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Pharmacy > Health and Disease Week 31 > Flashcards

Health and Disease Week 31 Flashcards

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1
Q

Which 2 cell types do the testes contain?

A
  1. Leydig cells
  2. Sertoli cells
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2
Q

Where is sperm produced?

A

the sertoli cells in the seminiferous tubules of the testes

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3
Q

Where are the male sex hormones produced?

A

the Leydig cells

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4
Q

What are the steps for the synthesis of androgens?

A
  1. cholesterol is the precursor for androgens
  2. cholesterol -> pregnenolone -> progesterone -> androgens
  3. androstenedione and testosterone are examples of androgens
  4. they both convert to dihydrotestosterone which is more potent and interacts with androgen receptors
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5
Q

What are the 5 main areas for the effects of the androgens?

A
  1. testes
  2. hypothalamus
  3. male sexual characteristics
  4. metabolism
  5. pituitary
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6
Q

How do androgens impact the testes?

A

the androgens drive spermatogenesis

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7
Q

What are the effects on metabolism of the androgens?

A
  1. protein anabolism
  2. bone growth
  3. erythropoietin
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8
Q

What are the effects of androgens on the hypothalamus and pituitary?

A
  1. inhibit GnRH secretion from the hypothalamus
  2. inhibit LH secretion from the pituitary
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9
Q

What are the steps of androgen release?

A
  1. hypothalamus secretes GnRH
  2. anterior pituitary secretes FSH and LH
  3. FSH drives the sertoli cells to produce sperm
  4. LH drives the Leydig cells to make testosterone
  5. testosterone drives other organs and provides negative feedback to pituitary and hypothalamus
  6. sertoli cells also release inhibin, which feeds back to pituitary to stop FSH release
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10
Q

What are the 4 functions of the ovaries?

A
  1. oogenesis
  2. maturation of the oocyte
  3. ovulation
  4. secretion of the female sex steroid hormones
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11
Q

define oogenesis

A

the production of the ovum

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12
Q

Where does oogenesis occur?

A

in the ovarian follicles

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13
Q

Which 2 phases make up the ovarian cycle?

A
  1. follicular phase (preovulatory)
  2. luteal phase (postovulatory)
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14
Q

What are the steps of the ovarian cycle?

A
  1. the oocytes develop into primordial follicles
  2. then to primary follicles
  3. then to secondary follicles
  4. there are an increasing number of cells around the egg as it develops and these cells start to make sex hormones
  5. the egg is released, forming the corpus luteum
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15
Q

What happens in the follicular phase of the ovarian cycle?

A
  • this phase is under the control of FSH released from anterior pituitary
  • causes development of the egg
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16
Q

What happens in the luteal phase of the ovarian cycle?

A
  • ovulation and the corupus luteum formation
  • under control of LH
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17
Q

What are the steps of ovarian follicle development?

A
  1. the thecal cells surrounding the follicle during its growth secrete oestrogen
  2. the follicle fuses with membrane and the egg is released
  3. this forms the corpus luteum
  4. the corpus luteum develops and secretes progesterone
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18
Q

define uterine cycle

A

a repeating series of changes in the endometrium of the uterus

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19
Q

What are the 3 stages of the uterine cycle?

A
  1. menses
  2. proliferative phase
  3. secretory phase
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20
Q

menses

A

this stage involves breakdown of the endometrium leading to menstruation

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21
Q

proliferative phase

A

cells in the endometrium proliferate to restore the tissue

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22
Q

secretory phase

A

the endometrial glands get bigger and secrete hormones to make the endometrium an ideal place for implantation of an egg

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23
Q

What are the 4 hormones of the female reproductive system?

A
  1. FSH
  2. LH
  3. oestrogens
  4. progesterones/progestogens
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24
Q

What does FSH do?

A

stimulates the development of the follicle to release an egg

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25
What does LH do?
triggers ovulation and formation of the corpus luteum
26
What do oestrogens do?
have many functions
27
What do the progesterones/progestogens do?
stimulate endometrial growth and secretion
28
What are the steps of female sex hormone release?
1. hypothalamus release GnRH 2. causes anterior pituitary to release FSH and LH 3. FSH acts on granulosa cells in the follicles to cause maturation of an egg 4. LH acts on thecal cells in the ovaries to cause release of androgens 5. the androgens are converted to oestrogens by the granulosa cells 6. granulosa cells also secrete inhibin, which inhibits FSH secretion 7. oestrogen also inhibits GnRH and LH secretion
29
What are the steps of synthesis of the female sex hormones?
1. cholesterol is main precursor 2. cholesterol -> pregnenolone -> progesterone (may stop here) -> androgens 3. the androgens are converted to androstenedione and testosterone 4. androstenedione is converted to oestrone in the ovaries 5. testosterone is converted to oestradiol
30
What are the steps on binding of sex hormones to receptors?
1. nuclear receptor has a DNA-binding domain and ligand-binding domain 2. the hormone-receptor complex can move into nucleus once hormone binds 3. complex binds to hormone-response elements (HREs) in gene sequences 4. the HRE has 2 half sites, and the 2 complexes dimerise, and can now bind to gene sequence
31
How do oestrogens activate their receptor?
same way as normal sex hormones, but: 1. can bind to alpha or beta receptor 2. oestrogen-receptor complex binds to oestrogen response elements (EREs)
32
How do progesterones activate their receptors?
same as sex hormones and oestrogen, but: 1. two isoforms of the progesterone receptor are A and B (NOT alpha and beta) 2. there is a single gene that encodes the progesterone receptor - A and B both have identical ligand binding
33
What are the 6 main areas of action of oestrogens?
1. ovaries/uterus 2. female sexual characteristics 3. hypothalamus 4. pituitary 5. metabolism 6. CNS
34
What are the actions of progesterone?
1. decreases GnRH secretion 2. induces secretory phase of uterine cycle 3. increases viscosity of cervial mucus 4. increases basal body temperature - temperature increases around ovulation
35
What are the 2 types of oestrogen preparations?
1. natural oestrogens 2. synthetic oestrogens
36
What are 2 examples of natural oestrogens?
1. oestradiol/oestrone 2. oestriol
37
What are 3 examples of synthetic oestrogens?
1. mestranol 2. ethinylestradiol 3. diethylstilbesterol
38
define SERMs (selective oestrogen receptor modulators)
a group of compounds that bind to oestrogen receptor as agonists or antagonists (drugs)
39
How do SERMs work?
1. shape of the receptor-SERM complex determines which genes it will bind to 2. ER alpha and beta are on different tissues - tissue specific effects
40
How do SERMs have a role in cancer treatment?
example is Tamoxifen which binds to oestrogen receptors in breast tissue and blocks ostrogens effect (growth), slowing or stopping cancer growth
41
What are the 2 types of progestrogen preparations?
1. natural progestogens 2. testosterone derivatives
42
What are 3 examples of natural progestogens?
1. hydroxyprogesterone 2. medroxyprogesterone 3. dydrogesterone
43
What are 3 examples of testosterone derivatives?
1. norgestrel 2. desogestrel 3. ethynodiol
44
What are the 2 main clinical uses of oestrogens and progestogens?
1. HRT in menopause 2. contraception
45
What causes menopause?
the ovaries lose their ability to respond to FSH and LH as all follicles have developed
46
What are the 3 phases of menopause?
1. perimenopause 2. menopause 3. postmenopause
47
How does menopause lead to osteoporosis?
oestrogen stimulates the apoptosis of osteoclasts, so prevents excess bone breakdown
48
What is an example of a drug used to maintain bone density after menopause?
Raloxifene (a SERM) is an agonist that acts as oestrogen to bind to receptors
49
What are the 2 options for HRT?
1. combination preparations 2. oestrogen-only prepatation PLUS progesterone
50
What are the effects of HRT?
1. can reduce menopausal symptoms and osteoporosis 2. oestrogens decrease LDL cholesterol levels
51
What are the 3 main methods of contraception?
1. barrier methods 2. intra-uterine devices (IUD) 3. oral contraceptives
52
What are the 3 types of oral contraceptives?
1. combined contraceptives 2. progestogen-only contraceptives 3. emergency contraceptives
53
Which drugs are in the combined pill?
oestrogen = ethinylestradiol progestogen = levonorgestrel
54
How does the combined pill work?
1. oestrogen inhibits secretion of FSH to prevent egg developing 2. progestogens inhibit LH secretion to prevent ovulation and to thicken mucus in cervix
55
How does the progestogen-only pill work?
1. negative feedback to stop LH release - no ovulation
56
Which drug is usually used for the morning-after pill?
levonorgestrel
57
How does the morning-after pill work?
high levels of progestogens inhibit LH surges and therefore ovulation to protect sperm from meeting an egg
58
What type of drug is used for abortion?
antiprogesterones
59
How does Mifepristone (an antiprogestogen) work?
1. it is a progesterone receptor antagonist and blocks receptor 2. used with misoprostol 3. both stop progesterone effects and cause uterine wall to contract 4. causes abortion
60
What are 4 examples of menstrual disorders?
1. dysmenorrhoea 2. menorrhagia 3. premenstrual syndrome 4. endometriosis
61
What is an example of a drug type used in pregnancy?
prostaglandins
62
What do prostaglandins do?
stimulate the uterine contractions to induce labour or abortion
63

Pharmacy (37 decks)

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