Exam Two - high yield for Montemayor

Question 1

SRY gene

Answer 1

Sex-determining region on the Y chromosome; promotes development of the testes via protein action of TDF

Question 2

5-alpha-reductase (type 2)

Answer 2

Responsible for the conversion of testosterone to DHT

Question 3

Leydig cells

Answer 3

Cells of the testes that produce testosterone

Question 4

_____ can be substituted for LH in clinical attempts to stimulate spermatogenesis in oligospermic men due to its increased availability. hCG is structurally most similar to LH and binds LH receptors

Answer 4

hCG

Question 5

DHT (details)

Answer 5

Required for external male genitalia and prostate

Binds the same androgen receptor as testosterone, with greater affinity

If deficient, default female external pattern will develop

Question 6

What happens in the absence of DHT in a genetic male?

Answer 6

Development of female eternal genitalia (outer vagina, labia major/minora, clitoris)

Question 7

What is required for Wolffian duct structures to develop?

Answer 7

testosterone “action”

Question 8

What are the Wolffian duct structures?

Answer 8

Epididymis, vas deferens, ejaculatory duct and seminal vesicles

Question 9

Breast development in a male can occur with…?

Answer 9

Peripheral conversion of testosterone to estradiol

Question 10

Which enzyme converts androgens to estrogens?

Answer 10

CYP19-aromatase

Question 11

What is required for pubertal hair growth?

Answer 11

DHT action

Question 12

What hormone is thought to be responsible in initiating puberty?

Answer 12

GnRH (pulsatile release)

Question 13

Circulating testosterone is found in which forms?

Answer 13

Majority is bound to SHBG (45-60%)

Minority is free (2-5%)

Question 14

What protein is responsible for maintaining adequate testosterone concentration in the testes?

Answer 14

ABP (androgen-binding protein)

Question 15

Why must testosterone be concentrated in the testes?

Answer 15

It is required to maintain adequate spermatogenesis (high concentration)

Question 16

Know the Tanner stages of puberty

Answer 16

1 —> 5

Question 17

Hypogonadotropic hypogonadism (details)

Answer 17

Congenital (Kallman syndrome: decreased or absent GnRH secretion, anosmia), idiopathic or acquired causes

Plasma LH, FSH, and testosterone levels are low

Testes are immature and have no sperm

Question 18

What is eunuchoidism?

Answer 18

Gonadal failure before puberty results in the absence of secondary sex characteristics

Question 19

What stimulates LH and FSH secretion?

Answer 19

Pulsatile hypothalamic GnRH release

Question 20

T concentration in peripheral circulation is diluted to about 100-fold less than T level in the ___________ ___________

Answer 20

seminiferous tubules

Question 21

When do hCG levels peak during pregnancy?

Answer 21

about 10 weeks

Question 22

Estriol levels….

Answer 22

are unique to pregnancy and can be used as a indicator of fetal health

Question 23

What is determined by the date of the last menstrual period?

Answer 23

The LMP determines *pregnancy duration (the mean is 40 wks total (gestational age) or 38 weeks from ovulation (embryonic/fetal age)

Question 24

What is the “luteal-placental shift”?

Answer 24

When the placenta takes over hormone synthesis from the corpus luteum (P+E levels may decrease during transition)

Question 25

What is thought to be the cause for morning sickness (aka hyperemesis gravidarum)?

Answer 25

pt's response to hCG

Question 26

hCG binds to what receptors with high affinity?

Answer 26

LH receptors (can also bind to FSH and TSH receptors with lower affinity)

Question 27

What is absolutely required to maintain pregnancy?

Answer 27

Progesterone (reduces smooth m. activity and promotes quiescent myometrium)

Question 28

Can progesterone be used as an indicator of fetal health?

Answer 28

No

Question 29

Estriol production requires what hormone from the adrenal glands of the fetus?

Answer 29

DHEA-S (androgen)

Question 30

What hormone levels are directly proportional to placental growth?

Answer 30

human placental lactogen (hPL)

Question 31

What is the main action of hPL?

Answer 31

To promote adequate glucose availability to the fetus (by antagonizing insulin, inhibiting maternal glucose uptake, "diabetogenicity of pregnancy")

Question 32

What type of hormones do syncytriotrophs produce?

Answer 32

peptide and steroid hormones

Question 33

What are the five described endocrine functions of the placenta?

Answer 33

xx

Question 34

Endocrine changes in the pregnant mother:

Answer 34

Increased prolactin levels Increased pituitary size (x2+, can cause Sheehan's) Decrease in LH and FSH production (negative feedback from estrogens and progesterone) ADH "set point" changed...released with lower osmolality Increased size of thyroid and total T3 and T4 (hCG weakly binds TSH, estrogen promotes increased TBG too) Increased cortisol Increased aldosterone (due to estrogen's ability to increase liver secretion of angiotensinogen (causes increased Ang II), however this does not cause hypernatremia, hypokalemia, or hypertension due to progesterones ability to blunt aldosterone's action and due to ADH's lower set point)

Question 35

For a women with a normal BMI, what is the average (normal) weight gain with pregnancy?

Answer 35

about 25-35 lbs.

Question 36

Main cardiovascular changes during pregnancy:

Answer 36

Increase in blood volume Increase in plasma volume (increase in aldosterone, lower set point for ADH) Decrease in hematocrit ("physiological anemia"... RBC production does not meet increase in plasma volume, contributes to reduction in TPR) Increase in CO Decreased TPR Decreased or Same MAP (increased CO, decreased TPR, MAP = CO x TPR)

Question 37

Where is the blood pumped by the increased CO directed to?

Answer 37

15% goes to uterus (non-pregnant % is 1%) 40% goes to kidneys (then skin, heart, and breasts) (no change = brain, gut, skeleton)

Question 38

What are the changes in Starling forces during pregnancy (causing edema)?

Answer 38

Increased capillary hydrostatic pressure (increased venous pressure in LE's due to compression on IVC by fetus and increased venodilation due to hormones) (increased in) Decreased capillary colloid osmotic pressure (increased liver productions of proteins can't keep up with increased plasma volume) (decreased out)

Question 39

Changes in the respiratory system during pregnancy:

Answer 39

Increase in alveolar ventilation Progesterone induced changes to fascia...resulting in elevation of diaphragm Increased 02 demand and CO2 production Increased sensitivity and response to CO2, ***causing reduction of PCO2 (~40 --> 32 mmHg) Response of kidneys to the respiratory alkalosis = increased secretion of HCO3-

Question 40

Renal changes during pregnancy:

Answer 40

Increased RBF and GFR ( ~ 50% due to increased blood volume and CO) Increased plasma renin, Ang II, and aldosterone Increased sodium retention Increased H20 intake and retention Decreased serum Na+ (due to ADH set point effects)

Question 41

GI changes during pregnancy:

Answer 41

due to progesterone: reflux, constipation, etc. (slowing)

Question 42

What are the three important nutrients during pregnancy?

Answer 42

protein, iron and folate

Question 43

Three stages of parturition?

Answer 43

xx

Question 44

do the

Answer 44

practice questions for male BSC