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s4 - Repro, Develop, Ageing, Pharm > REPRO - Endocrine > Flashcards

REPRO - Endocrine Flashcards

1
Q

What hormone does inhibin decrease and activin stimulate?

A

FSH

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2
Q

Where are the sex steroids E2 and P4 (progesterone) made?

A

(Gonads) The ovarian follicle

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3
Q

Kisspeptin neurones send projections to …

Causing…

A

GnRH neurones onto kisspeptin receptor

–> synthesis/release of GnRH

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4
Q

To where does the superficial hypophyseal arteries deliver blood to?

A

-the capillary network in upper infundibulum

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5
Q

To where do the portal vessels deliver blood with regulatory hormones to?

A

to the capillary network in the ANTERIOR pituitary

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6
Q

To where does the inferior hypophyseal arteries deliver blood to?

A

-to the POSTERIOR pituitary

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7
Q

To where do the hypophyseal veins deliver blood to?

A

to the CVS with pituitary hormones for delivery to the body

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8
Q

What is GnRH (10a.acids) secreted with?

A

GnRH Associated Peptide (GAP) (56a.acids)

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9
Q

GnRH pulses are every 30-120mins and they stimulate…How?

A

LH/FSH release from pituitary

-increases gene transcription of a and B subunits of LH/FSH on the pituitary gonadotrophs

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10
Q

What does fast pulse frequency of GnRH favour?

A

LH

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11
Q

What does slow pulse frequency of GnRH favour?

A

FSH

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12
Q

How is synthetic GnRH uses clinically?

A

-stimulates HPA axis in the form of a timed pump e.g. for delayed puberty

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13
Q

GnRH agonists given continuously have what effect?

A

downregulate response as they decouple the GPCR so less FSH/LH

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14
Q

3 examples of when GnRH agonists may be used (receptor becomes unresponsive so less FSH/LH)

A
  • ovulation induction, IVF,
  • endometriosis, uterine fibroids,
  • prostate cancer,
  • gonadal protection from chemo
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15
Q

Gonadotrophins are heterodimeric peptides, name 3, they all have 2 subunits, what are they?

A

-LH/FSH/hCG
-common alpha, specific beta subunit
(a made in excess, B synthesis limits hormone conc

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16
Q

What do all the alpha subunits have in common?

A

glycosylated and have N-linked carbohydrate side chains (O-linked in hCG)

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17
Q

Male: LH acts on receptors where to do what?

A

On leydig cell receptors of testis to convert more cholesterol to increase androgens

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18
Q

What do androgens in the testis cross over and stimulate?

A

Sertoli cells to control spermatogenesis

19
Q

Where does FSH act on receptors in males..to convert..?

A

Sertoli cells to convert androgens into more oestrogens

20
Q

What 2 effects does LH have in the female?

A
  • increases Theca cell androgen synthesis during follicular phase to mediate ovulation
  • stimulates progesterone production from CL
21
Q

What 2 effects does FSH have in the female?

A
  • causes follicular maturation

- enables granulosa cells to make oestrogen from androgens under aromatase

22
Q

What 3 mood/behavioural effects does testosterone have?

A
  • boistrous play
  • enhances sex drive
  • aggression
23
Q

What effect does DHT (converted via 5a reductase) have on hair? Hence clinically..

A

Promotes hair loss, so male pattern baldness treatments include 5a reductase inhibitors

24
Q

Where is TYPE I vs TYPE II 5a Reductase?

A

TYPE I - Scalp and Skin

TYPE II - Genital skin and Prostate

25
Q

What happens in 5adr? (5a reductase deficiency)

A
  • testes develop but no prostate
  • ext. genitalia are female
  • clitoris enlarges may get penis at 12 S.
26
Q

What is male pseudohermaphoditism a condition that is a mutation in what? Common in Dominican Republic

A

-mutation in TYPE II 5a reductase

27
Q

5 Unwanted effects of excessive androgens? eg. testosterone, DHT, nandolone, oxymetholone, stanozolol
1. -Gynaecomastia as aromatase converts it to oestrogens

A
  • HT and oedema as Ca2+/Na+/H20 retaining
  • cholestatic jaundice
  • supressed GnRH (neg feedback) so testicular regression and less spermatogenesis
  • virilisation and hirsuitism, baldness, acne
  • premature closure of long bone epiphysis
28
Q

Name 2 psychological changes in excessive androgen intake for example anabolic steroid abuse by athetes to increases muscle mass

A

-change in libido
-increased agression
NB: They are also hepatotoxic and can cause vascular disease

29
Q

What does the enzyme 21 OH convert progesterone into mainly? What builds up with a deficiency in this enzyme?

A

Aldosterone

-progesterone shunted to DHEA and androstenedione

30
Q

What are the effects of 21OH deficiency (CAH) increasing DHEA and androstendione on cortisol and testosterone hence..?

A
  • lack of cortisol so more ACTH and more cholesterol uptake in adrenal
  • adrostenedione –> more testosterone so excess male hormones (virilises XX) and adrenal hyperplasia
31
Q

CAH in XX causes ambiguous genitalia and acne, what does it cause in XY?

A
  • precocious deep voice
  • enlarged penis
  • small testes
  • pubic hair
32
Q

What are Cyproterone, Danazol and other androgen antagonists used to treat?

A

Exccess androgens for example in CAH

33
Q

What is Gonadorelin administered by a pump.

A

It is synthetic GnRH

34
Q

GnRH agonist analogues such as goserelin and buserelin are useful in prostate and breast cancer and endometriosis. How do they work?

A
  • cause an initial LH/FSH rise
  • remain bound to gonadotroph receptors
  • desensitisation so less testosterone
35
Q

What are GnRH antagonist like Cetrorelix and Ganirelix used to control?

A
  • control LH secretion in IVF

- for prostate and breast cancer

36
Q

Mesterolone (Methyltestosterone) is used to treat male what?

A

Male infertility associated with hypogonadism

37
Q

In partial AIS with impaired masculinisation of the genitalia, and lack of secondary sexual characteristics what may be given?

A

DHT, testosterone

38
Q

What is Danazoll’s mechanism? It is used for gynaecomastia, mastalgia, endometriosis and benign fibrocystic disease.

A

Danazol is an androgen derivative which is not converted to oestrogen so it inhibits testicular and ovarian function e.g. stops ovulation

39
Q

What is a possible chromosomal cause of 1ry hypogonadism?

A

Klienfelters 47XXY low testosterone levels, less neg feedback so FSH and LH are high

40
Q

What is a syndromic cause of 2dry hypogonadism. May be due to low GnRH secretion hence low LH/FSH

A

Kallman’s Syndrome

41
Q

In Kallman’s syndrome, what hormones may be given to correct the delayed puberty/infertility?

A

Gonadorelin or LH/FSH

42
Q

Give 3 uses for the androgen antagonist ‘cyproterone acetate’ that inhibits peripheral androgen receptors

A
  • male precocious puberty
  • supress Goserelin/Buserelin initial surge
  • for acne, hirsuitism, virilisaiton of females
  • in CAH
43
Q

What type of prostate cancers can œstrogens like Ethinyloestradiol and diethylstilbestrol treat?

A

Androgen dependent prostate cancers

5a reductase inhibitors also supress these

44
Q

Dutasteride is a TYPE I and TYPE II 5a reductase inhibitor, what about Finasteride? Where does it work?

A
  • Finasteride is only TYPE II 5a r. Inhibitor

- only genital skin and prostate action

s4 - Repro, Develop, Ageing, Pharm (14 decks)

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