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YR2 LCRS Endocrinology > 11. Endocrinology of Pregnancy > Flashcards

11. Endocrinology of Pregnancy Flashcards

(41 cards)

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1
Q

what is on either side of the prostate?

A

seminal vesicles

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2
Q

what are sertoli cells?

A

cells that make spermatozoa

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3
Q

what are leydig cells?

A

cells that make testosterone

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4
Q

what does aromatisation of testosterone result in and what is this hormone required for?

A

production of oestrogen

required in men for tubular fluid reabsorption and for bones

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5
Q

what occurs in men and women with aromatase deficiency?

A

men - infertile, osteoporosis. grow tall because oestrogen is required to close growth plates.

women - virilisation: hirsutism, deepening voice, amenorrhoea.

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6
Q

where is most tubular fluid reabsorbed?

A

within the rete testis and early epididymis

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7
Q

where is oestrogen mainly found?

A

in tubular fluid produced by sertoli cells

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8
Q

what are secretory products (fructose & glycoproteins) secreted into and what do they do?

A

secreted into the epididymal fluid to

  • provide energy for impending possible journey
  • coat the surface of the spermatozoa to protect them from hostile environments
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9
Q

what does semen consist of?

A
  • spermatozoa (15-120 million/ml)
  • seminal fluid (2-5ml)
  • leucocytes
  • potentially viruses (e.g. hep B, HIV)
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10
Q

what is seminal fluid contributed from?

A

small contribution: epididymis and testis

main contribution: accessory sex glands - seminal vesicles, prostate, bulbourethral glands

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11
Q

what is seminal fluid concentrated using?

A

androgens

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12
Q

what are the qualities of spermatozoa from the semineferous tubule?

A

quiescent and incapable of fertilising an ovum

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13
Q

what are the qualities of spermatozoa from the vas deferens?

A

capable of limited movement, limited capability of fertilising the ovum

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14
Q

where is full activity (capacitation) of the spermatozoa achieved?

A

within the ionic and proteolytic environment of the female reproductive tract - specifically the fallopian tube

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15
Q

what are the 3 main stages of capacitation?

A
  1. they lose their glycoprotein ‘coat’
  2. change in the surface membrane characteristics
  3. develop whiplash movements of tail
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16
Q

what is capacitation dependent on?

A
  • oestrogen: needs to happen in the female

- Ca2+

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17
Q

what is the acrosome reaction?

Study These Flashcards
A

changes in the surface membrane when in close proximity to the ovum:

  • sperm acrosome binds to ZP3 (glycoprotein receptor)
  • Ca2+ influx into sperm (stimulated by progesterone)
  • release of hyaluronidase (breaks down polysaccharides) and proteolytic enzymes
  • spermatozoan can then penetrate the zona pellucida (glycoprotein layer surrounding plasma membrane of oocyte) to get to the egg
18
Q

what happens when the sperm binds during fertilisation?

Study These Flashcards
A

a cortical reaction is triggered in the zona pellucida which blocks more sperm from binding

19
Q

what is a second polar body and when does it occur?

Study These Flashcards
A

it is a small haploid cell formed during oogenesis and it occurs during fertilisation

one of the cells (ovum) retains the cytoplasm during meiotic cell division while the other (‘polar body’) has no cytoplasm and undergoes degeneration

20
Q

what is the free-living phase, how long does it last and what does it involve?

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A

the free-living phase is the phase where the conceptus (fertilised egg) is not attached yet, which occurs in the luteal phase when oestrogen and progesterone is high

it can last 9-10 days

the conceptus continues to divide as it moves down the fallopian tube to the uterus and it receives nutrients from the uterine secretions

21
Q

describe the process of compaction

Study These Flashcards
A

the 8-cell conceptus compacts to form an 8-16 cell morula

22
Q

what is formed after a morula?

Study These Flashcards
A

a blastocyst: the inner cell mass becomes the embryo and the outer trophoblast cells become the chorion (which eventually becomes the placenta)

23
Q

describe the attachment phase of implantation and what it allows

Study These Flashcards
A

the outer trophoblast cells make contact with the uterine surface epithelium

this develops a system where nutrients from the mother can be received by all the embryonic cells

24
Q

describe the decidualisation phase of implantantion

Study These Flashcards
A

decidua = thick layer of modified mucus membrane

this phase involves changes of the underlying uterine stromal tissue which lines the uterus during pregnancy and is shed with afterbirth, which requires progesterone domination

25
what 2 molecules are particularly important in the attachment phase? describe them
1. leukaemia inhibitory factor (LIF) stimulated by Transforming Growth Factor, leptin, progesterone - from endometrial secretory glands - stimulates adhesion of the blastocyst to the endometrial cells 2. interleukin-11 (IL-11) stimulated by IL1, Tumour Necrosis Factor, Relaxin - released from endometrial cells - released into the uterine fluid
26
describe what happens during the decidualisation reaction
endometrial changes due to progesterone - glandular epithelial secretion (nutrients) - glycogen accumulation in stromal cell cytoplasm - growth of capillaries to increase blood supply - increased vascular permeability
27
what factors are involved in the decidualisation reaction?
- IL-11 - histamine - certain prostglandins - TGFb
28
how does hCG change during pregnancy?
hCG goes up as it takes over the role of LH it is produced in the placenta and the surge is measurable 2 weeks from conception using a pregnancy test or earlier using a blood test
29
how do oestrogen and progesterone change during pregnancy?
increase first 40 days: progesterone and oestrogen are produced in the corpus luteum, stimulated by hCG acting on LH receptors - this is essetial for developing the fetoplacental unit. oestrogen inhibits maternal LH&FSH but hCG overrides this after day 40: placenta starts to take over oestrogen and progesterone production, it is no longer driven by LH/FSH/hCG
30
what is DHEAS and what is its role?
a precursor molecule (dehydroepiandrosterone sulfate) produced by maternal and foetal adrenals it is taken up by the placenta to produce oestradiol, and is used to make small amounts of oestrone (though these also come from the mother)
31
how do foetal adrenals make DHEAS?
the mother provides the precursor which tends to be pregnenolone which is used to produce progesterone which the adrenals use to make DHEAS
32
what is the main oestrogen of pregnancy and how is it made?
oestriol DHEAS is conjugated in the foetal liver to form 16a-hydroxy DHEAS, which goes to the plancenta and is deconjugated to form oestriol
33
which maternal hormones increase during pregnancy?
- ACTH - adrenal steroids - prolactin - IGF1 (placenta makes GH) - iodothyronines (hCG shares an a-subunit with TSH) - PTH related peptides
34
which maternal hormones decrease during pregnancy?
- gonadotrophins - pituitary GH - TSH
35
what produces kisspeptin and what is its role?
the placenta produces kisspeptin its role is to switch off the reproductive axis by down-regulation. it is also an antimetastatic protein, regulating the invasion of the placenta into the endometrium
36
how can you assess whether a woman is ovulating?
- day 21 progesterone test | - ultrasound test
37
how does parturition (giving birth) involve endocrine control?
- parturition involves contraction of actin and myosin filaments so requires increased intracellular calcium - this increase is driven by oestrogen and inhibited by progesterone - oestrogen stimulates production of prostaglandins by the endometrial cells - the prostaglandins stimulate the production and release of calcium into the cytoplasm from intracellular stores - oestrogen also stimulates oestrogen receptors on the endometrial cells - progesterone inhibits prostaglandin synthesis and inhibits oestrogen receptors, so keeps the effects of oestrogen under control
38
what else is released at parturition and why?
oxytocin binds to its receptors which opens calcium channels, allowing calcium ions to move in from the outside
39
how does lactation involve endocrine control?
breast-feeding involves prolactin (promotes milk synthesis) and oxytocin (promotes milk ejection), which are stimulated by the same neuroendocrine reflex arc the neural pathways of nipple stimulation go to the hypothalamus and pituitary gland. the pituitary gland makes prolactin in the adenohypophysis and oxytocin in the neurohypophysis
40
what does hypogonadropic mean?
low LH/FSH
41
what does hypergonadotropic mean?
low testosterone/oestrogen

YR2 LCRS Endocrinology (18 decks)

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