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Reproductive Physiology Flashcards

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USMLE® Step 1 flashcards
1
Q

MIH ( AMH)

A

Mullerian-inhibniting hormone (MIH)

also called

anti-Mullerian hormone (AMH)

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2
Q

X → DHT

a rxn catalyzed by 5a-reductase

A

X is T (testosterone)

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3
Q

DHEA

(de. hydro.epi.andro.sterone)

A

de. hydro.epi.andro.sterone
- Formed as a product of the 2nd rxn of sex steroid synthesis.

Note: It functions as a metabolic intermediate in the biosynthesis of the androgen and estrogen sex steroids both in the gonads and in various other tissues.

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4
Q

SRY

A

Sex-determining Region of Y chromosome

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5
Q

List male androgens:

A

Testosterone (T)

    • androstenedione (precursor of extraglandular estrogen in men)
    • DHEA
    • DHT
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6
Q

genital swelling (- )DHT/f

A

labia majora

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7
Q

which one of the following can not be detected during 6-7 wks gestation period:

A- germ cells

B- seminiferous tubules

C- leydig cells

D- sertoli cells

A

C- leydig cells appear later- 8-9 weeks

Choice A might have been difficult to eliminate. Indirectly, it’s been given that during 6-7 weeks sertoli cells enclose germ cells.

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8
Q

Normal levels of testosterone (T), Estrogen (E) and estradiol 17B depends on:

A

age

gender

health status

time of the day

women: phase of menstrual cycle

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9
Q

Other hormones in the same family as LH/FSH

A

TSH and hCG

•FSH, LH, TSH, hCG are all are glycoproteins with à and ß subunits

  • à chains of TSH, hCG. LH and FSH are the same
  • ß chain confers specificity
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10
Q

external genitalia-f

A

clitoris

labia mjora

labia minora

lower vagina

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11
Q

Morris Syndrome

A

Androgen insensitivity syndrome

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12
Q

Female differentiation at 9 weeks:

Enumerate the events

A
  1. Activation: XX activation (both)
  2. Mitosis: Germ cells → oogonia
  3. Meiosis: oogonia
  4. Support: cells surrounded by granulosa cells and stroma
  5. Theca cell development from stroma
  6. Meiosis arrest in late prophase
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13
Q

Androgen insensitivity syndrome

Mode of inheretance

Genotype and phenotype

A

X-Linked recessive due to the absence of androgen receptors on target tissue.male genotype but appears as female phenotype

Genotype: XY

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14
Q

What happens to Wolffian ducts in the absence of Testosterone?

A
  1. Wolffian duct regression
  2. Mullerian duct development ( into fallopian tubes, uterus cervix and upper 1/3 of vagina).
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15
Q

92AA long GnRH

A

preprohormone

preprohormone → prohormone → decapeptide-GnRH + GAP

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16
Q

precursors of theca and leydig cells

A

mesenchymal stromal cells

One of 2 cell types that is indifferent in both m and f; and is present in the 1st 5 week in-utero gonals.

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17
Q

Identify compounds A and B (sex steroid synthesis)

A → 17à-hydroxypregnenolone → B

A

A- pregnenolone

B- DHEA

♦ 2nd and 3rd reactions of the synthesis of sex steroids, which takes place in SER. They are also common for both m and f.

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18
Q

testes develop from —— via action of SRY region of Y chromosome.

A

primitive gonads

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19
Q

time period at which the external genitalia of both genders begin to differentiate

A

~9-10 wks

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20
Q

sex steroid metabolism is similar to ……….

A

similar to corticosteroids and mineral corticoids metabolism

  1. metabolized mainly in liver
  2. excreted in urine
  3. with halg life of ~30-60 min
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21
Q

Sex Steroid circulation (sex steroids and progestrone)

A

Sex steroids are bound to SSBG or albumin.

Sex steroids: testostrone and estrogen

Progestrone circulate bound to corticosteroid binding globulin (CBG).

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22
Q

MIH (AMH) is produced by

A

sertoli cells

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23
Q

genital tubercle (-) DHT/f

A

clitoris

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24
Q

the common tissue of labia majora and scrotum

A

genital swelling

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25
Q

Total # of Cs for male sex steroids:

A

19

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26
Q

Specific events of male gonadal differentiation:

  • 6-7 weeks
  • 8-9 weeks
A

In males at 6-7 wks

  • Semineferous tubules form
  • sertoli cells enclose germ cells

8-9 wks

  • Leydig cells appear
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27
Q

The time periods at which testes are distinguishable and functional

A
  1. Distinguishable in 7 weeks
  2. Fully functional in 14-15 wks( additional 7-9 weeks).
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28
Q

Testosterone paracrine action on Wolffian ducts

A

Development of:epididymis, vas deferens, seminal vesicles and ejaculatory ducts.

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29
Q

During female gonadal differentiation (~9wks) some of these cells undergo meiosis:

A

oogonia

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30
Q

The source function of testostrone during development of male internal genitalia

A

Testosterone (produced by leydig cells) act in paracrine manner to stimulate development of wolffian ducts into epididymis, vas deferens, seminal vesicles and ejaculatory duct.

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31
Q

The common tissue of clitoris and glans penis:

A

genital tubercle

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32
Q

Regardless of the genetic make up, prior to 6 weeks gestation, the fetus has indifferent gonads that have formed from —–

A

the genital ridges

Note: at 6 wks gestation, migratory germ cells invade the genital ridges.

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33
Q

From —- cell, theca cells develop.

Hint- 9wks, female gonadal differentiation

A

stroma

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34
Q

GnRH binds the plasma membrane of ——- in pituitary and stimulates the release of both FSH and LH.

A

gonadotroph

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35
Q

5-alpha-reductase converts testosterone to this compound

A

DHT

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36
Q

The common target tissues of DHT in both m/f:

A

Genital tubercle

Genital swelling

Urethral fold

Urogenital sinus

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37
Q

Precursor of extraglandular estrogens in men

A

Andro.sten.edione (made from DHEA)

Note 1 : both ovaries and testies produce estrogen and androgen. Androgens produced from adrenal cortex in both sexes gets convrted to estrogen in adipose and other extragonadal external adrenal tissues.

Note 2: Androstenediol, or 5-androstenediol (abbreviated as A5 or Δ5-diol), also known as androst-5-ene-3β,17β-diol

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38
Q

The time frame whithin which the androgenic hormones take effect in women

A

After menopause androgenic hormones are produced by adrenals

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39
Q

The period by which the leydig cells appear during m. gonadal differentiation

A

By 8-9 week

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40
Q

A period of gonadal differentiation, in which (both m/f) in-utero gonals are indifferentiated

A

1st 5 week- indifferent gonals

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41
Q

genital tubercle (+) DHT (m)

A

glans penis

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42
Q

T is produced by

A

leydig cells of testes

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43
Q

precursor of sertoli cells (cell type found in the first 5 week)

A

coelomic epithelial

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44
Q

True hermaphrodites

A

true hermaphrodites are individual with both male and female gonads.

45
Q

urogenital sinus + DHT (m)

A

prostate gland

46
Q

69AA GnRH

A

prohormone

preprohormone (92aa) → prohormone (69aa) →

decapeptide-GnRH (10aa) + GAP (GnRH associated peptide)

47
Q

genetic state: XY, normal

  1. Gonads
  2. Mullerian ducts
  3. Wolffian ducts
  4. Ext. Genitalia
A
  1. testes
  2. regressed MD
  3. developed WD
  4. Male
48
Q

Meta female

A

Dysgenic ovary

MD-developed

WD- regressed

external genitalia: female

49
Q

The common linage for the genitalia differentiation is based on the presence of ——— .

A

dihydrotestosterone DHT

50
Q

The common tissue of lower vagina and prostate gland

A

urogenital sinus

51
Q

DHT

A

dihydrotestosterone

The common linage for the genetical differentiation is based on the absence of DHT.

T → DHT (enzyme: 5a reductase)

52
Q

male determinant chromosome

A

Y

53
Q

estrogens are produced in

A

ovaries and testes

ovaries: large amt (small amt of T)

Testies: Small amt ( L. amt T)

54
Q

Hormones required for libido in women

A

androgens

55
Q

CBG

A

corticosteroid binding globulin

56
Q

The two internal ducts ithat are present in an early embryo, (regardless of the sex) are:

A

Wolffian duct

Mullerian duct

57
Q

mullerian duct future

A

female internal re[productive tract

58
Q

Locations/sub-location of GnRH production

A

arcuate nucleusandpreoptic are of hypothalamus

59
Q

Location of sex steroid production

A

Testes and ovaries (functioning as endocrine glands , in addition to gamete production)

60
Q

precursor of extraglandular estrogens in men

A

androstenedione

61
Q

GnRH (decapeptide) & GAP

  1. Synthesis
  2. Processing
A

1- synthesis: as preprohormone (92 AA) in arcuate nucleus and preoptic area of hypothalamus.

2- Processing: 2 cleavages

  • 1st cleavage: pro-hormone (69 AA)
  • 2nd cleavage: a 56 AA, GAP- GnRH Associated Protein.

3- GnRH as a decapeptide with 10 AA.

Note: both GAP and GnRH are secreted into portal circulation.

62
Q

At 6 week gestation the genital ridges are invaded by

A

migratory germ cells

  • Prior to 6 wks, the fetus has indifferent gonads with genital ridges.
63
Q

location for the following conversions:

Androstenediol to andsosterone

T to DHT

A

SER

64
Q

genetic state: XO, Turners

  1. Gonads
  2. Mullerian ducts
  3. Wolffian ducts
  4. Ext. Genitalia
A
  1. Streak
  2. MD- developed
  3. WD- regressed
  4. Female
65
Q

The structures that are formed from mullerian duct in the absence of testosterone:

A

fallopian tubes

uterus

cervix

upper 1/3 of vagina

(in the absence of T, female is the “default” pattern)

66
Q

Two distinct roles of reproductive system

A

1- endocrine ( reg’ by HPG axis) and 2- reproductive

67
Q

SSBG

A

steroid binding globulin (circulate sex steroids)

68
Q

Reactions catalyzed by 17β-hydroxysteroid dehydrogenases

A

Androstenedione is converted to testosterone, DHEA is converted to androstenediol, and estrone is converted to estradiol by the 17β-hydroxysteroid dehydrogenases

69
Q

DHT

A

Dihydrotestosterone

70
Q

coelomic epithelial

A

during the first 5 week- precursors of granulosa and sertoli cells

71
Q

genetic state: XY, No Androgen receptor

  1. Gonads
  2. Mullerian ducts
  3. Wolffian ducts
  4. Ext. Genitalia
A
  1. Testes
  2. MD- regressed
  3. WD- regressed
  4. Female
72
Q

development of male internal genitalia depends on these two hormones produced by fetal testes:

A
  1. testosterone
  2. MIH- Mullerian- inhibiting hormone
73
Q

genetic state: XY, Reduced Testosterone

  1. Gonads
  2. Mullerian ducts
  3. Wolffian ducts
  4. Ext. Genitalia
A
  1. Testes
  2. MD- regressed
  3. WD- Regressed/Variable
  4. M/F
74
Q

urethral folds ( - )DHT (f)

A

labia minora

75
Q

FSH/LH structure

A

•FSH, LH, TSH, hCG are all are glycoproteins with à and ß subunits

à chains of TSH, hCG. LH and FSH are the same

ß chain confers specificity

76
Q

Reproductive (exocrine) function of reproductive system

A
  1. Gametogenesis
    1. male: continuous
    2. female: cyclical
  2. Maintnance of:
    1. reproductive tract
    2. secondary sex characteristic
77
Q

GAP

A

GnRH associated peptide (hormone).

78
Q

Estrogens (3 different types):

A

Estradiol 17B, estrone, estriol.

79
Q

Regulation of endocrine function of reproductive system

A

Hypothalamic pituitary- gonadal axis (HPG axis) In males: HPT (testicular ) axis

80
Q

After X chromose activation, germ cells undergo mitosis and form

A

oogonia

81
Q

cell(s) responsible for estrogen production (f):

A

granulosa and thecal

82
Q

When does f. gonadal differentiation begin?

A

~ 9 weeks

83
Q

Source of androgenic hormones in women

A

Adrenal Cortex

84
Q

locations of progesterone production

A

Initially: corpus luteum

later: placenta

85
Q

location and function of SRY gene

A

located on the short arm of Y chromosome

•Testes develop from primitive gonads via action of SRY region of Y chromosome

86
Q

Klinefelters

A

XXY with dysgenic testes

MD regressed

WD developed

external genialia: male

87
Q

Total # of carbon of estrogens

A

18

88
Q

cell types of indifferent m/f gonads during the first 5-week of pregnancy

A
  1. coelomic epithelial
  2. mesenchymal stromal cells
89
Q

The genes that encode androgen receptors are located on this chromosome

A

X

90
Q

The common tissue of labia minora and penile shaft:

A

urethral folds

91
Q

External genitalia - m

A

glans penis

scrotum

penile shaft

prostate gland

92
Q

During development of male internal genitalia ,testostrone is produced by

A

Leydig cells

93
Q

major organ for sex steroid metabolism

A

mainly liver

94
Q

Hormones that affect the differential secretion of LH and FSH (in addition to GnRH)

A
  1. testosterone
  2. estrogen
  3. activin
  4. ihibin
95
Q

manifestation of Morris syndrome(46XY)

A

genetic male- phenotype female (ext. genitalia)no internal tract

blind-ending vagina

greater than average height

infertile

absent or very slight pubic/axial hair.

96
Q

hCG

A

Human chorionic gonadotropin

97
Q

wolffian ducts future

A

male internal reproductive tract

98
Q

An X-linked recessive defect that leads to the absence of androgen receptors on target tissues.

A

Androgen insensitivity syndrome.

male genotype- female phenotype

99
Q

Reactions catalyzed by 5a-reductase (male specific pathways)

Location

A

Reactions:

androstenediol —> androsterone (C19)

Testosterone —> DHT

5a-reductase mainly in testostrone target cells

Dihydrotestosterone, or 5α-dihydrotestosterone, also known as androstanolone or stanolone, is an endogenous androgen sex steroid and hormone.

Androsterone, or 5α-androstan-3α-ol-17-one, is an endogenous steroid hormone, neurosteroid, and putative pheromone. It is a weak androgen with a potency that is approximately 1/7 that of testosterone. Androsterone is a metabolite of testosterone and dihydrotestosterone.

100
Q

urogenital sinus (-) DHT/f

A

lower vagina

101
Q

individuals with the gonads of one sex but the external genitalia of the opposite sex or both sexes

A

Pseudohermaphrodites

102
Q

Estrone (E1) and Estradiol (E2) are converted to —— in the liver.

A

estriol (E3)

Note: estradiol 17B, Estrone and Estriol are produced by granulosa and thecal cells of ovary.

103
Q

Rhythmic secretion of this hormone influences rate of expression for genes encoding the à, ßLH and ßFSH subunits.

A

Rhythm of GnRH secretion influences rate of expression for genes encoding the à, ßLH and ßFSH subunits.

104
Q

genetic state: XY, Red. 5-a-reductase

  1. Gonad
  2. Mullerian ducts
  3. Wolffian ducts
  4. Ext. Genitalia
A
  1. Testes
  2. MD- regressed
  3. WD- developed
  4. M/F
105
Q

GAP secretion and function

A

secreted simultaneously from hypothalmic neurons with GnRH into portal circulation.

Possible Role: inhibition of prolactin secretion

106
Q

Progesterone circulation

A

Bound to CBG

unlike estrogen and testostrone that circulate bound to SSBG or albumin.

107
Q

active stimulation and transformation of wolffian duct into male reproductive tract is required for:

A

development of testes

108
Q

genetic state: XX, normal

  1. Gonads
  2. Mullerian ducts,
  3. Wolffian ducts
  4. Ext. Genitalia
A
  1. ovary
  2. MD- developed
  3. WD- regressed
  4. Female
109
Q

The stage (meiosis) at which female cells are arrested at:

A

late prophase

Primary oocytes arrested in prophase I before birth.

Medical Physiology (21 decks)

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