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Endocrinology > Reproductive Endocrinology & Disorders > Flashcards

Reproductive Endocrinology & Disorders Flashcards

1
Q

where does oogenesis begin?

A

in utero (as foetus)

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2
Q

when is oogenesis completed?

A

fertilisation

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3
Q

when does oogenesis cease?

A

at menopause

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4
Q

what is a primordial germ cell?

A

earliest recognisable germinal cell

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5
Q

what is a primordial germ cell capable of?

A

mitosis

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6
Q

where does a primordial germ cell migrate to and when?

A

genital ridge by week 6 of embryo development

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7
Q

what is oogonia?

A

completion of last pre-meitotic division to oocytes

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8
Q

what are primary oocytes?

A

1st meiotic division

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9
Q

what are secondary oocytes?

A

2nd meiotic division

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10
Q

how many types of polar bodies are there?

A

2 (sperm & egg)

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11
Q

what do both polar bodies have in common?

A

relatively small

contain little cytoplasm

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12
Q

what does the presence of 2 polar bodies signify?

A

sperm entry & completion of 2nd meiotic division (fertilisation)

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13
Q

when is the number of eggs in a female highest?

A

before birth

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14
Q

what happens to the number of eggs in a foetus just before birth?

A

rapidly decreases

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15
Q

can an ovary produce eggs after the age of 20/30 if it has been damaged?

A

no as no stem cells present - born with finite number of eggs

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16
Q

what is the average length of ovarian cycle?

A

28 days

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17
Q

how many phases does an ovarian cycle have & what are they?

A

2

  • follicular phase
  • luteal phase
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18
Q

what happens during the follicular phase?

A

Maturation of egg, ready for ovulation at midcycle – ovulation signals end of follicular phase

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19
Q

what happens during the luteal phase?

A

Development of corpus luteum.

Induces preparation of reproductive tract for pregnancy (if fertilisation occurs)

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20
Q

what is a primary follicle?

A

Before birth, the primary oocyte is surrounded by a single layer of granulosa cells

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21
Q

what is each primary follicle capable of producing?

A

a single ovum

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22
Q

what happens to primary follicles until puberty?

A

degenerate to scar tissue at some stage before ovulation

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23
Q

atresia

A

scar tissue

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24
Q

luteinisation

A

transformed to the corpus luteum

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25
Q

what hormone does corpus luteum produce?

A

progesterone

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26
Q

which hormone is secreted in the follicular phase?

A

oestrogen

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27
Q

which hormone is secreted in the luteal phase?

A

progesterone

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28
Q

if no fertilisation has occurred how long would the corpus luteum survive?

A

no longer than 14 days after ovulation

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29
Q

what signals the start of new follicular phase?

A

degeneration of corpus luteum signals

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30
Q

what hormones does the anterior pituitary secrete?

A

FSH

LH

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31
Q

what does the hypothalamus secrete & what does it act on?

A

GnRH

anterior pituitary

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32
Q

what dies the FSH act on?

A

ovary

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33
Q

what does LH act on?

A

ovary

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34
Q

what does FSH do?

A

stimulates development of follicles

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35
Q

what does LH do?

A

stimulates follicle maturation, ovulation & development of the corpus luteum

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36
Q

what do FSH + LH stimulate?

A

secretion of oestradiol & ovulation

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37
Q

what do theca cells produce?

A

androgen

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38
Q

what is androgen converted to & where?

A

to oestradiol

by the granulaosa

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39
Q

what does oestrogen do to the anterior pituitary?

A

suppresses FSH production

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40
Q

what forms the corpus luteum?

A

remaining granulosa that have proliferated

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41
Q

what do theca cells convert androgen to?

A

oestrogen

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42
Q

oligomenorrhea

A

reduction in frequency of periods to less than 9/year

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43
Q

primary amenorrhoea

A

failure of menarche by the age of 16 years

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44
Q

secondary amenorrhea

A

cessation of periods for >6 months in an individual who has previously menstruated

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45
Q

menarche

A

first menstrual cycle

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46
Q

what are the physiological causes of amenorrhoea?

A

pregnancy

post-menopausal

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47
Q

amenorrhea

A

abnormal absence of menstruation

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48
Q

what should you consider in primary amenorrhea?

A

congenital problems

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49
Q

what ovarian problems can cause secondary amenorrhoea?

A

PCOS

Premature ovarian failure

50
Q

what are oestrogens?

A

class of steroid hormones which control the development & maintenance of female sexual characteristics

51
Q

where does glandular oestrogen synthesis?

A

in the granolas & theca cells of the ovaries as well as the corpus luteum

52
Q

what is the rate limiting step of the production of oestrogen?

A

conversion of cholesterol to pregnenalone

53
Q

what does oestrogen production fluctuation match?

A

thickness of endometrium

54
Q

what uterine problems can cause secondary amenorrhoea?

A

uterine adhesions

55
Q

uterine adhesions

A

problems with shedding endometrium due to adhesions

56
Q

what pituitary problems can cause secondary amenorrhoea?

A

high PRL

hypopituitarism

57
Q

give some examples of oestrogen deficiency

A

flushing
libido
dyspareunia

58
Q

dyspareunia

A

difficult or painful sexual intercourse

59
Q

anosmia

A

loss of sense of smell

60
Q

what would anosmia suggest?

A

kallman’s

61
Q

what is Kallman’s due to?

A

failure of production of GnRH

62
Q

what would a thick endometrium suggest?

A

polycystic ovaries

63
Q

what would a thin endometrium suggest?

A

decreased oestrogen

64
Q

what investigations should all patients with oligo/amenorrhea have?

A

LH, FSH, oestradiol

thyroid function, prolactin

65
Q

what is female hypogonadism identified by?

A

low levels of oestrogen

66
Q

primary hypogonadism

A

problem with ovaries

67
Q

secondary hypogonadism

A

problem with hypothalamus or pituitary

68
Q

what would a high LH/FSH suggest in primary hypogonadism?

A

hypergonadotrophic hypogonadism

69
Q

give an example of a cause of primary hypogonadism

A

premature ovarian failure

70
Q

give an example of secondary hypogonadism

A

high PRL

hypopituitarism

71
Q

what would an FSH > 30 suggest?

A

post-menopausal

72
Q

give some examples of causes of POF

A

chromosomal abnormalities
gene mutations
autoimmune disease
iatrogenic

73
Q

POF

A

premature ovarian failure

74
Q

what chromosomal abnormalities could cause POF?

A

Turner’s syndrome

Fragile X

75
Q

what gene mutations could cause POF?

A

FSH/LH receptor

76
Q

what autoimmune diseases are associated with POF?

A

Addison’s
thyroid
APS1/2

77
Q

what are the iatrogenic causes of POF?

A

radiotherapy

chemotherapy

78
Q

what characterises secondary hypogonadism?

A

low estradiol and low/norma LH or FSH

79
Q

what hypothalamic problems could cause secondary hypogonadism?

A

functional hypothalamic disorders
Kallman’s syndrome
IHH

80
Q

IHH

A

idiopathic hypogonadotrophic hypogonadism

81
Q

what other things could cause secondary hypogonadism?

A

Prader-Willi
Haemachromatosis
pituitary problems

82
Q

what is IHH identified by?

A

absent or delayed sexual development associated with inappropriate low levels of gonadotrophin and sex hormone levels in absence of anatomical / functional defects of hypothalamic-pituitary gonadal axis

83
Q

what is the only clinical difference between IHH and Kallman’s?

A

anosmia in kallman’s

84
Q

what is the major defect in IHH?

A

inability to activate pulsatile GnRH secretion during puberty

85
Q

Kallman’s syndrome

A

A genetic disorder characterised by a loss of GnRH secretion + anosmia or hyposmia

86
Q

hyposmia

A

reduced ability to smell & detect odours

87
Q

which sex is Kallman’s dynamo more common in?

A

males

88
Q

what can cause loss of LH/FSH stimulation?

A

non-functioning pituitary macroadenoma
empty sella
pituitary infarction

89
Q

non-functioning pituitary macroadenoma

A

pituitary tumour

pressure effects lead to hypopituitarism

90
Q

empty sella

A

small or no pituitary gland normal pituitary function except loss of FSH/LH

91
Q

what can cause hyperprolactinemia?

A

micro/macro prolactinoma

drugs

92
Q

PCOS

A

polycystic ovarian syndrome

93
Q

what are the oestrogen levels like in PCOS?

A

normal

94
Q

what is the rotterdam criteria?

A

2 of:
menstrual irregularity
hyperadrogenism
polycystic ovaries

95
Q

what is the rotterdam criteria used for?

A

diagnosis of PCOS

96
Q

hirsutism

A

excess hair; usually used when referring to women with male pattern hair distribution

97
Q

what is hirsutism caused by?

A

androgen excess at hair follicles

98
Q

what can cause androgen excess at hair follicle?

A
  • excess circulating androgen

- increased peripheral conversion at the hair follicle

99
Q

what can cause hirsutism?

A 
PCOS
familial 
idiopathic 
non-classical congenital adrenal hyperplasia 
adrenal/ovarian tumour
100
Q

CAH

A

congenital adrenal hyperplasia

101
Q

what is CAH?

A

an inherited group of disorders charaterised by a deficiency in one of the enzymes necessary for cortisol synthesis

102
Q

what is the inheritance pattern of CAH?

A

autosomal recessive

103
Q

when is classic CAH typically diagnosed?

A

infancy

104
Q

what is classic CAH due to?

A

21alpha-hydroxylase deficiency

105
Q

what is non-classic CAH due to?

A

partial 21alpha-hydroxylase deficiency

106
Q

what does non-classic CAH usually present with?

A

hirsutism
menstrual disturbance
infertility due to anovulation

107
Q

when does non-classic CAH usually present?

A

adolescence/adulthood

108
Q

anovulation

A

he failure of the ovary to release ova over a period of time generally exceeding 3 months

109
Q

what is the karyotype of Turner syndrome?

A

22X

110
Q

name some features of turner syndrome

A

short stature
webbed neck
shield chest with wide spaced nipples
cubitus valgus

111
Q

XX gonadal dysgenesis

A

absent ovaries but no chromosomal abnormality

112
Q

what is the most common congenital form of primary hypogonadism?

A

klinefelter’s syndrome

113
Q

what’s they karyotype of klinefelter’s syndrome?

A

47 XXY

114
Q

what could cause gynaecomastia?

A 
physiological 
drugs 
tumours 
endocrine disorders 
systemic illness 
hereditary disorders
115
Q

oligomenorrhea

A

cycles > 35 days

116
Q

GnRH

A

gonadotrophin releasing hormone

117
Q

what is GnRH synthesised by?

A

neurons in hypothalamus

118
Q

what kind of release does GnRH exhibit?

A

pulsatile release

119
Q

what does GnRH do?

A

stimulates FSH & LH

120
Q

what happens to insulin in PCOS?

A

diminished biological response to a given level of insulin

121
Q

twin-twin transfusion syndrome

A

unbalanced vascular communications within placental bed

Endocrinology (23 decks)

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