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ENDOCRINOLOGY - BRS > Sex Hormones :) > Flashcards

Sex Hormones :) Flashcards

1
Q

define puberty

A

Maturation of reproductive organs

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2
Q

define thelarche

A

development of the breasts

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3
Q

define pubarche

A

pubic hair growth

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4
Q

-arche

A

onset of

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5
Q

define gonadarche

A

activation of gonads by the HPG axis (hypothalamic-pituitary-gonadal (HPG) axis)

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6
Q

define menarche

A

onset of menstrual cycles

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7
Q

define spermarche

A

onset of spermatogenesis

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8
Q

define spermatogenesis

A

the origin and development of the sperm cells within the male reproductive organs, the testes.

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9
Q

define adrenarche

A

adrenal androgen production

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10
Q

when does adrenarche start

A

2 years before gonadarche

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11
Q

what are the 2 key adrenal androgen hormones

A

DHEA/DHEAS
Testosterone

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12
Q

role of adrenal androgen

A

play a role in development of male sex organs and important for onset of female body hair following puberty

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13
Q

what is oestradiol

A

steroid hormone that matures and maintains the reproductive system

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14
Q

state the 3 components of puberty

A
  1. Production of sex-steroids i.e Oestradiol and Testosterone
  2. Develop secondary sexual characteristics
  3. Attain capability to reproduce
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15
Q

what is tanner staging?

A

the way we grade puberty (I= pre-pubertal and 5 = adult)

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16
Q

what 3 characteristics are taken into consideration in Tanner staging?

A
  1. thelarche
  2. genetalia => testicular vol in boys
  3. pubarche
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17
Q

how does the Tanner Staging regarding genetalia measure?

A

testicular volume in boys

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18
Q

what is the pre-pubertal testicular volume in boys?

A

< 4mls

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19
Q

what is the adult size testicular volume in men?

A

> 15mls

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20
Q

what is the first sign of puberty

A

gonadarche

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21
Q

what are the effects of oestradiol in women - 4

A
  1. thelarche
  2. hair growth
  3. sweat gland composition
  4. changes to external genitalia
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22
Q

what is axillary hair growth?

A

armpit hair

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23
Q

how is testicular size measured

A

using a Prader Orchidometer

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24
Q

how does the Prader Orchidometer work

A

compares testicular size to beads

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25
Q

state the 4 effects of testosterone in males

A
  1. deepening of voice
  2. hair growth
  3. sweat gland composition
  4. changes to external genitalia
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26
Q

what is the first sign of puberty in girls after gonadarche

A

thelarche

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27
Q

what is the late sign of puberty in girls

A

menarche

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28
Q

when does puberty occur in girls?

A

8-13 yrs

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29
Q

when does puberty occur in boys?

A

9-14 years

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30
Q

state the 2 gonads

A

ovaries and testes

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31
Q

trophin

A

to stimulate or grow

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32
Q

what does gonadotropin lead to the release of? - 2

A

LH and FSH

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33
Q

as the Tanner stage increases, what happens to gonadotropin levels

A

gonadotropin levels increase

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34
Q

why is adrenarche more important in girls?

A

girls do not produce testosterone so are more dependant on adrenal androgens

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35
Q

order of puberty progession in females

A

adrenarche => thelarche => growth spurt => pubarche => menarche

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36
Q

order of puberty progression in males

A

adrenarche => increase in testicular volume => pubarche => growth spurt => spermarche

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37
Q

order of puberty progression in males

A

adrenarche => increase in testicular volume => pubarche => growth spurt => spermarche

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38
Q

normal GnRH secretion is….

A

pulsatile

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39
Q

what does pulsatile mean?

A

released in bursts

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40
Q

why is pulsatility important

A

stimulates the pituatory gland

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41
Q

what would happen if GnRH wasn’t pulsatile?

A

decreased LH and FSH secretion

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42
Q

what does GnRH do

A

stimulates pituitary gland to make and release gonadotrophins

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43
Q

what does HPG stand for?

A

hypothalamic–pituitary–gonadal (HPG)

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44
Q

when is the HPG axis first activated

A

pre-puberty

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45
Q

what is mini-puberty

A

the activation of HPG axis shortly after birth

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46
Q

what is classed as an abnormal onset of puberty

A

mean +/- 2.5 standard deviations

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47
Q

what is precocious puberty?

A

early puberty before 8 years old

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48
Q

what is delayed puberty

A

late puberty after 14 years

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49
Q

what is amenorrhoea?

A

absence of periods for at least 3-6 months or up to 3 periods a year

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50
Q

what is primary amenorrhoea?

A

not ever having periods

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51
Q

what is secondary amenorrhoea?

A

when you have had periods but they have stopped.

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52
Q

why is mini-puberty important? - 4

A
  1. Sertoli cell maturation
  2. Behavioural effects
  3. Penile length
  4. Testicular descent
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53
Q

define peak height velocity

A

the period of time in which a child experiences the fastest growth

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54
Q

link between menarche and peak height velocity

A

menarche is often soon after individual reaches peak height velocity

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55
Q

amenorrhoea - age where it is abnormal

A

> 16 yrs

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56
Q

in the first 18 months are periods regular?

A

no

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57
Q

how many days is in a standard menstrual cycle

A

28 days

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58
Q

commonest cause of secondary amenorrhoea

A

pregnancy

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59
Q

what is the common variation between the menstrual cycle

A

+ or - 2 days for each person each month

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60
Q

what is oligomenorrhoea?

A

few periods

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61
Q

what is oligomenorrhoea?

A

irregular or infrequent periods

62
Q

what is defined as oligomenorrhoea

A

> 35 days cycles

63
Q

3 phases of the ovarian cycle

A

follicular phase => ovulation => luteal phase

64
Q

what happens in the follicular phase?

A

Follicle stimulating hormone (FSH) rises => 2-3 follicles start to grow => Produce E2 (oestradiol) and Inhibin B => The restriction of the FSH window lead to the non-dominant follicles to undergo atresia => Dominant ‘Graafian’ follicle emerges => E2 continues to increase => inducing an LH surge

65
Q

what does inhibin B do?

A

acts on the pituitary gland to reduce FSH secretion

66
Q

what is the dominant follicle called

A

Graafian

67
Q

what releases inhibin B

A

follicles

68
Q

define atresia

A

degeneration of ovarian follicles

69
Q

low oestradiol => feedback cycle

A

low oestradiol => -ve feedback to reduce FSH secretion

70
Q

what is ovulation

A

when the egg is released from the follicle

71
Q

as oestradiol increases what happens to the feedback loop?

A

increase in oestradiol => switch of -ve to +ve feedback to induce LH surge

72
Q

what happens in ovulation?

A

LH increases => releasing egg from follicle

73
Q

what induces ovulation

A

LH increase

74
Q

when egg is released from follicle, what happens to the rest of the follicle?

A

under the action of LH the rest of the follicle becomes corpus luteum

75
Q

what happens in the luteal phase?

A

formation of the corpus luteum

76
Q

what does the corpus luteum produce? - 2

A

progesterone
oestradiol

77
Q

role of progesterone

A

maintains the uterus lining

78
Q

what is the role of oestrogen

A

thickens endometrium (lining of your uterus) for a fertilized egg to implant and grow

79
Q

role of beta hCG

A

helps thicken a person’s uterine lining to support a growing embryo and tells the body to stop menstruation

80
Q

what happens to testosterone and oestrogen production when there is decrease LH and FSH secretion?

A

decreased LH and FSH => decreased testosterone and oestrogen

81
Q

impact of hypogonadism in men

A

decreased testosterone in a man

82
Q

impact of hypogonadism in women

A

decreased oestrogen in women

83
Q

what occurs in the primary conditions in endocrinology?

A

problem with gland that makes hormone

84
Q

what is primary hypogonadism?

A

problem with testes or ovaries producing hormones

85
Q

state the 3 phases of the endometrium-uterine cycle

A

menstrual phase => proliferative phase => secretory phase

86
Q

what happens in the menstrual phase of the endometrium-uterine cycle?

A

shedding of the endometrium lining

87
Q

what happens in the proliferative phase of the endometrium-uterine cycle?

A

Endometrial lining regrows => growth of new epithelial cells, gland proliferation and increase in stroma or arterioles

88
Q

what hormone is involved in the proliferative phase of the endometrium-uterine cycle

A

oestradiol

89
Q

what hormone is involved in the secretory phase of the endometrium-uterine cycle

A

progesterone

90
Q

what happens to the no of stroma and arterioles in the proliferative phase

A

increases

91
Q

what shaped glands produce glycogen in the secretory phase

A

cork-screw shaped

92
Q

what happens to the arteries in the secretory phase of the endometrium-uterine cycle

A

coiling and lengthening

93
Q

what happens to the volume of stromal cells in the secretory phase of the endometrium-uterine lining

A

increases

94
Q

what does the stromal cells cause the endometrium to become

A

thick and spongy

95
Q

what happens in secondary hypogonadism

A

problems with pituitary gland controlling LH and FSH secretion

96
Q

what happens in tertiary hypogonadism

A

problems with the hypothalamus controlling pituatory gland

97
Q

what does LMP stand for

A

last menstrual period

98
Q

define menopause

A

period of a woman’s life in which menstruation ceases

99
Q

define perimenopause

A

menopausal symptoms leading up to menopause

100
Q

define post-menopause

A

after 1 year of menopause

101
Q

what is the ovarian reserve

A

The total number of healthy, immature eggs in the ovaries.

102
Q

define Premature ovarian insufficiency (POI)

A

menopause before the age of 40

103
Q

define Late onset hypogonadism

A

decrease in free testosterone

104
Q

what is a free hormone

A

active form of hormone not bound to proteins

105
Q

why does free testosterone decrease as you age

A

bc increased SHBG

106
Q

what is diurnal rhythm

A

biological rhythm that primarily express a periodicity during daylight hours

107
Q

define Gynaecomastia

A

breast enlargement in men

108
Q

if an embryo implants on the uterus lining - what hormone is produced

A

beta-hCG

109
Q

what does beta-hCG act on and cause?

A

hCG acts on LH receptors => causes corpus luteum to survive and carry on making progesterone

110
Q

role of LH in terms of corpus luteum

A

You need LH activity to form and maintain corpus luteum

111
Q

if the embryo doesn’t implant what happens to progesterone levels

A

falls

112
Q

can you measure GnRH in blood

A

no

113
Q

whay is used to measure GnRH pulsatility in blood

A

LH

114
Q

what menstrual phase has more frequent GnRH pulsatility

A

follicular phase

115
Q

which menstrual phase has the less frequent pulsatility and why

A

luteal phase => because progesterone slows pulses

116
Q

when there is decreased testosterone and oestrogen what happens

A

reduced -ve feedback => increased LH and FSH

117
Q

What is the most common physiological cause of primary hypogonadism in women

A

menopause

118
Q

state 3 causes of primary hypogonadism in MEN

A

cancer - leading to removal of testes
infection
trauma

119
Q

what is secondary hypogonadism also called

A

hypogonadotrophic hypogonadism

120
Q

what happens to gonadotropin levels in secondary hypogonadism

A

low

121
Q

what hormones are low in secondary hypogonadism

A

low FSH and LH => low E2 and testosterone

122
Q

state 3 causes of secondary hypogonadism

A
  1. pituatory tumor
  2. high prolactin
  3. hypothalamic amenhorrea (menopause)
123
Q

define hypothalamic amenhorrea

A

when the hypothalamus slows or stops releasing gonadotropin-releasing hormone (GnRH)

124
Q

what leads to hypothalamic amenhorrea

A

menopause

125
Q

what are the hormone levels in menopause

A

decreased oestrogen => less -ve feedback => high LH and FSH

126
Q

what is inhibin

A

a protein regulating the pituitary secretion of FSH.

127
Q

what happens to inhibin levels in menopause

A

low

128
Q

age range of menopause

A

45-55

129
Q

state 7 symptoms of menopause

A
  1. Hot flushes
  2. Sleep disturbance
  3. Osteoporosis => joint pain
  4. Amenorrhoea
  5. Sexual dysfunction
  6. Weight gain
  7. Cessation of fertility
130
Q

what therapy is often used to treat menopause

A

Menopausal Hormone Therapy

131
Q

how does Menopausal Hormone Therapy work

A

replaces oestrogen

132
Q

what is the impact of oestrogen on the endometrium

A

causes endometrium to proliferate

133
Q

link between oestrogen and cancer risk

A

high oestrogen => increased risk of cancer

134
Q

if given oestrogen replacement, what must be added to the treatment if endometrium is intact to decrease cancer risk?

A

progesterone

135
Q

state 3 causes of premature ovarian insufficiency

A

autoimmune
genetic
cancer therapy

136
Q

what hormone is used to reflect ovarian reserve

A

anti-mullerian hormone (AMH)

137
Q

what produces AMH

A

granulosa cells in the ovaries

138
Q

what is the levels of AMH at menopause

A

low

139
Q

what does testosterone bind to?

A

sex hormone binding globulin (SHBG)

140
Q

can testosterone unbind itself from SHBG

A

no

141
Q

can testosterone activate itself to activate androgen receptors

A

no

142
Q

what other protein in blood plasma can testosterone bind to

A

albumin

bioavailable testosterone

143
Q

what type of rhythm does testosterone have

A

diurnal

144
Q

when is testosterone highest in the day

A

morning before 11am

145
Q

impact on testosterone after eating

A

decreases temporarily

146
Q

state 7 impacts of testosterone deficiency

A
  1. Sexual dysfunction
  2. Erectile dysfunction
  3. reduced growth of hair
  4. mood disturbance
  5. changed body composition
  6. impacted spermatogenesis
  7. low testosterone = impact on bone health
147
Q

what is the testosterone tissue effect in the prostate and scalp - state reaction conversion and enzyme

A

testosterone => Di-Hydro-Testosterone (DHT)

ENZYME: 5a-reductase

148
Q

state the enzyme catalysing testosterone tissue effect in prostate and scalp

A

5a-reductase

149
Q

state the enzyme catalysing testosterone tissue effect in adipose tissue

A

aromatase

150
Q

state the testosterone tissue reaction in adipose tissue stating conversion and enzyme

A

testosterone => oestrogens

ENZYME = aromatase

151
Q

impact of DHT on balding

A

increased DHT = increased balding

ENDOCRINOLOGY - BRS (21 decks)

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