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ER Exam 2 > The Menstrual Cycle > Flashcards

The Menstrual Cycle Flashcards

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1
Q

What are the 3 phases of puberty in females?

A

Thelarche - breast development Adrenarche - Increase in adrenal androgen secretion Menarche - Beginning of menstrual cycles

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2
Q

At what points in a female’s life are FSH levels highest?

A

Fetus

Infancy

Senescence

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3
Q

At what point in a female’s life is LH at its highest?

A

Fetus

Infancy

Monthly during reproductive years

Senescence

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4
Q

What phase of oocyte maturation marks gonadotropin dependency?

A

Formation of secondary oocyte (contains antrum)

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5
Q

The dominant follicle is the one that has the most ___ receptors

A

FSH

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6
Q

The time from the onset of the LH surge to ovulation is known as what? Lasts how long?

A

Periovulatory period

32-36 hours

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7
Q

What does the corpus luteum produce? When?

A

Large amounts of progesterone and some estrogen

A few days after ovulation

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8
Q

During the LH surge, ___ is released from ____ which lead to the breakdown of the follicle wall, tunica albuginea, and surface epithelium at the follicular stigma.

A

Inflammatory cytokines and hydrolytic enzymes from the theca and granulosa cells

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9
Q

What stimulates the oocyte to release TGF-B-related factor GDF9?

A

LH

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10
Q

What is the function of GDF9?

A

Stimulates cumulus cells to secrete hyaluronic acid and other extracellular matrix components to cause expansion of oocyte complex and make it easier to catch

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11
Q

What protein signals to the corpus luteum to remain viable for pregnancy?

A

Human chorionic gonadotropin (hCG)

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12
Q

During follicular atresia, what cells undergo apoptosis and what cells persist?

A

Apoptosis: granulosa cells, oocytes

Persist: Thecal cells - repopulate celluar stroma of the ovary

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13
Q

Rapid rise in what hormone(s) will eventually trigger the LH surge?

A

Estradiol and GnRH

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14
Q

In the HPO axis, what cells secrete both inhibins and activins?

A

Granulosa cells

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15
Q

Progestins and Estrogens have what effect on the hypothalamus and anterior pituitary?

A

Both positive and negative feedback

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16
Q

What is the effect of estradiol on the gonadotrophs in the late follicular phase?

A

Enhance sensitivity of gonadotrophs to GnRH => larger and larger releases of LH

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17
Q

After ovulation, what cells does LH act upon?

A

Cells of corpus luteum

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18
Q

In the female, both LH and FSH receptors are present on what steroid-producing cell?

A

Granulosa cells

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19
Q

What is the relationship of FSH and estrogen levels during the menstrual cycle?

A

Inversely related

More FSH released in response to low estrogen

FSH inhibited in response to high estrogen

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20
Q

In the late luteal phase, the demise of the corpus luteum causes a decrease in what hormones?

A

Progesterone

Estradiol

Inhibin

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21
Q

In females, where is estradiol synthesized?

A

Ovaries

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22
Q

What enzyme mediates the conversion of estrone to estradiol?

A

17B-Hydroxysteroid dehydrogenase (17B-HSD)

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23
Q

What structure of the ovary synthesizes estrogen during the follicular phase?

A

Follicle

24
Q

What structure of the ovary synthesizes estrogen during the luteal phase?

A

Corpus luteum

25
Q

What phase of the menstrual cycle lowers basal body temperature? Due to what?

A

Follicular phase

High levels of estrogen

26
Q

What phase of the menstrual cycle raises basal body temperature? Due to what?

A

Luteal phase?

High levels of progesterone

27
Q

Disintegration of the corpus luteum causes what to happen to the basal body temperature?

A

Decrease, signifies onset of next menstruation

28
Q

The demise of the corpus luteum signals the beginning of what phase of the menstrual cycle?

A

Menstrual phase

29
Q

What is the action of progesterone on the epithelial cells of the endometrium?

A

Inhibitory

30
Q

What is the action of estrogen during the proliferative phase of the menstrual cycle?

A

Proliferation and differentiation of the endometrial stroma and epithelium

Synthesis of progestin receptors (to inhibit too much proliferation)

31
Q

What hormone stimulates the early secretory phase?

A

Progesterone

32
Q

What is the action of progesterone in the middle to late secretory phase?

A

Pregnancy: promotes differentiation of stromal cells into predecidual cells to decidual cells

Non-pregnancy: orchestrate menstruation

33
Q

What is the action of contraceptive steroids?

A

Inhibit secretion of GnRH and FSH/LH and abolish folliculogenesis and ovulation

34
Q

What is the progestin effect of the oral contraceptive?

A

Causes cervical mucus to thicken and impair sperm penetration into uterus

Impair mobility of uterus and oviducts, decreasing transport of ova and sperm

35
Q

What defines menorrhagia?

A

Loss of >80 mL of blood

36
Q

What defines dysmenorrhea?

A

Painful periods

37
Q

What defines oligomenorrhea?

A

Existence of few, irregular periods

38
Q

What disorders of menstruation will occur with dysfunction of HPO axis?

A

Oligomenorrhea and amenorrhea

39
Q

What disorder is the most common cause of female sterility?

A

Endometriosis

40
Q

What characterizes endometriosis?

A

Presence and growth of endometrial glands and stroma outside of the uterus instead of inside => bleeding, inflammation, and scarring

41
Q

What organs/tissue does endometriosis normally involve?

A

Ovaries, bowel, or tissue lining the pelvis

42
Q

A patient with chronic pelvic pain, dysmenorrhea, dyspareunia, rectal pain/constipation, and infertility may be diagnosed with what?

A

Endometriosis

43
Q

What disorder is the most common cause of female infertility?

A

Polycystic Ovarian Syndrome (PCOS)

44
Q

When does PCOS typically manifest?

A

During adolescence

45
Q

What are some common symptoms of PCOS?

A

Unexplained hypreandrogenism

Anovulation

Polycystic ovary (duh)

46
Q

What are the physiological characteristics of PCOS?

A

Abnormal ovarian steroidogenesis and folliculogenesis

Dominant follicles did not shed and instead became cysts

47
Q

In PCOS, what do the levels of LH, FSH, and testosterone look like?

A

Elevated LH and testosterone

Decreased FSH

48
Q

A young, obese, hirsute female of reproductive age presents with oligomenorrhea and infertility. What is her diagnosis?

A

PCOS

49
Q

What disorder is the most common cause of female congenital hypogonadism?

A

Turner syndrome

50
Q

What is the most common genotype of Turner Syndrome?

A

45, X

51
Q

What hormone is elevated in Turner syndrome? Why?

A

FSH

Germ cells of the ovaries did not develop, so the ovaries are CT-filled streaks with no follicles to act upon

52
Q

A female pt with short stature, absent secondary sex characteristics, webbed neck, shield-like chest, normal but infantile internal and external genitalia most likely has what diagnosis?

A

Turner syndrome

53
Q

Due to a reduction in estrogen and inhibin, a patient undergoing menopause would most likely have elevated levels of what hormones?

A

FSH and LH (no negative feedback)

54
Q

Menopause is officially diagnosed after how long?

A

12 months after the last menstrual period

55
Q

What is the average age of a menopausal patient?

A

51.4 years

56
Q

A menopausal patient with mood changes and hot flashes may be placed on what to treat her symptoms?

A

Antidepressants

Gabapentin

ER Exam 2 (16 decks)

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