Multiple cysts in ovary

*Abnormalities:
- Menstrual irregularities
- Hormonal dysregulation
- Increased resistance to insulin
- Hirsutism
- Acne
- Bilateral ovary enlargement

*PCOS= Elevated LH –> ^ androstenedione & testosterone by ovarian theca cells
- testosterone levels dec. post ovulation, w/o ovulation they stay elevated

*Findings:
- Endocrine abnormalities: poor glucose tolerance, hyperinsulinemia
- Acanthosis nicrgicans: XS growth of keratinocytes (from ^ insulin) –> formation of velvety skin

Question 17

Down Syndrome Screening
*1st trimester (beta-HCG, nuchal translucency, PAPP-A)
*2nd trimester (beta-HCG, inhibin A, alpha FP, estriol)

Answer 17

*1st trimester: ^ Beta-HCG, ^ Nuchal translucency, Decreases PAPP-A

*2nd trimester: ^ Beta-HCG, ^ inhibin A, dec. alpha FP, dec. estriol)