Exam 4: Wed 3.23. hormones, being preggers, and organ systems Flashcards Preview

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Flashcards in Exam 4: Wed 3.23. hormones, being preggers, and organ systems Deck (69)
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1

Purpose of male and female hormones

Control reproductive function and secondary sexual characteristics in respective gender groups

2

How are homones technically classified?

as steroids

3

Where are male and female hormones produced? 

  • Primarily produced by the gonads
  • A small amount in the adrenal cortex (insignificant amounts to produce physiologic effects)

4

What are male and female hormones called?

Male hormones 

called androgens

Female hormones 

  1. Estrogens (primarily estradiol, usually referred to as estrogen)
  2. Progestins (progesterone)

5

Endocrine feedback loop of testosterone (3) 

 

  • Testosterone made in testes, regulated by anterior pituitary luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
  • LH and FSH regulated by gonadotropin-releasing hormone (GnRH) from the hypothalamus
  • ↑testosterone in circulation inhibits production of these hormones (negative feedback) – levels are fairly constant at all times, until aging process ↓production

6

How does replacement therapy of male hormones affect the body? (8) G-LiMB2S

Reported benefits:

  • Glucose metabolism
  • Libido
  • Mood (can be negative too) 
  • Body composition
  • Bone mineralization (reduces risk of osteoporosis)
  • Strength

Negative

  • Concern that there may be ↑ risk of prostate cancer
  • small balls

7

Medical Reasons Androgens may be prescribed by Doc (5)

  1. Can be administered medically for protein loss,  muscle catabolism, effects of HIV, rarely the treatment of choice by physicians – and mixed success
  2. Delayed puberty – androgens may be used on short-term basis to “kick start” puberty, as long as no underlying pathology exists
  3. Limited use in hormone-sensitive tumors
  4. Anemia – testosterone is potent stimulator of EPO, but other more direct drugs are preferable
  5. Hereditary angioedema (defect in clotting factors) – androgens may be used prophylactically due to their action on liver to restore clotting factors

8

Adverse effects of Androgen supplementation for women (4) 

  • masculinizing effects
  • hirsutism (abnormal growth of face and body hair)
  • deepening voice
  • enlarged external genitalia

*reversible 

9

Adverse effects of Androgen supplementation for men (5) B2ErPS

  • Bladder irritation
  • Breast swelling and soreness
  • Frequent or prolonged Erections
  • Increased risk of Prostate cancer
  • Small balls (if you haven't seen it, it is a strange sight) 

*reversible

10

Adverse effects of Androgen supplementation for children (2)

  • accelerated sexual maturation
  • premature closure of epiphyseal plates

11

Long term effects of Androgen supplementation (3)

  • liver damage/carcinoma
  • hypertension
  • fluid retention

 

12

Antiandrogens- what do they do and what are they used for? 

  • Inhibit synthesis or effects of androgen production
  • May be used in treatment of prostate cancer or benign prostatic hypertrophy
    • Names: Finasteride (Propecia, Proscar), dutasteride (Avodart)

13

Points about androgen abuse and athletics- use, prevelance, ect.. (6)

  1. Anabolic steroids used to enhance athletic performance,↑ muscle size and strength
  2. Increasingly seen in younger athletes – at least 6% of high school athletes admit to use
  3. Usually obtained illegally, taken in “stacking” dosage to ↑ effects
  4. Use a steroid dosing cycle – athletes have a variety of ways to avoid detection during sports drug testing
  5. No question athletic performance is improved, as is lean body mass and muscle strength  - but how much is undetermined
  6. Athletes also use other performance-enhancing techniques such as blood doping, growth hormones

14

Adverse effects of androgen abuse outlined with the athletics powerpoints (7) MR LASH2

  • Mood (“roid rage”)
  • Changes in Reproductive function
  • Liver damage
  • Cardiomyopathy Arrhythmias
  • Effects can be Severe and fatal
  • Hepatic tumors
  • HDL lipids

15

When asking athlete about possible steroid abuse, what are a couple of approaches? 

  • Ask about any additional meds or supplementation (more non-threatning word choice)
  • Can ask if they take any supplements in a cycle if they respond with saying they take a variety of things
  • How do the supplements help you?
  • Important to prevent pt. for getting defensive. 

16

The role of estrogen in puberty (5) PEPS2

initiates:

  • Puberty
  • Epiphyseal plates closure
  • Pelvic girdle widening 
  • Subcutaneous fat stores 
  • Sexual organs maturation 

17

Progesterone. What is it good for? 

(to be sung to the tune of 'War') 

  • Facilitates and maintains pregnency
    • Less important in sexual maturation

18

The female cycle and hormone activity (4)

  • FSH released by anterior pituitary in follicular phase, which matures into ovum
  • LH released by anterior pituitary at menstrual midpoint, with smaller burst of FSH, for ovulation – follicle releases ovum, then becomes infiltrated with lipids (corpus luteum)
  • Corpus luteum controls second half of menstrual cycle – continues to grow for ~1 week post ovulation, secreting estrogen and progesterone – thickens uterine lining, and progesterone stimulates mucus for potential implantation of a fertilized egg
  • If no fertilization, corpus luteum regresses and menstruation occurs

19

If the egg is fertilized in the uterus, then........(4)

  • human chorionic gonadotropin (HCG) is released, takes over the role of LH and prevents destruction of corpus luteum
  • Corpus luteum persists until 9-14th week of gestation, producing progesterone to facilitate uterine environment

  • Placenta produces estrogen and progesterone thereafter – also facilitates development of mammary glands for lactation

  • Estrogen may play a role in parturition (labor)

20

7 Pharmacological Uses of Estrogen and Progesterone

C2HEF- MO

  1. Contraceptives - altering control between pituitary and ovarian hormones
  2. Carcinoma – metastatic breast cancer treated by estrogen
  3. Hypogonadism – low ovarian function, bleeding abnormalities
  4. Endometriosis – progesterone and estrogen/progesterone combos
  5. Failure of ovarian development
  6. Menstrual irregularities (amenorrhea, dysmenorrhea)
  7. Osteoporosis – estrogen replacement

21

Women who have multiple miscarriages may take _____ to help maintain pregnancy

progesterone

22

Points about HRT (hormone replacement therapy)- the good and the bad (7) BP C3oST2

  • Improves Bone mineralization
  • Improves Plasma lipids
  • Controversial
  • Cardiovascular improvement- possibly
  • Several RCTs have shown↑ risk of Stroke, Thromboembolic disease
  • Timing may be important – start HRT when women are <60 y.o. and within 10 years of reaching menopause
  • Zero benefit in protecting Cognitive decline of Alzheimer’s, mixed results in other cognitive studies

23

Adverse effects of taking estrogen and/or progesterone (6) STAMP

  • Stroke
  • Thromboembolism
  • Abnormal blood clotting
  • Menstrual function may be altered with prolonged use
  • PE
  • Cannot use estrogen with estrogen-sensitive breast cancers – importance of screening for women on contraceptives

24

What do Selective Estrogen Receptor Modulators (SERMs) do? 

  • Bind to and activate estrogen receptors on certain tissues while blocking the effects on other tissues (Dr. T thinks this is really cool)
  • Can reduce carcinogenic effects of estrogen on breast and uterine tissue while producing favorable effects on bone mineralization and cardiovascular function

25

Name 2 Selective Estrogen Receptor Modulators (SERMs)

  1. Tamoxifen (Tamofen, Nolvadex)
  2. Raloxifene (Evista) 

26

Use and side effects of Raloxifene (Evista) 

  • primarily used to treat osteoporosis
  • may also give protection against breast cancer
  • side effects
    • hot flashes
    • bone/joint pain
    • GI effects
    • “flu-like” symptoms

27

True or False: Tamoxifen can increase fertility

True (happened to Dr. T's friend at age 41) 

28

What do Anti-estrogens (Clomiphene) do? (2)

  • treats infertility by promoting ovulation
  • Fulvestrant (Faslodex) – an antiestrogen used to treat estrogen-sensitive breast cancers

29

What muppet was MB most like?

30

What may Antiprogestins be used for? (3) 

  • termination of pregnancy (RU486)
  • treatment of uterine fibroids and endometriosis
  • Cushing syndrome (blocks cellular glucocorticoid receptors)