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Year 1: Patho/Pharm > Reproduction - PATHO > Flashcards

Reproduction - PATHO Flashcards

1
Q

2 functions of the testicles

A
  1. Testosterone production
    - Leydig cells
    - line seminiferous tubules
    - production testosterone and androgens
  2. spermatogenesis
    - sertoli cells
    - line seminiferous tubules
    - production sperm
    - mature in epididymis and stored in vas deferens
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2
Q

Testicular descent occurs when in utero

A

Descent from abdomen -> inguinal canal -> scrotum
last 3 months of development

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3
Q

Control of blood flow to Leydig Cells

A

Autonomic adrenergic neurons

Blood flow to surface of testicles
cools to 4 degrees
temperature for spermatogenesis

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4
Q

Function of the Epididymis

A
  1. Structural
    - posterior testicle
    - 5-7cm
    - connection seminiferous tubules to vas deferens
  2. Functional
    - matruation sperm
    - 12 days to swim across
    - testosterone, nutrients
    A. motility
  3. maturation
  4. fertility
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5
Q

Function of the vas deferens

A
  • storage of mature sperm
  • muscular peristalsis for ejactulation
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6
Q

Anatomy and function of the prostate

A
  1. Seminal fluid
    - high pH (alkaline)
    - survival and motility of sperm
    - secreted from the seminal vesicle

Size of walnut
- surrounds urethra
- common duct for sperm and urine

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7
Q

Brief summary Embryonic Male Development

A

Chromosome Y expression SRY signalling

TDF - testes determining factor

MIF - mullerian inhihitory factor (inhibition internal female genitalia)

Leydig cells secrete testosterone - testicle development (wolfian duct)

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8
Q

Male Hormones Gonad development
Definition

A

GnRH
- gonadotropin releasing hormone
- hypothalamus
- stimulates release of anterior pituitary gonadotrophins

LH
- leutinizing hormone
- Leydig cells
- production androgens and testosterone
- primary and secondary sexual characteristics (testicular development)

FSH
- follicle stimulating hormone
- Sertoli cells
- production sperm (spermatogenesis)

Testosterone
- produced by Leydig cells (testicles)
- produced by adrenal glands
- primary and secondary sexual characteristics
- anabolic (muscle, bone buildnig)
- libido
- hair, acne, sebaceous glands, etc.

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9
Q

List Structural Disorders
Penis

A

Cryptorchidism
- undescended testicle

Ectopic testicle

Phimosis
- unable to retract prepuce

Paraphimosis
- unable to reduce prepuce

Hypospadias
- uretra on the ventral side of the shaft

Peyronie’s disease
- fibrosis of penis results in bend

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10
Q

Cryptorchidism
Definition

A

Testicles do not descend to scrotum from abdomen

Unilateral > bilateral (high sterility)

Found anywhere along ectopic, abdomen, inguinal canal, suprapubic

palpable and non-palpable

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11
Q

Cryptorchidism
Incidence and Complications

A

3-4% at birth
1% remain undescended at 1 year

Complications
- infertility
- 50x increase risk of testicular cancer in adulthood (contralateral testicle)

Co-morbidities: anatomy
- vas deferens
- epididymis
- urethra, upper genital tract
- hypospadias
- mixed sex: both cryptorchidism + hypospadias

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12
Q

Cryptorchidism
Etiology

A

genetics x environment (hormones x structure x maternal age)

  1. Structural
    - adhesions
    - fibrosis
    - narrowing inguinal canal
    - no gubernaculum (cord that pulls them through)
  2. Hormonal (environmental)
    - insensitive to gonadotrophic hormones, maternal hormones
  3. Maternal age
    - advanced maternal age
  4. Heredity (genetics)
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13
Q

When is physiological cryptorchidism normal
Retractile Testicle

A
  • involuntary retraction of testes into inguinal canal (can be repositioned) in response to ANS activation
  • cold, physical excitement
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14
Q

Cryptorchidism
Treatment

A
  1. Monitor for first month
    - 50% descend in first month
  2. Referral to urology MD
    - 6 months
    - Rx. Testicular ultrasound
    - assess gonads and genitals (comorbidities)
  3. Surgical intervention
    - 6-18 months

Orchiopexy
- surgical descent of testicles
- 20% remain infertile
- retain 50x increase risk for testicular cancer

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15
Q

Phimosis
Definition

A

Inability to retract the prepuce (foreskin)

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16
Q

Two Types phimosis

A
  1. Congenital phimosis
    - normal
    - up to age 3 years should not retract the foreskin to clean
  2. Poor hygiene
    - not usually STI (can be)
    - poor hygiene
    - poor diabetic control (immunocompromised)
    - secondary infection
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17
Q

Phimosis
Pathophysiology

A

Most commonly from poor hygiene

  • inflammation
  • swelling
  • erythema
  • edema
  • pain
  • discharge
    –> cannot retract the foreskin
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18
Q

phimosis
Complications

A
  1. blanitis
    - inflammation glans of penis
  2. posthitis
    - inflammation prepuce
  3. paraphimosis
    - inability to reduce the forskin
    - cuts off circulation to glans of penis
    - medical emergency
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19
Q

Phimosis
Treatment

A
  1. Treat infection and inflammation
  • if infection, treat infection
  • corticosteroid cream for inflammation
  • control blood sugars if diabetic
  1. MD referral
    - surgical release or circumcision
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20
Q

Phimosis
Incidence and risk factors

A
  • can occur at any time, any age
  • poor hygiene
  • poor diabetic control
  • not usually STIs
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21
Q

Paraphimosis
Definition

A

Inability to reduce the prepuce over the glans of the penis

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22
Q

Paraphimosis
Pathophysiology

A

Inflammation prepuce or glans
inability to reduce foreskin over
restriction blood flow to glans
MEDICAL EMERGENCY

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23
Q

Paraphimosis
Treatment

A

Surgical release or circumcision

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24
Q

Hypospadias
Definition

A

Urethral opening is on the ventral side of the penis (glans, shaft, base, penoscrotal junction, perineum)

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25
Q

Medical management
hypospadias

A

Referral to urology for surgical repair and assessment

Co-morbidities
- mixed, intersexed
- cryptorchidism

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26
Q

Peyronie’s Disease
Definition

A

“bent nail” disease

Inealstic fibrous scar/plaque in the tunica albuginea of the corpus cavernosa

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27
Q

Peyronie’s Disease
Risk factors

A

Age 40-65 years
collagen loss
Dupuytren contractures
beta blockers
diabetes
penile trauma

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28
Q

Peyronie’s Disease
Pathophysiology

A

Trauma to tunica albuginea / corpus cavernosa

Bleeding –> inflammation –> fibrosis

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29
Q

Peyronie’s Disease
Clinical Signs and Symptoms

A
  • palpable fibrous lump
  • bend when erect
  • +/- pain on erection
  • +/- erection / penetration
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30
Q

Peyronie’s Disease
Treatment

A
  1. Urology MD consult
    - 50% will resolve in 12 monts
  2. Pharmacological management
    - L carnitine
    - potassium aminobenzoate
    - Q10
    - Colchicine
    - Collagenase clostridium histolyticum (CCH)
    * more successful for early lesions
  3. Surgical management
    - suture
    - Nesbit patch
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31
Q

List of Examples
Masses and Swelling of Testicles

A
  1. Testicular torsion
  2. Hydrocele
  3. Varicocele
  4. Spermatocele
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32
Q

Hypospadias
Etiology

A

Multifactoria
- genetic
- endocrine
- advanced maternal age
- low birth weight

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33
Q

Hypospadias
Complications

A
  • Chordee (penile torsion)
  • skin tethering
  • penis bows/bends ventrally or to right/left side
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34
Q

Varicocele
Definition

A

Dilation of testicular veins, pampiniform plexus, resulting in backflow of blood into testicles

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35
Q

Varicocele
Pathophysiology and incidence

A
  1. Increase blood flow to testes
    - adolescents (increased testosterone)
    - 10% adolescents
    - hot weather, exercise
  2. Dysfunction of valves leads to backflow of blood into testes
    - congenital defect
  3. Tumor/thrombus leads to increase venous pressure
    - Right sided varicocele
    - older age
  4. Dysfunction testes
    - decreased spermatogenesis
    - decreased androgen production
    - atrophy of testicle (smaller size)
    - low testosterone
    - high FSH and LH
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36
Q

Varicocele
Clinical Signs and Symptoms

A
  1. symptomatic
  2. asymptomatic

Asymptomatic
- detected through infertility testing
- low sperm count
- low testosterone
- high FSH, high LH

Symptomatic
- Dull ache
- heaviness
- worse with exercise, warm weather, prolonged standing
- palpable spaghetti like cords
- small testicle on inspection

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37
Q

Varicocele
Right or Left Interventions

A

Left 90%

Right 10%
- BAD
- compression inferior vena cava
1. tumor
2. thrombus
- emergency referral

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38
Q

Varicocele Treatment Pathways

A
  1. Referral to Urology MD
    - Mild (left side only) - watch
    - Moderate/severe - varicocelectomy
  2. Retroperitoneal US (moderate/severe, or right side)
    - order to have prepared for referral
    - R/O tumor, infarct
  3. Doppler US of testes
    - visualization venous distention of pampiniform plexus
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39
Q

Hydrocele
Definition

A

Most common cause of scrotal swelling

Fluid accumulation between tunica vaginalis (visceral and parietal) layers

Not usually associated with infertility

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40
Q

Hydrocele
Etiology

A
  1. Congenital hydrocele
    - 6% infants
    - majority resolves by 12 months
  2. Vascular
    - abnormal fluid secretion/asboprtion
  3. Trauma
    - trauma, torsion, surgery
  4. Infection
    - epididymitis
    -orchitis
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41
Q

Hydrocele
Treatment pathways

A
  1. Non-communicating hydrocele
    - watch and wait
    - not usually associated with infertility
    - majority congenital hydroceles resolve 12 months
  2. communicating hydrocele
    - urology MD referral
    - aspriation
    - sclerotherapy
  3. Severity of symptoms
    - asymptomatic/mild (watch and wait)
    - moderate/severe (treatment)
  4. Age
    - < 2 years, watch and wait
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42
Q

Hydrocele
Clinical Signs and Symptoms

A
  • painless swollen testicle
  • unilateral or bilateral
  • “swollen water balloon”
  • worsens throughout day
  • large swelling -> compression blood supply -> pain (communicating hydrogcele)
  • infection = pain
43
Q

Hydrocele
Diagnosis

A
  1. Transillumination
  2. Ultrasound
44
Q

Spermatocele
Definition

A

Diverticulum of the epididymis
- fluid filled cyst located between epididymis and testicle

45
Q

Spermatocele
Clinical Signs and Symptoms

A
  • usually not painful
  • asymptomatic
  • palpable, freely movable mass (outside tunica vaginalis)
  • cyst - filled with milky fluid, sperm
  • not associated with infertility
  • heaviness of testicle
46
Q

Spermatocele
Treatment

A
  • scrotal support
  • removal if associated with pain
47
Q

Painful vs. Non-painful
Testicular masses

A

non-painful
- testicular cancer
- hydrocele
- varicocele
- spermatocele

Painful
- epididymitis
- testicular torsion
- orchitis

48
Q

Testicular Torsion
Definition

A

Torsion of the blood vessels (arteries, veins) supplying the testicles resulting in decrease blood flow and ischemia

Medical emergency
Needs to be treated within 4 hours

49
Q

TWIST Score
Testicular Torsion

A
  1. Hard testicle / 2
  2. swelling /2
  3. N/V /1
  4. Cremasteric reflex absent /1
  5. riding high testicles / 1

Score
0-2 differential diagnosis
3-4 intermediate risk, referral, US
>5 emergency consult, immediate US

50
Q

Clinical Signs and Symptoms
Testicular Torsion

A
  • Hard testicles
  • edema
  • nausea and vomiting
  • absent cremasteric reflex
  • riding high testicle
  • unilateral pain
  • Prehn sign (not relieved by support of testicle)
51
Q

Pathophysiology
Testicular Torsion

A

Etiology
- spontaneous (wake up in severe pain)
- trauma
- > incidence < 25 years of age
- any age

  • Torsion of the vascular supply to testicles
  • cut off blood flow
  • ischemia, inflammation, necrosis
52
Q

Testicular Torsion
Treatment

A

Surgical intervention within 6 hours 90% testicles saved;

12 hours 50% testicles saved

24 hours 10% testicles saved

53
Q

Balanitis
Definition and pathophysiology

A

Inflammation of the glans (head) of the penis
*non-circumcized > circumcized

Accumulation:
- smegma (glandular secretions)
- epithelial cells
- mycobacterium (acid-fast bacterium)
- Candidiasis (yeast)

54
Q

Balanitis
Etiology

A
  1. Non-infectious
    - poor hygiene (pre-pubescence)
    - trauma
    - skin condition (psoriasis, eczema, lichen plantus)
    - drug reaction
  2. Infectious
    - Mycobacterium
    - STD
    - Candidias

*R/O with culture and sensitivity swab

55
Q

Balanitis
Complications

A

Posthitis
- inflammation of the prepuce

Paraphimosis
- inability to reduce the prepuce

Phimosis
- inability to retract foreskin

Blanoposthitis
- inflammaiton both prepuce and gland of penis

56
Q

Blanoposthitis
Definition

A

Co-occurance of posthitis (inflammation prepuce) + balanitis (inflammation glans of penis)

*usually occur together

57
Q

Risk factors
Balanitis

A
  • Immunocompromised
  • Poorly controlled diabetes
  • non-circumcized
  • pre-pubescent males
  • poor hygiene
58
Q

Treatment
Balanitis

A
  1. Hygiene Education
  • Clean daily, lukewarm water
  • avoid soaps, lubricants, baby wipes
  • retract foreskin > 3 years of age vs. clean under foreskin
  1. Treat inflammation and/or infection
  • Inflammation:
    Hydrocortisone 1% maximum 14 days
  • Yeast infection:
    Azole cream + hydrocortisone 1% for maximum 14 days
  • Mycobacterial infection:
    PO cloxacillin/cephalexin/clarithromycin 7 days, hydrocortisone cream 1% for 14 days
  1. Referrals
  • Urology/dermatology
  • circumcision for refractory cases
    -*investigate immunocompromised conditions (diabetes, HIV, etc.)
59
Q

Urethritis
Definition

A

Inflammation of the urethra
*Most commonly STD

60
Q

Urethritis
Etiology

A
  1. Infectious
  2. Non infectious

Most common STDs

Clinical signs and symptoms after 1 week:

Neisseria gonorrhea
- gram negative cocci
- symptoms develop in 1 week after contraction

Clinical signs and symptoms 1-5 weeks after:

Chlamydia trachomatis (gram negative)
mycoplasma genitalium (gram negative)
ureaplasma urealyticum (gram negative)
Trichomonas (protozoan)
candidia albicans (yeast)
herpes simplex virus
adenovirus

61
Q

Clinical Signs and Symptom
Urethritis

A
  • Asymptomatic (males > females)
  • dysuria
  • burning
  • pruritis
  • erythema
  • +/- discharge (mucopurulent/mucoid/purulent/bleeding)
  • obstruciton/urgency/retention
62
Q

Urethritis
Empirical Treatment

A

Empirical treatment treats for BOTH N. gonorrhea and C. trachomatis (co-occurring infections)

Ceftriaxone 250mg IM once
+
Azithromycin 1g PO once OR doxycycline 100mg BID for 7 days

*Non-gonococcal (asymptomatic, culture and sensitivity swab)
Azithromycin 1g PO once
OR
Doxycycline 100mg BID for 7 days

63
Q

Patient Education
Urethritis

A
  1. All partners in last 60 days to be treated
  2. Reported to public health
  3. Test for cure for 1-2 weeks after infection (*if alternative regime used)
  4. Symptom resolution 7-14 days post antibiotics
64
Q

Urethritis Treatment
Special populations

A
  1. Pregnancy & Children

Ceftriaxone
Azithromycin

*Doxycycline is contraindicated in pregnancy and children

  1. Allergy to penicillin

Ciprofloxacin + Azithromycin OR
Azithromycin + gentamicin
*Test for cure > 1-2 weeks after therapy (3-4 weeks if NAAT being used)

65
Q

Non-infectious causes Urethritis

A
  • inflammation
  • trauma
  • urological procedure
  • foreign bodies
  • autoimmune reactive arthritis (Reiter syndrome - shigella, campylobacter, chlamydia)
66
Q

Epididymitis
Definition

A

Inflammation of the epididymis

67
Q

Epididymitis
Etiology

A

Most commonly sexually active males < 35 years (rare before puberty)

  1. Sexually transmitted infection (Individuals < 35 years)
  2. Non-sexually transmitted infections (Individuals > 35 years)
  3. Sterile

STI Causes:
- Neisseria gonorrhea
- Chlamydia trachomatis
- Enterobactericeae (unprotected anal sex)

Non-sexually transmitted infection
- Cloriform
- Pseudomonas aeruginosa
- E. coli
- *hematogenous spread from genitourinary tract or chronic prostatitis

Sterile
- urine - structural reflux urine into epididymis
- drug - amiodarone therapy
- vasculitis (Behcet disease, henoch-schonlein purpura, polyarteritis nodosa)
- idiopathic
- urology procedure

68
Q

Chemical epididymitis

A
  • reflux of urine into the epididymis
  • Heavy lifting
  • sterile form of epididymitis
69
Q

Clinical Signs and Symptoms
Epididymitis

A
  • Acute unilateral testicular pain
  • Palpable swelling and pain (spermatic cord, testicles, epididymus (lower pole -> head))
  • testicular erythema and swelling
  • hydrocele (fluid between tunica vaginalis)
  • Fever, malaise, fatigue (infection)
  • +/- discharge (discharge = STI)
  • Relief of pain with testicular support (Prehn Sign)
  • UTI symptoms - urethritis
  • prostitis symptoms

*infection ascends the urether

70
Q

Complication
Epididymitis

A
  • abscess
  • infarcts (testicles, prostate)
  • chronic epididymis and scaring (antibiotics cannot reach the site of infection)
  • infertility
71
Q

Co-morbidities
Epididymitis

A

If the epididymitis is infectious:

  • Prostitis
  • urethritis
  • urinary tract infections

*infectious organism ascends the urethra –> prostate –> vas deferens / bladder

72
Q

Differential diagnosis
Epididymitis

A
  1. Testicular torsion
    - sudden pain
    - TWIST score: N/V, hard testicle, swelling testicle, riding high testicle, no cremasteric reflex, no prehn sign, unilateral
  2. Testicular cancer
    - progresses over weeks, not acute
    - low grade pain
73
Q

Treatment
Epididymitis

A
  1. Etiology: STI (N. gonorrhea / C. trachomatis)
  • Ceftriaxone 250mg IM once AND
  • Azithromycin 1g PO once
  • doxycycline 100mg BID for 10-14 days
  1. Etiology: non-STI or enteric organisms
  • Ciprofloxacin 500mg BID for 10-14 days
  • Levofloxacin 500mg once daily for 10-14 days
74
Q

Special populations
Epididymitis

A

Penicillin Allergy

Ciprofloxacin/Levofloxacin 500mg ONCE
Azithromycin 1g PO ONCE
Doxycycline 100mg BID for 10-14 days

75
Q

Causative organism
Epididymitis incidence

A

< 35 years of age OR multiple sexual partners OR purulent discharge
STI
N. gonorrhea / C. trachomatis
Empirical treatment

ceftriaxone 250mg IM once
azithromycin 1g PO once
doxycycline 100mg BID 10-14 days

> 35 years of age
Assume non-STI and gram negative enterococci
Empirical treatment

ciprofloxacin 500mg BID /levofloxacin 500mg OD for 10-14 days

*Re-assess if symptoms persist after 3 days

76
Q

Patient Education
Epididymitis

A
  • return to doctor if symptoms do not resolve in 3 days (re-assess empiric treatment)
  • public health reportable
  • all partners treated within 60 days
77
Q

Duration of therapy
Epididymitis

A

Minimum 10-14 days

*secondary to chronic prostatitis
up to 6 weeks of antibiotic therapy

78
Q

Prostatitis
Definition and types

A

Inflammation of the prostate

  1. Acute prostatitis
  2. Chronic prostatitis
  3. Bacterial prostatitis
  4. non-bacterial prostatitis
  5. Idiopathic
79
Q

Acute Prostatitis
Clinical Signs and Symptoms

A

*Similar to UTI

  • Fever, chills, malaise
  • perineal, rectal, lower back pain
  • irritative/obstructive voiding
  • Pain worse when standing (pelvic floor contracts prostate)
  • palpation prostate enlarged, swollen, tender, indurated, warm
80
Q

Diagnostic and laboratory tests
Prostatitis

A

obtain urine sample before empiric treatment

81
Q

Acute Prostatitis
Treatment

A

MUM’s Guideline
10-14 days
re-assess

  • Ciprofloxacin 500mg BID for 3-4 weeks
  • Levofloxacin 500mg OD for 3-4 weeks
  • Norfloxacin 400mg BID for 3-4 weeks
  • TMP/SMX

Additional 2-4 weeks needed after symptoms have resolved to prevent chronic prostatitis

82
Q

Acute Prostatitis
Unable to void
Treatment

A

Hospitalization

  1. IV antibiotics
  2. Suprapubic catheterization (foley contraindicated)

Ampicillin IV OR Ceftriaxone IV
+
Gentamicin IV OR tobramycin IV

83
Q

Chronic Prostatitis
Clinical Signs and Symptoms

A

*Relapsing UTI suspect chronic prostatitis

  • urinary frequency, urgency
  • urinary retention
  • dysuria
  • ejactulatory pain
  • pelvic or genital pain
  • hemospermia
  • some patients are asymptomatic
  • prostate exam is usually normal
84
Q

Chronic Prostatitis
Incidence

A

Incidence increases with age

85
Q

Chronic Prostatitis
Diagnostics and treatment

A
  1. Urine culture and sensitivity

Syndrome approach (cultures may be negative)

  1. Antibiotic treatment
    - Levofloxacin 500mg once for 4-6 weeks
    - Ciprofloxacin 500mg BID for 4-6 weeks
    SECOND LINE
    - TMP/SMX
  2. Alpha blockers
    - TeraZOSIN
    - block alpha receptors, relaxation smooth muscles
  3. Referral to urology MD
    - no resolution 4-6 weeks
86
Q

Non-pharmacological treatment
Prostatitis

A
  1. Anti-inflammatories
  2. hot sitz bath
  3. bedrest (relaxation pelvic floor muscles)
87
Q

Complication
Prostatitis

A
  1. Prostatic caliculi
    - stones in the prostate
    - infected with bacteria
    - hard to eradicate
    - Rx. surgical removal
  2. Inflammatory chronic pelvic pain syndrome
    - chronic pain
    - perineal, testicular, penile, lower abdomen, ejactulatory
    - dysuria, hesitancy, interrupted flow
    - exacerbated by sexual activity
  3. Chronic prostatitis
  4. Abscesses
  5. Bacteremia
  6. Epididymitis
88
Q

Orchitis
Definition

A

Inflammation of the testicles and scrotal sac secondary to epididymis infection or secondary to systemic illness (Ex. Mumps, COVID19)

89
Q

Orchitis
Clinical Signs and Symptoms

A
  • Secondary to infection: Fever, WBC
  • Inflammation: swelling, erythema to testicles, pain
  • unilateral or bilateral
  • +/- hydrocele
  • prostration (doubled over in pain)
90
Q

Orchitis
Pharmacological and Non-pharmacological Treatment

A

Pharmacological
- Treat infection
- COVID19 antivirals
- Bacterial epididymitis
- No pharmacological treatment for mumps

Non-pharmacological
- bed rest
- support testicles
- ice
- anti-inflammatories

91
Q

Complications
Orchitis

A

Infertility

92
Q

menarch

A

menstruation
occurs 2.5 years after thelarche in females

93
Q

Thelarch

A

emergence of breast buds
approximately 8 years-12 years females
= gonadarche for females
stage 2 tanner

94
Q

pubarche

A

pubic hair appearance
8 years of age
stage 2 tanner

95
Q

gonadarche

A

formation testes males and ovaries females
stage 2 tanner development
corresponding to thelarche in females
Stage 2 tanner

96
Q

Pre-puberty
hypothalamus-pituitary axis

A

GnRH
gonadotropin releasing hormone

LH
leutinizing hormone

FSH
follicle stimulating hormone

low levels of all hormones
FSH > LH

97
Q

Puberty
Hypothalamus- pituitary axis

A

surges of FSH and LH at night time during REM sleep
small release GnRH results in large release FSH and LH

LH > FSH

98
Q

Male Secondary sexual characteristics are controlled by what hormone?

A

LH
leutinizing hormone
results in release of testosterone from leydig cells
secondary sexual characteristics - hair, growth, muscles, testicles

FSH
follicle stimulating hormone
results in spermatogenesis from sertoli cells in the seminiferous tubules in the testicles

99
Q

Female secondary sexual characteristics, controlled by what hormones

A

LH
leutinizing hormone
results in release of estrogen from the theca cells in the ovaries
Estrogen receptors in ovaries, placenta, breast tissue

FSH
follicle stimulating hormone
promotes development of the ovarian follicle and stimulates estrogen secretion

FSH and LH spike occurs on day 14 of the cycle

100
Q

Female hormones during ovulation

A

LH and FSH spike
promote ovulation

Estrogen and LH highest during ovulation

progesterone is highest post-ovulation

101
Q

Effect of estrogen
Non-reproductive

A
  • bone density
  • liver: decrease LDL, increase HDL
  • CNS: memory, cognition
  • Skin: collagen, elasticity, healing
  • Kidney: protective against CKD
  • CVS: prevents atheroscelerosis, platelet adhesion
102
Q

Effects of estrogen
Reproductive

A

Vaginal mucosa: growth squamous epithelium

cervical mucosa: fluid secretions, motility sperm increased and survival increased

fallopian tubes: motility and cillia action inrease

Uterine muscles: increase blood flow, contraction, oxytocin sensors

Endometrium: growth, increase progesterone receptors

breasts: ducts, prolactin increase

103
Q

Effects of progesterone
Reproductive

A

vaginal mucosa: thinning squamous epithelium

Cervical mucosa: thickening, plug cervix

Fallopian tube: decrease ciliary motility

Uterine muscles: relaxation, decrease sensation oxytocin

endometirum: decrease estrogen receptors, activate glands, blood vessels

breasts: growth lobules, alveoli, inhibition prolactin

Year 1: Patho/Pharm (39 decks)

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