Female Repro

Question 1

• accomplished within 2 months
• postpubertal male can produce several hundred million sperm each day
• each primary spermatocyte yields 4 equally viable spermatozoa

Answer 1

spermatogenesis

Question 2

• take anywhere from 12 to 50 years to complete on cyclic basis from onset of puberty until menopause
• female born with limited, largely nonrenewable supply of germ cells
• each primary oocyte yields only one cytoplasm-poor polar bodies that disintegrate

Answer 2

oogenesis

Question 3

OOGENESIS

1. _______ during early fetal life gives rise to primary oocytes
2. During fetal development, ______ begins. After puberty, _________ completes meiosis I, which produces a secondary oocyte and a first polar body that may or may not divide again.
3. The _________ begins meiosis II.
4. A secondary oocyte (and first polar body) is ________.
5. After _______, meiosis II resumes. The ______ splits into an ovum and a 2nd polar body
6. The _______ of the sperm cell and the ovum unite, forming a _____ (2n) zygote.

Answer 3

1. Mitosis
2. meiosis I; primary oocytes
3. secondary oocytes
4. ovulated
5. fertilization; oocyte
6. nuclei; diploid

Question 4

• located in the hypothalamus
• stimulates the anterior pituitary gland to release ________ or ________

Answer 4

Gonadotropin Releasing Hormone

• gonadotrox or gonadotropins

Question 5

2 types of gonadotropin

Answer 5

1. luteinizing hormone
2. follicle stimulating hormone/FSH

Question 6

• stimulates the development of ovarian follicles
• 2 cells that produce estrogen

Answer 6

FSH

1. thecca cells
2. granular cells

Question 7

• acts on the mature follicle to stimulate ovulation
• acts on the corpus luteum (secrete progesterone and estrogen)

Answer 7

LH

Question 8

corpus luteum produces

Answer 8

1. estrogen
2. progesterone
3. relaxin
4. inhibin

Question 9

• Promote development and maintenance of female reproductive structures, feminine secondary sex characteristics, and breasts
• Increase protein anabolism
• Lower blood cholesterol
• Moderate levels inhibit release of GnRH, FSH, and LH

Answer 9

estrogen

Question 10

• Works with estrogens to prepare endometrium for implantation
• Prepares mammary glands to secrete milk
• Inhibits release of GnRH and LH

Answer 10

progesterone

Question 11

• Inhibits contractions of uterine smooth muscle
• During labor, increases flexibility of pubic symphysis and dilates uterine cervix

Answer 11

relaxin

Question 12

• Inhibits release of FSH and, to a lesser extent, LH

Answer 12

inhibin

Question 13

OVARIAN CYCLE

Answer 13

1. primordial follicles
2. primary follicles
3. secondary follicle
4. mature (graafian) follicle
5. ovulation
6. corpus luteum
7. corpus albicans

Question 14

14th day

Answer 14

ovulation

Question 15

uterine/menstrual cycle

Answer 15

1. menstrual phase
2. preovulatory phase
3. ovulation
4. postovulatory phase

Question 16

if no implantation = ___ progesterone —> thickened uterine lining dies —> shedding —> menstruation (after 28 days)

Answer 16

• ↓ progesterone

Question 17

• ________ production happens between the menstrual phase and the ovulation phase
• thickened uterus lining

hormone levels throughout the menstrual cycle:
___ estrogen
___ LH
___ FSH (but lower)
___ progesterone

Answer 17

• estrogen

↑ estrogen
↑ LH
↑ FSH (but lower)
↓ progesterone

Question 18

after ovulation…

↑ progesterone (____ day)

↓ progesterone (____ day)

Answer 18

• 22nd
• 28th

Question 19

• a cyclical disorder of severe physical and emotional distress
• appears during the postovulatory (luteal) phase of the female reproductive cycle and dramatically disappears when menstruation begins
• They may include edema, weight gain, breast swelling and tenderness, abdominal distension, backache, joint pain, constipation, skin eruptions, fatigue and lethargy, greater need for sleep, depression or anxiety, irritability, mood swings, headache, poor coordination and clumsiness, and cravings for sweet or salty foods
• The cause is unknown.

Answer 19

Premenstrual syndrome (PMS)

Question 20

• more severe syn- drome in which PMS-like signs and symptoms do not resolve after the onset of menstruation.
• Clinical research studies have found that suppression of the reproductive cycle by a drug that interferes with GnRH (_______) decreases symptoms significantly.
• Because symptoms reappear when estradiol or progesterone is given together with leuprolide, researchers propose that PMDD is caused by abnormal responses to normal levels of these ovarian hormones.
• _______ (____________) have shown promise in treating both PMS and PMDD.

Answer 20

• leuprolide
• SSRIs (selective serotonin receptor inhibitors)

Premenstrual dysphoric disorder (PMDD)

Question 21

• characterized by the growth of endometrial tissue outside the uterus
• tissue enters the pelvic cavity via the open uterine tubes and may be found in any of several sites—on the ovaries, the rectouterine pouch, the outer surface of the uterus, the sigmoid colon, pelvic and abdominal lymph nodes, the cervix, the abdominal wall, the kidneys, and the urinary bladder.
• Endometrial tissue responds to hormonal fluctuations, whether it is inside or outside the uterus.
• With each reproductive cycle, the tissue proliferates and then breaks down and bleeds.
• When this occurs outside the uterus, it can cause inflammation, pain, scarring, and infertility.
• Symptoms include premenstrual pain or unusually severe menstrual pain.

Answer 21

endometriosis

Question 22

• After ______, it is the second-leading cause of death from cancer in U.S. women
• can occur in males but is rare
• seldom seen before age 30; its incidence rises rapidly after menopause
• An estimated ____ of the _______ cases diagnosed each year in the United States, particularly those that arise in younger women, stem from inherited genetic mutations (changes in the DNA).
• two genes that increase susceptibility to breast
  cancer: _______ & _______.
• Mutation of ______ also confers a high risk for ovarian cancer.
• In addition, mutations of the p53 gene increase the risk of breast cancer in both males and females, and mutations of the androgen receptor gene are associated with the occurrence of breast cancer in some males.
• it is generally not painful until it becomes quite advanced
• Early detection by _______ and ________, is the best way to increase the chance of survival.

Answer 22

• lung cancer
• 5% of the 180,000 cases
• BRCA1 (breast cancer 1) and BRCA2
• BRCA1
• breast self-examination and mammograms

Question 23

• most effective technique for detecting tumors less than 1 cm (0.4 in.) in diameter is _________, a type of radiography using very sensitive x-ray film.
• The image of the breast, called a __________, is best obtained by compressing the breasts, one at a time, using flat plates.
• A supplementary procedure for evaluating breast abnormalities is _________.
• Although ultrasound CANNOT detect tumors smaller than 1 cm in diameter (which mammography can detect), it can be used to determine whether a lump is a ______, ______, and ______ (and therefore possibly malignant) tumor.

Answer 23

• mammography
• mammogram
• ultrasound
• benign, fluid-filled cyst or a solid

BREAST CANCER

Question 24

Factors that increase the risk of developing breast cancer

Answer 24

1. Family history of breast cancer
2. Nulliparity (never having borne a child) or having a first child after age 35
3. Previous cancer in one breast
4. Exposure to ionizing radiation, such as x-rays
5. Excessive alcohol intake
6. Cigarette smoking.

Question 25

The American Cancer Society recommends the following steps to help diagnose breast cancer as early as possible: * All women over ___ should develop the habit of monthly breast self-examination. * A physician should examine the breasts every 3 years when a woman is between the ages of ___ and ___, and every year after age ___. * A mammogram should be taken in women between the ages of ___ and ___, to be used later for comparison (_________). * Women with no symptoms should have a mammogram every year after age ___. * Women of any age with a history of breast cancer, a strong family history of the disease, or other risk factors should consult a physician to determine a schedule for mammography

Answer 25

- 20 - 20 and 40; 40 - 35 and 39; baseline mammogram - 40 BREAST CANCER

Question 26

Treatment for breast cancer

Answer 26

1. hormone therapy 2. chemotherapy 3. radiation therapy 4. lumpectomy (removal of the tumor and the immediate surrounding tissue) 5. modified or radical mastectomy, 6. combination of these approaches.

Question 27

A ____________ involves removal of the affected breast along with the underlying pectoral muscles and the axillary lymph nodes. (Lymph nodes are removed because metastasis of cancerous cells usually occurs through lymphatic or blood vessels.) _______ and _______ may follow the surgery to ensure the destruction of any stray cancer cells.

Answer 27

- radical mastectomy - Radiation treatment and chemotherapy BREAST CANCER

Question 28

Several types of chemotherapeutic drugs are used to decrease the risk of relapse or disease progression of breast cancer: 1. ________: an estrogen antagonist that binds to and blocks estrogen receptors, thus decreasing the stimulating effect of estrogen on breast cancer cells. _______ has been used for 20 years and greatly reduces the risk of cancer recurrence. 2. ________: a monoclonal antibody drug, targets an antigen on the surface of breast cancer cells. It is effective in causing regression of tumors and retarding progression of the disease. 3. The early data from clinical trials of two new drugs, _________ and ________, show relapse rates that are lower than those for tamoxifen. These drugs are inhibitors of _______, the enzyme needed for the final step in synthesis of estrogens. 4. Two drugs — _______ and _______ —are being marketed for breast cancer prevention. Interestingly, _______ blocks estrogen receptors in the breasts and uterus but activates estrogen receptors in bone, providing effective treatment for osteoporosis while possibly decreasing the risk of breast or endometrial (uterine) cancer.

Answer 28

1. Nolvadex® (Tamoxifen) - Tamoxifen 2. Herceptin® 3. Femara® and Amimidex® - aromatase 4. Tamoxifen and Evista® (raloxifene) - raloxifene BREAST CANCER

Question 29

Even though this is the sixth most common form of cancer in females, it is the leading cause of death from all gynecological malignancies (excluding breast cancer) because it is difficult to detect before it metastasizes (spreads) beyond the ovaries. Risk factors associated with this include: - age (usually over age ___) - race (______ are at highest risk) - family history of ovarian cancer - more than ___ years of active ovulation - ________ or first pregnancy after age ___ - a high-fat, low-fiber, vitamin __ deficient diet - prolonged exposure to ______ or ______

Answer 29

- 50 - whites - 40 years - nulliparity; 30 - vitamin A deficient - asbestos or talc OVARIAN CANCER

Question 30

- Early cancer has NO symptoms or only MILD ones associated with other common problems, such as abdominal discomfort, heartburn, nausea, loss of appetite, bloating, and flatulence. - Later-stage signs and symptoms include an enlarged abdomen, abdominal and/or pelvic pain, persistent gastrointestinal disturbances, urinary complications, menstrual irregularities, and heavy menstrual bleeding.

Answer 30

OVARIAN CANCER

Question 31

- carcinoma of the cervix of the uterus, starts with _________, a change in the shape, growth, and number of cervical cells. - The cells may either return to normal or progress to cancer. - In most cases, this may be detected in its earliest stages by a _______. - Some evidence links cervical cancer to the virus that causes genital warts, _________ - Increased risk is associated with having a large number of sexual partners, having first intercourse at a young age, and smoking cigarettes. - vaccine: ______

Answer 31

- cervical dysplasia - Pap test - human papillomavirus (HPV) - Gardasil vaccine CERVICAL CANCER

Question 32

- __________ is a yeastlike fungus that commonly grows on mucous membranes of the gastrointestinal and genitourinary tracts. - The organism is responsible for ___________, the most common form of vaginitis, inflammation of the vagina. - It is characterized by severe itching; a thick, yellow, cheesy discharge; a yeasty odor; and pain. - The disorder, experienced at least once by about ____ of females, is usually a result of proliferation of the fungus following antibiotic therapy for another condition. - Predisposing conditions include the use of _______, _______, _______, ________ - not considered as a STD

Answer 32

- Candida albicans - vulvovaginal candidiasis - 75% of females - oral contraceptives or cortisone-like medications, pregnancy, and diabetes VULVOGAVINAL CANDIDIASIS

Question 33

- caused by the bacterium _________ - bacterium cannot reproduce outside body cells; it “cloaks” itself inside cells, where it divides. - MOST PREVALENT sexually transmitted disease in the United States. - In most cases, the initial infection is __________ and thus difficult to recognize clinically. - In males, urethritis is the principal result, causing a clear discharge, burning on urination, frequent urination, and painful urination. - Without treatment, the epididymides may also become inflamed, leading to sterility. - In 70% of females with this, symptoms are ABSENT, but this is the leading cause of __________ - The uterine tubes may also become inflamed, which increases the risk of ectopic pregnancy (implantation of a fertilized ovum outside the uterus) and infertility due to the formation of scar tissue in the tubes.

Answer 33

- Chlamydia trachomatis - asymptomatic - pelvic inflammatory disease CHLAMYDIA

Question 33

STDs

Answer 33

1. Chlamydia 2. Gonorrhea 3. Syphilis 4. Genital Herpes 5. Genital Warts

Question 34

- “the clap” is caused by the bacterium ___________. - In the US, 1–2 million new cases of gonorrhea appear each year, most among individuals aged ___-___ years. - Discharges from infected mucous membranes are the source of transmission of the bacteria either during sexual contact or during the passage of a newborn through the birth canal. - The infection site can be in the mouth and throat after oral-genital contact, in the vagina and penis after genital intercourse, or in the rectum after recto–genital contact. - Males usually experience urethritis with profuse pus drainage and painful urination. - Both infected males and females may harbor the disease WITHOUT any symptoms, however, until it has progressed to a more advanced stage; about 5–10% of males and 50% of females are asymptomatic. - An estimated 50,000 to 80,000 women in the United States are made infertile by gonorrhea every year as a result of scar tissue formation that closes the uterine tubes. - Administration of a __________ in the infant’s eyes prevents infection.

Answer 34

- Neisseria gonorrhoeae - 15–29 yrs old - 1% silver nitrate solution GONORRHEA

Question 35

- caused by the bacterium Treponema pallidum, is transmitted through sexual contact or exchange of blood, or through the placenta to a fetus. - During the primary stage, the chief sign is a painless open sore, called a ______, at the point of contact. It heals within ___-___weeks. - From ___-___ weeks later, signs and symptoms such as a skin rash, fever, and aches in the joints and muscles usher in the _________, which is SYSTEMATIC — the infection spreads to all major body systems. - When signs of organ degeneration appear, the disease is said to be in the __________. If the nervous system is involved, the tertiary stage is called _________. As motor areas become damaged extensively, victims may be unable to control urine and bowel movements. Eventually they may become bedridden and unable even to feed themselves. In addition, damage to the cerebral cortex produces memory loss and personality changes that range from irritability to hallucinations.

Answer 35

- chancre - 1 to 5 weeks - 6 to 24 weeks - SECONDARY STAGE - TERTIARY STAGE - neurosyphilis SYPHILIS stages: 1. Chancre 2. Systemic Syphilis 3. Organ Degeneration

Question 36

- an incurable STD - _____________ causes genital infection, producing painful blisters on the prepuce, glans penis, and penile shaft in males and on the vulva or sometimes high up in the vagina in females. - The blisters disappear and reappear in most patients, but the virus itself remains in the body. - A related virus, __________, causes cold sores on the mouth and lips. - Infected individuals typically experience recurrences of symptoms several times a year.

Answer 36

- Type II herpes simplex virus (HSV-2) - Type I herpes simplex virus (HSV-1) GENITAL HERPES

Question 37

- an infectious disease caused by viruses. - ___________ causes ________, which is commonly transmitted sexually. - Patients with a history of this may be at increased risk for cancers of the cervix, vagina, anus, vulva, and penis. - NO CURE - vaccine: _______

Answer 37

- Human papillomavirus (HPV) - genital warts - Gardasil vaccine GENITAL WARTS

Question 38

- Cessation of woman’s menstrual cycle - Usually occurs between ages of ___ and ___ - Period of transition called the ______ Symptoms: * progressive ovarian failure * Increasingly irregular cycles * Dwindling estrogen levels

Answer 38

- 45 and 55 - climacteric MENOPAUSE

Question 39

- occurs in the oviduct/fallopian tube - must occur within 24 hours after ovulation. *Sperm usually survive 48 hours outside the male reproductive tract but can survive up to 5 days in female reproductive tract. Sperm migration: * Contractions of ________ * Upward contractions of _________ * _______ released by mature eggs

Answer 39

- myometrium - oviduct smooth muscle - Allurin FERTILIZATION

Question 40

- Fertilized ovum divides _______. - Within a week, it grows and differentiates into ______ capable of implantation. - ________ becomes the embryo and then fetus. - _________ cells of blastocyst support fetus during intrauterine life.

Answer 40

- mitotically - blastocyst - Blastocyst - Trophoblast IMPLANTATION

Question 41

- About ___ weeks from conception (___ weeks from the first day of the last menstrual period) Physical changes: * uterine enlargement (more than 20 times) * breasts enlarge and develop ability to produce milk * volume of blood increases 30% * weight gain * respiratory activity increases * urinary output increases

Answer 41

- 38 weeks (40 weeks) PREGNANCY

Question 42

- During ______, elevated placental estrogen and progesterone promote development of mammary glands. - _______ stimulates synthesis of enzymes essential for milk production. - Withdrawal of _______ at parturition initiates lactation.

Answer 42

- gestation - Prolactin - placental steroids LACTATION

Question 43

Advantages: 1. immunity - ________ - ________ - ________ 2. good digestion - ________ factor promotes multiplication of __________

Answer 43

Advantages: 1. immunity - Secretory IgA - Mucus - Lactoferrin 2. good digestion - Bifidus factor promotes multiplication of Lactobacillus bifidus