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Pathophysiology > reproduction > Flashcards

reproduction Flashcards

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:

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

placenta:

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:

A

Cytotrophoblasts release placental growth factor and vascular endothelial growth factor

Trophoblast Invasion and Angiogenesis = healthy placenta

21
Q

abnormal placenta causes pre-eclampsia:

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:

A

Syncytiotrophoblast

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

23
Q

Maternal consequences of Pre-eclampsia:

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

Foetal Consequences of Pre-eclampsia:

A
  • Foetal growth restriction
  • Intra-uterine foetal death
  • stillbirth / neonatal deaths
  • premature infants
  • low birth weight
  • development of disease in later life
25
Q

Treatment Regimes for pre-eclampsia :

A

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
Q

Diabetes Mellitus:

A

Characterised by chronically raised blood glucose concentration due
to insufficient levels of the hormone insulin or the a deficiency in
insulin action

27
Q

type 1 diabetes -

A

Insulin-dependent diabetes mellitus

Childhood

Autoimmune disease
destroys pancreatic beta cells

28
Q

type 2 diabetes -

A

Insulin-independent diabetes mellitus

adults

Target tissues become
resistant to insulin

29
Q

Gestational diabetes -

A

Become diabetic during pregnancy

Revert to normal health after birth

30
Q

Effects of Pregnancy on Maternal Glucose

Homeostasis:

A

increase in maternal appetite = increase in glucose and free fatty acids = increased fat stores and glycogen

31
Q

cortisol -

A

increases plasma energy supplies for foetus

32
Q

Actions of Human Placental Lactogen:

A

phosphorylation of growth hormone receptor = activation of signalling pathways = Stimulates gluconeogenesis and Increases lipolysis

33
Q

Changes in Maternal Physiology During Pregnancy:

A

metabolic rate increases

insulin increases

placental secretion of placental lactogen and cortisol increses

plasm glucose and fatty acid metabolism increases

34
Q

Pregnancy is a state of relative…

A

insulin resistance

35
Q

Effects of Glucose and Insulin on Foetal Growth:

A

High Glucose (hyperglycemia)

= increase in number of beta cells

= increase in foetal insulin

= promotes foetal growth

36
Q

Maternal Risks of diabetes mellitus:

A
  • Electrolyte imbalance = Osmotic stress = oxidative stress = apoptosis, tissure damage
    …Retinopathy
    …Neuropathy
    …Nephropathy
  • hypertension
  • urinary tract infection
  • hypoglycemia
37
Q

Foetal Risks of diabetes mellitus:

A
  • miscarriage
  • still births
  • foetal growth restriction
  • congenital abnormalities
  • prematurity
  • macrosomia (birth weight > 4kg) = obstructive labour
38
Q

treatment of diabetes mellitus:

A
  • Control of blood glucose levels by diet, insulin or glucagon injections
39
Q

Long term consequences of

Diabetic pregnancy on child:

A

Obesity
Secondary Diabetes
Hyperlipideamia
Hypertension

40
Q

Infertility =

A

Inability to conceive after 12 month of

regular unprotected intercourse

41
Q

Effects of Aging on Fertility:

A

decrease in oocyte population and quality

increased risk of spontaneous abortion and genetic abnormalities

42
Q

Causes of Infertility:

Anovulation….

A

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
Q

Causes of Infertility: Fallopian tube disease…

A 
Cause: 
- Pelvic
Inflammatory
Disease
- Infections e.g. Chlamydia

Treatment:

  • treat infection
  • Surgery
  • In vitro fertilization
44
Q

Causes of male Infertility:

A
  • Sexual dysfunction
  • Varicocele
  • Prostate infection
  • Hypothalamic Disease
  • Pituitary Disease

= Testicular atrophy
= reduced sperm
production

Pathophysiology (7 decks)

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