female reproduction

Question 1

what is the hormone:
development of breast + ductal system
stimulate ENDOMETRIAL PROLIFERATION
growth of female internal genitalia: ovaries, fallopian tubes, uterus, vagina
growth of female external genitalia
stimulate bone growth (inhibit osteoclast activity)
↑HDL, ↓LDL

Answer 1

estrogen

Question 2

types of estrogen in body

Answer 2

estradiol (ovary, most potent)
estrone (converted from androgens in adrenal cortex to estrone via aromatase in adipose tissue, males/females)
estriol (placenta, least potent)

Question 3

what is the hormone:
inhibit endometrial proliferation
promotes SECRETORY CHANGES in endometrium (prepare for implantation)
produces thick cervical mucus (inhibit sperm entry into uterus)
smooth muscle relaxation (incl uterus - prevent ctx + miscarriage)
secretory changes in breast (prepare for milk production)

Answer 3

progesterone

Question 4

what is made by the syncytiotrophoblast of placenta

Answer 4

bHCG

Question 5

most common location of fertilization

Answer 5

ampulla of fallopian tube

Question 6

bHCG (from synctiotrophoblasts) is detectable after a pregnancy when:

Answer 6

blood: 1 week after conception
urine: 2 weeks after conception

Question 7

implantation occurs

Answer 7

6 days after fertilization

Question 8

fertilization must occur within

Answer 8

1 day after ovulation

Question 9

role of syncytiotrophoblast and its bHCG secretion

Answer 9

prevent CL degeneration → maintain estrogen + progesterone levels

Question 10

when does the placenta become the main source of estrogen (estriol) + progesterone

Answer 10

6 wks (no longer CL)

Question 11

what inhibits lactation during pregnancy

Answer 11

↑ progesterone + estrogen from the placenta

once placenta removed: ↓ estrogen + progesterone → lactation

Question 12

prolactin + oxytocin are both stimulated by

Answer 12

suckling

Question 13

made by anterior pituitary

induces milk production

Answer 13

prolactin

Question 14

released by posterior pituitary

induces milk let down (into the ducts)

Answer 14

oxytocin

Question 15

α subunit of HCG is similar to

Answer 15

LH, FSH, TSH

Question 16

protective against enodmetrial cancer

Answer 16

progesterone

Question 17

primary oocyte is arrested in

Answer 17

prOphase I (until Ovulation)

Question 18

secondary oocyte is arrested in

Answer 18

metaphase II (until fertiization)

Question 19

> 35 day cycle

Answer 19

oligomenorrhea

Answer 20

polymenorrhea

Question 21

frequent, irregular periods

Answer 21

metrorhagia

Question 22

heavy or prolonged (>7 days) periods

Answer 22

menorrhagia

Question 23

heavy, frequent, irregular periods

Answer 23

menometrorrhagia

Question 24

painful periods with unknown cause

Answer 24

1­° dysmenorrhea

Question 25

painful periods due to endometriosis or fibroid

Answer 25

2° dysmenorrhea

Question 26

sexual development of female

Answer 26

breast buds form → pubic hair → menarche → may have anovulatory cycles within first few years (irregular periods)

Question 27

tx of anovulation few years after menarche

Answer 27

OCP | check pregnancy test first!

Question 28

treatment of 1° dysmenorrhea

Answer 28

NSAIDs | +/- hormonal contraceptive

Question 29

use of hormonal contraceptives

Answer 29

dysmenorrhea dysfunctional retinue bleeding PCOS

Question 30

MOA of hormonal birth control

Answer 30

progestin +/- estrogen → negative feedback to pituitary + hypothalamus →↓ FSH/LH release → no LH surge → prevent ovulation

Question 31

SE of estrogen

Answer 31

endometrial hyperplasia → can progress to endometrial cancer growth of ER+ cancer (breast cancer) ↑ risk of venous thromboembolism (DVT, PE)

Question 32

metabolism of estrogen (in birth control pill, HRT) is by

Answer 32

``` cyp450 potential for drug-drug interactions - drugs that induce P450 and enhance estrogen metabolism (ineffective birth control, HRT): Guinness, Coronas, PBRS, induce chronic alcoholism Griseofulvin Carbamazepine Phenytoin Barbiturates Rifampin - tx for latent TB St. John's wart chronic alcoholism ```

Question 33

use of progestin

Answer 33

``` birth control (alone or with estrogen) abnormal uterine bleeding oppose estrogen proliferative effect on endometrium - used in women receiving estrogen replacement who still have a UTERUS (protect uterus from endometrial cancer) ```

Question 34

SE of progestin

Answer 34

irregular bleeding (esp when used alone)

Question 35

contraceptive that can cause hepatic adenoma

Answer 35

OCP

Question 36

contraceptive that can cause ↓ bone mineral density

Answer 36

DMPA injection - depo provera

Question 37

menopausal symptoms

Answer 37

``` ↓ estradiol production in ovaries produce S/S: Menopausal Symptoms wreak HAVOC Mood changes - depression Sleep disturbances Hot flashes Atrophy of vagina → Vaginal dryness Osteoporosis Coronary artery disease (↑ risk) ```

Question 38

diagnosis of menopause

Answer 38

12 months of amenorrhea

Question 39

labs once in menopause

Answer 39

ovaries stop producing: estradiol, inhibin →↑ GnRH, FSH, LH

Question 40

permanent cessation of menstruation due to decline in number of ovarian follicles onset: 51 yrs

Answer 40

menopause

Question 41

menopause before 40 yo

Answer 41

premature ovarian failure

Question 42

predominant estrogen in post-menopausal women

Answer 42

estrone: androgen (from adrenal cortex) converted to estrone by aromatase in adipose tissue

Question 43

sudden onset of heat in face/chest → periphery associated with diaphoresis, palpatations followed by chills, shivering lasts 2-4 minutes may disturb sleep

Answer 43

hot flashes

Question 44

treatment of hot flashes

Answer 44

HRT (estrogen) better than SSRI, SNRI, gabapentin | herbal: contain estrogen (avoid in breast cancer)

Question 45

use of HRT

Answer 45

relieve menopausal symptoms - not to prevent CAD, osteoporosis use for shortest time possible, lowest dose (

Question 46

contraindications for HRT

Answer 46

CAD active liver disease history of breast cancer, stroke, VTE

Question 47

using HRT in women with a uterus

Answer 47

estrogen + PROGESTERONE (protective) | unopposed estrogen increases risk of endometrial cancer

Question 48

differential diagnosis of 1° amenorrhea

Answer 48

``` turner syndrome (most common) imperforate hymen androgen insensitivity syndrome mullerian duct agenesis delayed puberty ```