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Gen Med (Endocrine) > Reproductive - Physiology > Flashcards

Reproductive - Physiology Flashcards

1
Q

In the hypothalamic pituitary gonadal axis, what is released from the hypothalamus?

A

GnRH

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2
Q

In the hypothalamic pituitary gonadal axis, what is released from the pituitary gland?

A

LH and FSH

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3
Q

In males, where does LH exert its action? What effect does it have?

A

It acts on the Leydig cells of the testes to stimulate testosterone production

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4
Q

What are some actions of testosterone in males?

A

Anabolism, male secondary sexual characteristics, maintenance of libido

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5
Q

When testosterone is produced by the testes, it acts locally to aid with what process?

A

Spermatogenesis

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6
Q

Testosterone exerts negative feedback on which hormones involved in the hypothalamic pituitary gonadal axis?

A

GnRH, LH and FSH

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7
Q

In males, where does FSH exert its action? What effect does it have?

A

It acts on the Sertoli cells of the testes to produce mature sperm

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8
Q

Inhibin exerts negative feedback on which hormones involves in the hypothalamic pituitary gonadal axis?

A

FSH

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9
Q

What is the action of activin?

A

To counteract inhibin, and promote secretion of FSH

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10
Q

What is the average duration of the menstrual cycle?

A

28 days

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11
Q

How often is GnRH produced?

A

2 hourly intervals

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12
Q

In females, where does LH exert its action? What effect does it have?

A

It acts on the theca cells of the ovary to stimulate androgen production

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13
Q

In females, where does FSH exert its action? What effect does it have?

A

It acts on the granulosa cells of the ovary to stimulate follicular development and activity of aromatase

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14
Q

In both males and females, the action of FSH also results in the production of what hormone?

A

Inhibin

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15
Q

What is the role of aromatase?

A

To convert ovarian androgens into oestrogen

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16
Q

The mechanisms initiating puberty are thought to result from what?

A

Withdrawal of central inhibition of GnRH release

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17
Q

What peptide is believed to play a crucial role in the regulation of GnRH production and the timing of puberty?

A

Kisspeptin

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18
Q

LH and FSH are both low in the pre-pubertal child. In early puberty, which begins to rise first?

A

FSH

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19
Q

What is the average age of puberty onset in males?

A

12 years

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20
Q

What is the first sign of puberty to develop in males?

A

Enlargement of the testes

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21
Q

A boy has officially entered puberty when the testicular volume reaches what?

A

4ml

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22
Q

What is the average age of puberty onset in females?

A

11 years

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23
Q

What is the first sign of puberty to develop in females?

A

Development of breast buds

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24
Q

What is the average age of the onset of menarche in females?

A

13 years

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25
Q

Menarche usually occurs when in relation to the onset of puberty?

A

2-3 years later

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26
Q

What days of the menstrual cycle correspond to the follicular phase?

A

Days 1-13

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27
Q

Day 1 of the menstrual cycle corresponds to what physiological event?

A

The first day of menstruation

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28
Q

What days of the menstrual cycle correspond to the ovulatory phase?

A

Day 14

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29
Q

What days of the menstrual cycle correspond to the luteal phase?

A

Days 15-28

30
Q

An increase in the level of what hormone stimulates the dominant follicle to develop, and kicks off the follicular phase of the menstrual cycle?

A

FSH

31
Q

In response to FSH stimulating the dominant follicle to develop, what hormone is increased from the follicle?

A

Oestrogen

32
Q

Increasing oestrogen in the follicular phase of the menstrual cycle leads to a surge in what hormone?

A

LH

33
Q

A surge in the level of what hormone in the menstrual cycle leads into the ovulatory phase of the cycle?

A

LH

34
Q

After the dominant follicle has ruptured and the remaining granulosa cells become the corpus luteum in the luteal phase of the menstrual cycle, what hormones does the corpus luteum secrete?

A

Oestrogen and progesterone

35
Q

The luteal phase of the menstrual cycle always lasts how long?

A

14 days

36
Q

In the menstrual cycle, progesterone levels peak when?

A

7 days after ovulation

37
Q

Progesterone measured when gives the most reliable answer as to whether a woman has ovulated or not?

A

7 days before the onset of the next predicted menses (day 21 of an average 28 day cycle)

38
Q

If implantation does not occur after ovulation, the corpus luteum regresses and the levels of what hormones fall to allow the endometrium to be shed?

A

Progesterone and inhibin

39
Q

Reducing levels of progesterone and inhibin once implantation has not occurred after ovulation allows the levels of which hormones to rise in order for the cycle to start again?

A

GnRH and FSH

40
Q

If implantation and pregnancy occurs following ovulation, what hormone is produced by the trophoblast to maintain corpus luteum function for 10-12 weeks until the placenta has formed?

A

HCG

41
Q

The proliferative phase corresponds to which days of the menstrual cycle?

A

Days 5-14

42
Q

In response to the increasing levels of oestrogen produced in the follicular phase, what happens to the endometrium?

A

It thickens

43
Q

The secretory phase corresponds to which days of the menstrual cycle?

A

Days 15-28

44
Q

What effect does progesterone have on the endometrium in the secretory phase of the menstrual cycle?

A

Inhibits further proliferation, causes the endometrium to differentiate and mature

45
Q

The head of the sperm is surrounded by a cap like structure known as what?

A

Acrosome

46
Q

The tail of the sperm contains vast amounts of which organelle?

A

Mitochondria

47
Q

Only sperm which pass through which anatomical structure are capable of fertilisation?

A

Epididymis

48
Q

Spermatozoa are able to fertilise an oocyte for how long after ejaculation?

A

5 days

49
Q

Conception can occur if intercourse has occurred at any time within what frame?

A

The 5 days before ovulation

50
Q

Where does fertilisation take place?

A

Ampulla of the Fallopian tube

51
Q

When spermatozoa reach the cumulus oophorus of the oocyte, their acrosomes release what to break up the cumulus cells and allow them to penetrate the zona pellucida?

A

Lytic enzymes

52
Q

Low testosterone or oestradiol with high gonadotrophins indicates there is a problem where in the hypothalamic pituitary gonadal axis?

A

Gonads

53
Q

Low testosterone or oestradiol with low or normal gonadotrophins indicates there is a problem where in the hypothalamic pituitary gonadal axis?

A

Hypothalamus or pituitary gland

54
Q

During which phase of the menstrual cycle does PMS occur?

A

Luteal phase

55
Q

What is the name for a severe form of PMS?

A

Pre-menstrual dysphoric disorder

56
Q

What are the pharmacological treatment options for PMS?

A

SSRI or COCP

57
Q

What is the average age of onset of the menopause?

A

51 years

58
Q

Clinically, when are women described as being post-menopausal?

A

When they haven’t had a period in over a year, in association with a permanently raised LH/FSH

59
Q

After the menopause, where is oestrogen still being produced?

A

Adipose tissue, bones and brain

60
Q

Large fluctuations in the level of which hormone may be responsible for menopausal symptoms?

A

GnRH

61
Q

Urogenital atrophy during/after the menopause can lead to what symptoms?

A

Dyspareunia, increased risk of infections and stress incontinence

62
Q

What pharmacological treatment is available for the treatment of hot flushes?

A

SNRIs e.g. venlafaxine

63
Q

What are the 2 most significant complications of the menopause?

A

Decreased bone density and an increased cardiovascular risk

64
Q

Premature menopause is usually treated with HRT until what age in order to maintain bone health?

A

50 years

65
Q

Should women with premature menopause use contraception if they do not want to conceive?

A

Yes

66
Q

HRT should only be given for up to how long?

A

5 years

67
Q

Combined HRT should be given to which women?

A

Post-menopausal women with an intact uterus

68
Q

Cyclical HRT should be given to which women?

A

Women with menopausal symptoms who are still menstruating

69
Q

What treatments are useful for treating symptoms of urogenital atrophy?

A

Oestrogen pessaries or creams

70
Q

HRT increases the risk of which malignancies?

A

Breast and endometrial

71
Q

Why should women who have a uterus not be given oestrogen only HRT?

A

To reduce the risk of endometrial cancer

72
Q

What HRT regimen should be offered to women with a previous history or increased risk of VTE?

A

Transdermal HRT

Gen Med (Endocrine) (12 decks)

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