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Pathophysiology > reproduction > Flashcards

reproduction Flashcards

(44 cards)

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1
Q

Cannabinoid Receptor function:

A

= GPCR coupled to Gαi

  • Inhibit adenylyl cyclase = cAMP concentrations decrease
  • Mitogen activated protein kinase signalling increases
  • Activate K+ channels
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2
Q

where are cannabinoid Receptor expressed?

A

Female:

  • Uterus
  • Endometrium
  • Ovaries
  • Fallopian tubes
  • placenta

Male:

  • Sperm
  • Testes
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3
Q

How do Endocannabinoids effect Reproduction?

A
  • Female Infertility (Oocyte development and release)
  • Embryo transport/ Ectopic pregnancy
  • Embryo implantation
  • Miscarriage
  • Male Infertility (Sperm production and function)
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4
Q

normal formation of oocyte:

A

Gonadotropin releasing hormone (GnRH) secretion leads to…

  • luteinizing hormone (LH) and follicle stimulating hormone (FSH) binding to Gαs GPCR on ovarian follicle

= forms oestrogen and pogesterone

= ovulation

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5
Q

tetrahydrocannabinol (THC) effect on oocyte development…

A
  • tetrahydrocannabinol (THC) binds to cannabinoid receptor in hypothalamus
  • reduces Gonadotropin releasing hormone (GnRH) secretion
  • Reduced secretion of follicle stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary
  • also activation of cannabinoid receptor on ovarian follicle inhibit adenylyl cyclase
  • reduces progesterone and oestrogen production
  • No ovulation
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6
Q

reduced cannabinoid receptor expression in Fallopian tubes =

A

increased risk of ectopic

pregnancy

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7
Q

The Role of Anandamide in Embryo Implantation:

A

decreased Anandamide expression determines implantation site

= reduced cannabinoid receptor expression

= decreased expression of NAPE Phospholipase D

= increased expression of Fatty acid amine hydroxylase

  • progesterone and leptin promotes implantation at that site
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8
Q

Pathophysiological Consequences of Endocannabinoid System

Dysregulation in of Female Reproduction:

A

increased Anandamide expression:

  • implantation failure
  • ectopic pregnancy
  • compromised placentation =
  • growth retardation
  • preeclampsia
  • spontaneous abortion
  • miscarriage
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9
Q

Spermatogenesis:

A

hypothalamus secretes Gonadotropin releasing hormone (GnRH)…

  • release of FSH/LH from the anterior pituitary…
  • formation of testosterone and inhibin in testes
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10
Q

endocannabinoid effects on male reproduction…

A

= decreased motility and capacitation (cannot fertilise ovum) of sperm

tetrahydrocannabinol (THC): binds to cannabinoid receptor in hypothalamus and inhibits release of FSH/LH

Anandamide: high levels = toxic = less active sperm

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11
Q

Pre-eclampsia:

A

A pregnancy-specific syndrome characterised by
hypertension, proteinuria and oedema after 20
weeks gestation

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12
Q

hypertension =

A

high blood pressure

systolic > 140
diastolic > 90 mmHg

symptoms =

  • headache
  • dizziness
  • blurred vision
  • nausea
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13
Q

proteinuria =

A

The presence of > 0.3g of protein in urine in 24 hrs

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14
Q

Oedema =

A

block of lymph flow, so protein from capillaries builds up in interstitial spaces, and promotes water retention

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15
Q

Normal Changes to the Cardiovascular System During Pregnancy:

A

increased aldosterone/vasopressin acts on kidneys to increase salt/water retention = increased blood volume = increased heart rate

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16
Q

Blood pressure

in 1st and 2nd trimesters =

A

decreases

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17
Q

Oestrogen Increases…

A

…NO signalling = relaxation of vascular smooth muscle

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18
Q

risk factors for pre-eclampsia:

Study These Flashcards
A
  • Age
  • No previous pregnancies
  • Previous pre-eclampsia
  • maternal weight
  • multiple pregnancy
19
Q

placenta:

Study These Flashcards
A
  • provides nutrients: Oxygen, glucose, amino acids, fluids
  • Protects foetus from pathogens and maternal immune
    system
  • Produces hormones, growth factors, cytokines, vascular
    mediators
  • Substitutes for lungs/ heart and kidneys for foetus: Removes carbon dioxide, metabolic waste products
20
Q

Development of Mature Placenta:

Study These Flashcards
A

Cytotrophoblasts release placental growth factor and vascular endothelial growth factor

Trophoblast Invasion and Angiogenesis = healthy placenta

21
Q

abnormal placenta causes pre-eclampsia:

Study These Flashcards
A

have High Pressure + Low Flow = hypoxia (poor foetal blood supply)

due to Anti-angiogenic state and Endothelial Dysfunction (due to oxidative stress)

= Vascular smooth muscle constriction = Increased hypertension

22
Q

Role of Maternal Immune System in Pre-eclampsia:

Study These Flashcards
A

Syncytiotrophoblast

debris in Maternal Circulation = Systemic Immune Response = Inflammation and Hypertension

23
Q

Maternal consequences of Pre-eclampsia:

Study These Flashcards
A
  • Hypertension (stroke)
  • Renal impairment
  • Liver impairment
  • oedema
  • Placental abruption
  • Eclampsia (convusions)
24
Q

Foetal Consequences of Pre-eclampsia:

Study These Flashcards
A
  • Foetal growth restriction
  • Intra-uterine foetal death
  • stillbirth / neonatal deaths
  • premature infants
  • low birth weight
  • development of disease in later life
25
Treatment Regimes for pre-eclampsia :
Control of hypertension: - beta blocker (Nifedipine) - Ca2+ channel blocker (Hydralazine) - false neurotransmitter (alpha-mehtyldopa produces alpha-methylnoraadrenaline) low dose asprin: - inhibits cyclooxygenase = reduces inflammation and blood pressure antioxidant therapy: vitamin C + E
26
Diabetes Mellitus:
Characterised by chronically raised blood glucose concentration due to insufficient levels of the hormone insulin or the a deficiency in insulin action
27
type 1 diabetes -
Insulin-dependent diabetes mellitus Childhood Autoimmune disease destroys pancreatic beta cells
28
type 2 diabetes -
Insulin-independent diabetes mellitus adults Target tissues become resistant to insulin
29
Gestational diabetes -
Become diabetic during pregnancy Revert to normal health after birth
30
Effects of Pregnancy on Maternal Glucose | Homeostasis:
increase in maternal appetite = increase in glucose and free fatty acids = increased fat stores and glycogen
31
cortisol -
increases plasma energy supplies for foetus
32
Actions of Human Placental Lactogen:
phosphorylation of growth hormone receptor = activation of signalling pathways = Stimulates gluconeogenesis and Increases lipolysis
33
Changes in Maternal Physiology During Pregnancy:
metabolic rate increases insulin increases placental secretion of placental lactogen and cortisol increses plasm glucose and fatty acid metabolism increases
34
Pregnancy is a state of relative...
insulin resistance
35
Effects of Glucose and Insulin on Foetal Growth:
High Glucose (hyperglycemia) = increase in number of beta cells = increase in foetal insulin = promotes foetal growth
36
Maternal Risks of diabetes mellitus:
- Electrolyte imbalance = Osmotic stress = oxidative stress = apoptosis, tissure damage ...Retinopathy ...Neuropathy ...Nephropathy - hypertension - urinary tract infection - hypoglycemia
37
Foetal Risks of diabetes mellitus:
- miscarriage - still births - foetal growth restriction - congenital abnormalities - prematurity - macrosomia (birth weight > 4kg) = obstructive labour
38
treatment of diabetes mellitus:
- Control of blood glucose levels by diet, insulin or glucagon injections
39
Long term consequences of | Diabetic pregnancy on child:
Obesity Secondary Diabetes Hyperlipideamia Hypertension
40
Infertility =
Inability to conceive after 12 month of | regular unprotected intercourse
41
Effects of Aging on Fertility:
decrease in oocyte population and quality increased risk of spontaneous abortion and genetic abnormalities
42
Causes of Infertility: | Anovulation....
Polycystic Ovary Syndrome due to hormone imbalance - high LH/FSH ratio - increase in testosterone = male pattern hair growth treatment = - stimulate ovarian function - increase FSH body weight also has an influence due to increases in leptin = decreased FSH/LH = no ovulation
43
Causes of Infertility: Fallopian tube disease...
``` Cause: - Pelvic Inflammatory Disease - Infections e.g. Chlamydia ``` Treatment: - treat infection - Surgery - In vitro fertilization
44
Causes of male Infertility:
- Sexual dysfunction - Varicocele - Prostate infection - Hypothalamic Disease - Pituitary Disease = Testicular atrophy = reduced sperm production

Pathophysiology (7 decks)

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