Women's Health Flashcards
(75 cards)
0
Q
Anti-Mullerian Hormone
A
produced by the Sertoli cells of the testes and causes Müllerian ducts to degenerate
1
Q
SYN Gene
A
- located on the Y chromosome
- causes testes to form
- stimulates Wolffian ducts to grow & degeneration of the Müllerian ducts
2
Q
How many layers of cells are primordial follicles covered by?
A
1 single layer of granulosa cells
3
Q
Adrenarche
A
activation of the adrenal cortex
4
Q
Gonadarche
A
activation of the gonads by FSH & LH
5
Q
Pubarche
A
appearance of pubic hair
6
Q
Thelarche
A
appearance of breast tissue
7
Q
Menarche
A
onset of first menstrual period; 1st menstrual cycle approx. 11-15 y/o
8
Q
Menarche begins _____ after the onset of puberty.
A
2.6 years
9
Q
KISS1 gene function
A
- stimulated by Leptin
- codes for Kisseptin protein –> GnRH production
10
Q
6q21 region LIN28B gene
A
genetic determinant of age variations in puberty/menarche
11
Q
Determinants of age at puberty (6)
A
- genetics
- nutrition
- geographic location: earlier onset assoc. w/ closeness to equator & lower altitudes
- exposure to light: more light assoc. w/ earlier onset
- body composition: more fat = earlier onset
- exercise
12
Q
Female Athlete Triad
A
- eating disorder
- amenorrhea
- osteoporosis (long term)
13
Q
What are the layers of the theca cells?
A
- Theca Interna: produces androgens that get converted to estrogens
- Theca Externa: capsule of the follice/fibrous core
14
Q
Follicle Atresia
A
occurs during follicular phase after a single follicle outgrows all others; remaining follicles involute/degenerate and die off d/t the FSH suppression from elevated estrogen levels
15
Q
Mittelschmerz
A
painful ovulation
- tx w/ strong NSAIDS for pain
16
Q
Mechanisms responsible for ovulation (3)
A
- LH surge: sets up pseudo inflammatory response
- FSH: stimulates plasminogen activator release
- Prostaglandins E&F: cause lysosomal enzyme release to digest follicle wall
17
Q
Hormones produced by theca cells (2)
A
Androstenedione & Testosterone
18
Q
Inhibin
A
hormone secreted by the granulosa cells of the corpus luteum; inhibits secretion of FSH from anterior pituitary
19
Q
(3) types of estrogens
A
- Beta estradiol (E2): primary estrogen; very potent compared to other types; produced by the ovaries
- Estrone: formed in peripheral tissues
- Estriol: least potent; produced by the ovaries
20
Q
(2) types of progestins
A
- Progesterone: most potent & prevalent type
2. 17-alpha-hydroxyprogesterone
21
Q
What are the 2 aromatase enzymes?
A
17BHSD1: estrone –> estradiol-17B
P450arom: androstenedione –> estrone
22
Q
(5) Factors causing Increased Aromatase
A
- age
- obesity (adipose tissue makes aromatase)
- insulin
- FSH & LH
- alcohol
23
Q
(3) Factors causing Decreased Aromatase
A
- prolactin
- anti-mullerian hormone
- glyphosphate (common herbicide)
24
Tamoxifen
medication used to tx breast CA by blocking estrogen receptors in the breast tissue to stop cellular growth; helpful to tx both estrogen positive & negative tumor types
has opposite effect in uterine tissues; stimulates uterine tissue proliferation - not suggested for use in women w/family hx of uterine CA
25
Roles/Functions of estrogen
- proliferation of female tissue: ovaries, Fallopian tubes, uterus, glandular tissue, breasts
- deposition of fat: external genitalia
- stimulates epithelial changes in vagina
- stimulation of bone deposition/inhibition of bone resorption
- vasodilation & vascular growth
26
T/F: Estrogen is used curatively to tx vaginal infections?
TRUE - used in a topical or suppository form for children w/vaginal infections
strengthens vaginal tissue/epithelium by stimulating a change from cuboidal --> stratified epithelium
27
Which hormones influence the development of breast tissue?
1. estrogen: stromal tissue, ductile tissue, fat deposition, some lobule & alveoli development
2. progesterone: lobule & alveoli development
3. prolactin: lobule & alveoli development
28
RANK-L
protein produced by osteoblasts that binds to receptor on osteoclast to activate osteoclast activity (bone breakdown)
29
Osteoprotegrin
hormone produced by osteoblasts stimulated by estrogen; binds to RANK-L to inhibit ligand binding to osteoclasts --> inhibits bone breakdown
30
Roles/Functions of Progesterone
- promotes secretory changes in uterus (production of uterine milk)
- decreases frequency & intensity of uterine contractions
- --> inhibits prostaglandin production
- --> decreases sensitivity to oxytocin
- promotes Fallopian tube secretion
- promotes development of lobules & alveoli in breast tissue
31
Leukorrhea
WBCs released along w/necrotic tissue & blood during menstruation; causes resistance to infection
32
Menopause
obsolescence of ovaries - no estradiol production, few primary follicles d/t the reduction of estrogen, low inhibin levels, & high levels of LH & FSH
33
Average age of menopause
51.4 y/o
34
Diagnosis of Menopause
- 12 mons. of amenorrhea not caused by any other biological or physiological reason
- high FSH & LH levels (not required, but can aid in confirmation)
35
Blastocyst
fertilized ovum composed of 16 cells
36
When does implantation of the blastocyst usually occur?
about 5-7 days after fertilization
37
(2) Types of Trophoblastic cells
1. Cytotrophoblasts: structural
| 2. Syncytial trophoblasts: embed into the functional endometrium
38
Decidua
endometrial cells filled w/glycogen, proteins, & lipids (d/t progesterone); formed after implantation; provides sole source of nutrients to fetus up to 8 weeks post-implantation until placenta forms
39
When does the placenta begin providing nutrients to the fetus?
approx. 10th week of pregnancy
40
What are the (3) umbilical vessels?
(2) umbilical arteries: blood to the placenta from fetus
| 1) umbilical vein: blood from the placenta to the fetus (blood originally coming from mother
41
placental villi
trophoblastic projections into forming placenta near the maternal blood sinuses; ultimately form fetal capillaries carrying fetal blood
42
____ days after fertilization the fetal heart is functional
21 days - fetal heart pumps blood
43
Normal fetal:placental ratio
1 gram of placenta feeds 7 grams of fetal tissue
44
Normal PO2 in placental membrane
- mother: 50 mmHg
| - fetus: 30 mmHg
45
Double Bohr Effect
Fetal blood is alkaline d/t its high PCO2 conc. Maternal blood is acidic.
Fetal curve is shifted to the LEFT to allow fetus to hold onto O2 tightly.
Maternal curve is shifted to the RIGHT to give off O2 easily to supply fetus.
46
Human Chorionic Gonadotropin (hCG)
hormone secreted by trophoblasts to maintain the CL until placental take over; receptors located in endometrium & myometrium
- stimulates progesterone & E2 production (prevent menstruation)
- inhibits contractions produced by oxytocin
- immunosuppressant
47
When can hCG first be seen in maternal blood?
- appear 8-9 days after ovulation, quickly after implantation
- peaks 10-12 weeks after fertilization
48
Estradiol production
- initially produced by CL (first 5-6 weeks) stimulated by hCG
- afterwards is produced by syncytial trophoblasts (converted from DHEA-S)
49
Estradiol functions during pregnancy (2)
1. proliferation of maternal tissues: uterus (dramatic enlargement), breast & ducts, external genitalia (same as estrogen function in females)
2. relaxation of pelvic ligaments: sacroiliac joint & pubic symphysis (need Relaxin)
50
Estriol
lesser potent estrogen hormone derivative converted by the placenta during pregnancy from DHA androgen produced by fetal liver & adrenals; used as an index of fetal well-being & can be measured in maternal urine
51
Where is progesterone produced during pregnancy?
produced from cholesterol by the CL followed by the placenta; can be reused by the mother & fetus as major substrate for cortisol & aldosterone production
52
Human Chorionic Somatomammotropin (hPL)
```
hormone secreted by the placenta by the 5th week of pregnancy
- development of breast tissue
- formation of protein tissues
- decreases insulin sensitivity
(has similar functions to GH)
```
53
System Maternal Responses to Pregnancy
- Circulatory: increased CO 30-40% (27th week)
- --> Increased MAP, Increased blood vol (30%)
- Respiratory: increased O2 consumption & minute ventilation
- --> increased sensitivity to CO2
- Renal: increased GFR & RBF
54
spontaneous abortion
pregnancy loss before 20 weeks of gestation
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When do most miscarriages occur?
before 12 weeks
56
Chromosomal abnormalities account for how much of spontaneous abortions?
50%
57
submucosal leiomyoma
smooth mm tumor of the myometrium; when large can protrude into the uterus and impair implantation; cause of spontaneous abortion
58
(3) systemic vascular disorders assoc. w/spontaneous abortion
1. antiphospholipid antibody syndrome
2. coagulopathies
3. HTN
59
(3) bacterial infections assoc. w/spontaneous abortion
1. toxoplasma
2. mycoplasma
3. listeria
60
Ascending infections of the mother contributing to spontaneous abortion are more common in which trimester?
Second trimester
61
ectopic pregnancy
implantation of the fetus in any site other than a normal intrauterine location; occurrence = 1/150 pregnancies
62
What are the (4) most common sites of ectopic pregnancy?
1. Fallopian tubes (approx. 90%)
2. ovary
3. abdominal cavity
4. intrauterine portion of the Fallopian tube (cornual pregnancy)
63
(5) predisposing conditions for tubal ectopic pregnancies
1. prior PID resulting in Fallopian tube scarring (chronic follicular salpingitis)
2. appendicitis
3. endometriosis
4. previous surgery
5. intrauterine contraceptive devices
64
Ovarian ectopic pregnancy
fertilization and trapping of the ovum within the follicle just at the time of its rupture
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Abdominal ectopic pregnancy
fertilized ovum fails to enter or drops out of the fimbriated end of the tube
66
Hematosalpinx
blood-filled Fallopian tube
most commonly caused by a tubal ectopic pregnancy: inappropriate implantation of gestational sac and growth causing Fallopian tube distention & possible rupture
67
(3) basic types of twins
1. diamnionic dichorionic: may be monozygotic or dizygotic; cleavage days 1-3
2. diamnionic monochorionic: accts for 60% of monozygotic sets of twins; cleavage days 4-8
3. monoamnionic monochorionic: cleavage days 8-13
68
When are conjoined twins formed?
cleavage of the embryo between days 13-15
69
placenta previa
placenta forms in an abnormal position of the uterus lower than normal or on cervix; can result in serious 3rd trimester bleeding
70
(3) Types of placenta previa
1. marginal
2. complete - covers the internal cervical os & requires c-section
3. low-lying
71
placenta accreta
partial or complete absence of decidua w/adherence of the placental villous tissue directly to the myometrium & failure of placental separation
72
T/F: placental accreta is often a cause of life-threatening postpartum bleeding?
TRUE: approx. 80% mortality rate
73
(2) common predisposing factors to placenta accreta
1. placenta previa (60% of cases)
| 2. previous c-section
74
(3) Types of placenta accreta
1. accreta: invasion of the myometrium, but does not penetrate entire thickness (75-78% of cases)
2. increta: extends into myometrium and penetrates the muscle (17%)
3. percreta: penetrates entire myometrium to the serosa (5%)
