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Endocrinology > Reproductive Lecture 4 > Flashcards

Reproductive Lecture 4 Flashcards

1
Q

What drug results in an unusually high FSH/LH/testosterone?

A

clomiphene

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2
Q

Define primary amenorrhea

A

absence of menses by age 17

causes: Turner’s, complete androgen resistance, hormonal disorders

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3
Q

Define secondary amenorrhea

A

cessation of menstruation for longer than 6 months

causes: pregnancy, lactation

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4
Q

What is galactorrhea?

A

inappropriate milk production in someone who is not lactating (can be caused by prolactinomas)

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5
Q

Define oligomenorrhea

A

infrequent periods (cycle length >35 days)

causes: changes in CNS mechanisms that regulate GnRH release

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6
Q

Define dysmenorrehea

A

painful menses due to uterine contractions (prostaglandin synthesis promoted by E2)

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7
Q

Painful periods are due to which hormone?

A

prostaglandins

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8
Q

What are some causes of hirsutism (excessive hair growth)

A

excessive androgen production by adrenals

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9
Q

What differentiates hirsutism from virilization?

A

virilization includes more evidence of androgen stimulation like clitoral hypertrophy, deepening voice, balding

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10
Q

What is PMS?

A

Premenstrual syndrome

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11
Q

What is PCOS?

A

polycystic ovarian syndrome

root cause: insulin resistance, obesity

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12
Q

How is PCOS related to insulin?

A

high insulin stimulates androgen production (leading to infertility) and increased conversion to estrogens (weight gain)

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13
Q

What is the cause of the cysts in PCOS?

A

follicles degenerate into cysts, ovaries get really big

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14
Q

What are some symptoms of PCOS?

A
  • sleep apnea
  • menstrual irregularity
  • obesity/acne
  • hirsutism
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15
Q

What are treatments for PCOS?

A

metformin (can restore fertility)

Clomiphene (feedback on HPT axis)

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16
Q

Is fetal age the same as gestational age?

A

NO, fetal age is 2 weeks less than gestational age (which is calculated from first day of last menstruation)

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17
Q

When is the best chance for fertilization?

A

24 hours post-ovulation (48-72 hours post coitus for sperm)

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18
Q

What is the acrosomal reaction?

A

release of proteolytic enzymes that disperse granulosa cells and permit sperm attachment to ZONA PELLUCIDA

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19
Q

How are the enzyme rich contents of the acrosome released?

A

spermatozoan has receptors for glycoprotein (ZP3) so binding causes inreased IP3 leading to increased Ca++ which fuses inner and outer membranes

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20
Q

What is the first exocytosis step of fertilization?

A

1) exocytosis of spermatozoan internal membrane contents

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21
Q

Name the steps of fertilization

A

1) binding of sperm to zona pellucida
2) acrosomal reaction
3) penetration thru zona pellucida
4) fusion of plasma membrane
5) sperm nucleus enters egg cytoplasm

22
Q

What is the second exocytosis event of fertilization?

A

release of oocyte’s internal vesicles (harden glycoproteins of zona pellucida preventing polyspermy)

23
Q

Why is the Ca++ increase so important upon fertilization?

A

1) allows both exocytosis events

2) triggers completion of second meiotic division

24
Q

How long do sperm retain fertilizing capacity?

A

24-48 hours

25
Q

What percentage of sperm make it to the oviduct? ampulla?

A

0.1% to oviduct

a few hundred to the ampulla

26
Q

Does the vagina make sperm transport easier or harder?

A

easier (decreased acidity, increased cGMP to increase velocity and direction of sperm) contraction of ampulla wall to promote random interaction of sperm and ovum

27
Q

For how long does the blastocyst traverse the oviduct?

A

3 days

28
Q

What determines the timing of blastocyst entry into the uterus?

A

estrogen/progesterone balance

estrogen constricts isthmus, barring passage of embryo to uterus to allow time for endometrial development

progesterone promotes myometrium relaxation and transport of blastocyst to uterus

29
Q

What are the 3 successive processes of implantation?

A

1) adhesion
2) penetration
3) invasion

30
Q

What is the implantation failure rate?

A

70%

31
Q

What important cytokine increases integrins in endometrial cells (promoting implantation)?

A

IL-1

32
Q

What does osteopontin do/

A

binds integrins of both endometrium and blastocyst

33
Q

The egg hatches when ____________________

A

the zona pellucida dissolves

34
Q

What do stromal cells do?

A

form decidua and secrete nutrients (becomes barrier and endocrine organ later)

35
Q

Describe the burrowing and intermingling of endometrial cells and the egg

A

microvilli of trophoblasts interdigitate with endometrial cells then burrow under epithelial cells

36
Q

What hormone promotes the formation of the decidua from stromal cells?

A

progesterone

37
Q

What is the source of nutrients for the egg until vasculature can be established?

A

decidua

38
Q

What is invasion?

A

balance between decidual cells (defense) and trophoblast migration (offense)

to prevent from burrowing too deeply

39
Q

What do trophoblasts secrete to help with burrowing? (and is blocked by decidual cells)

A

matrix metalloproteinases (MMP)

40
Q

What 2 things do trophoblasts differentiate into?

A

1) syncytiotrophoblasts

2) cytotrophoblasts

41
Q

What are syncytiotrophoblasts?

A

mass without ell boundaries, extend between uterine epithelial cells

42
Q

What do syncytiotrophoblasts secrete?

A

TNF

43
Q

What do Cytotrophoblasts serete?

A

CRH and TRH

somatostatin

44
Q

Which of the two (syn or cyto) are responsible for most endocrine functions?

A

syncytiotrophoblasts

45
Q

What are 4 main functions of the placenta?

A

1) Gut (supplies nutrients)
2) Lung (gas exchange)
3) Kidney (fluid volume and waste disposal)
4) Endocrine gland

46
Q

How are nutrients transported to fetus?

A

diffusion of facilitate diffusion

oxygen diffuses down conc gradietn (fetal Hb has higher affinity for O2 than adult)

47
Q

How is CO2 transferred from fetal to maternal blood to be exhaled?

A

CO2: pCO2 in fetal blood is 2-3mmHg higher than maternal blood so it can diffuse down that gradient

48
Q

What is hCG and what other hormone is it similar to?

A

secreted by fertilized baby (can be detected 9 days post conception) made by syn under control of GnRH from cyto

similar to LH (rescues the luteum and stimulates secretion of progesterone and estradiol)

49
Q

What effect does hCG have on LH and FSH?

A

prevents it (otherwise would stimulate next cohort of follicles to develop)

complemented by inhibin

50
Q

What other hormone is produced by sync that is structurally similar to GH?

A

Human placental lactogen (HPL) aka Human Chorionic Somatomammotrophin (HCS)

51
Q

What does HPL do?

A

in response to hypoglycemia, it stimulate lipolysis and has anti-insulin actions on maternal carb metabolism (increases plasma glucose and FFAs to maintain continuous flow of nutrients to baby)

Endocrinology (16 decks)

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