Gonadal hormones

Question 1

How many carbons for each gonadal hormones.

Answer 1

Estrogen 18C
Progesterone C-21 steroid
Testosterone C-19 steroid

Question 2

Full estrogen antagonist.

Partial estrogen antagonist and agonist.

Answer 2

Clomiphene and Tamoxifen

Raloxifine (Selective E receptor modulator SERM)

Question 3

How does Clomiphene stimulate ovulation?

Answer 3

Interferes with negative feedback of E on hypothalamus and pituitary thus inc. secretion of gonadotropin releasing hormone (GnRH)

Question 4

Raloxifine agonist and antagonist effect?

Answer 4

Agonist: reduced bone resorption thereby decreases bone turnover and on lipid metabolism
Antagonist: Effect on uterine and breast tissues

Question 5

Antiestrogen drugs’ side effects.

Answer 5

Tamoxifen: hot flashes, vag bleeding, mens irreg, risk of endometrial cancer, n & v (least nauseating anticancer drug)
Clomiphene: ovarian enlargement, vasomotor flushes, visual disturbances
Raloxifine: hot flushes

Question 6

Basic nucleus of Progesterone.

Answer 6

Pregnane

Question 7

Two types of Progesterone.

Answer 7

17-alpha hydroxyprogesterone such as medroxyprogesterone acetate and megestrol acetate.
17-alpha ethinylandrogens (more potent) Norethindrone and Norethynodrel

Question 8

Norethindrone and Norethynodrel are commonly used as what?

Answer 8

oral contraceptives due to potent oral activity, more lipid soluble and less first pass metabolism

Question 9

Progesterone is used alone for the treatment of what?

Answer 9

Amenorrhea, abnormal uterine bleeding and endometriosis

Question 10

Injection used for amenorrhea and abnormal uterine bleeding, and dosing.

Answer 10

Medroxyprogesterone acetate (Depo-Provera injection)
150mg injected every 3 months

Question 11

Progesterone SE

Answer 11

Unexpected or increased lactation, depression, loss or changes in speech, coordination, stomach pain, swelling of face ankles feet, moods fatigue

Question 12

OCP used when progesterone levels are high and as abortifacient MOA.

Answer 12

Mifepristone (RU 486) - partial ago and anta progesterone. Interferes with progesterone and decreases hCG production

Question 13

Estrogen SEs

Answer 13

Feminization, nausea, stomach upset, depression, weight gain, inc blood clotting, edema, HTN, stroke MI, late bleeding

Question 14

Anastrozole and Finasteride are what type of inhibitors?

Answer 14

Anatrozole- Aromatase inhibitors

Finasteride- 5-alphase reductase inhibitors

Question 15

Depo-provera can be used postabortal state when? And during lactation?

Answer 15

postabortal state - 5 days postpartum

during lactation - 6wk postpartum

Question 16

Why is Progestrin the DOC during lactation?

Answer 16

Unlike Estrogen, do not inhibit the binding of prolactin to its receptors hence no decrease in breast milk.

Question 17

IUDs danger signal.

Answer 17

ACHES. Abdominal pain Chest pain/SOB Headache Eye pain and Severe leg pain

Question 18

This OCP inhibits cervical sperm penetration by thickening cervical mucus. Contains 28 active drugs.

Answer 18

Progesterone only oral; Norethidrone (Micronor)

Question 19

Used for erectile dysfunction to Pts taking Nitrates or alpha blockers. Give dosing

Answer 19

PGE1 Analogs: 1) Alprostadil

2) Caverject (intracavernosal inj) - nmt OD or 3x wkly at 24h each dose
3) MUSE (intraurethral pellet) nmt once per 24h

Question 20

Toxic Shock Syndrome is from what strain? From what use of OCP?

Answer 20

S. aureus

from use of tampons sponges IUD and cervical caps

Question 21

Obstructive and irritative symptoms of BPH.

Answer 21

Obstructive: weak stream, difficulty initiating, stream starts and stops, inability to terminate, post void dripping, urinary retention, feeling of incomplete empty bladder
Irritative: frequency, nocturia, pain during urination, urgency

Question 22

Most common form of vaginitis. Describe discharge.

Answer 22

Bacterial vaginosis. Creamy and fishy odor (yellow/gray) discharge. STD

Question 23

Severe pruritus vaginitis. Describe discharge. And DOC treatment.

Answer 23

Vaginal candidiasis. White cottage cheese, curdy discharge. Not STD
Tx Miconazole, Clotrimazole and Nystatin

Question 24

Protozoa infection vaginitis. Describe discharge

Answer 24

Trichomoniasis. Frothy, wet discharge. STD

Question 25

Vaginal discharge, spotting and soreness, burning vaginitis. And DOC treatment.

Answer 25

Atrophy. Metronidazole

Question 26

DOC for enuresis(bed wetting)

Answer 26

DDAVP antiduiretic hormone derivatives desmopressin

Question 27

DOC for urinary incontinence, an anticholinergic drug acts on M3 receptor

Answer 27

Oxybutynin

Question 28

Drugs that should be avoided in urinary incontinence.

Answer 28

Furosemide, glucocorticoids and thiazolidinediones

Question 29

Not a symptom of BPH

Answer 29

Jet stream urination

Question 30

Herbal product for prostatic hyperplasia.

Answer 30

Saw palmetto

Question 31

When to take OCP postpartum.

Answer 31

After 6 weeks postpartum

Question 32

Explain antiandrogen 5-alpha reductase inhibitor MOA.

Answer 32

5-alpha reductase catalyses testosterone to dihydrotestosterone (DHT) which prostate growth is dependent on, rather than testosterone.

Question 33

• Hormone used to improve uterine contraction in labor and to control postpartum bleeding is:
• What type of hormone is Diethylstilbestrol

Answer 33

• Oxytocin

- non-steroidal synthetic hormone