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GYN > Hormone in GYN > Flashcards

Hormone in GYN Flashcards

1
Q

Natural GnRH is a _____ peptide

A

Decapeptide

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2
Q

T 1/2 of GnRH

A

3-4 mins

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3
Q

Kallmann syndrome

A

Failure of neuronal migration in olfactory placode.
X- linked recessive
M:F = 6:1
Hypothalamic failure + anosmia +/- Colour blindness in male.
Height of pt is normal

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4
Q

Complaints of Kallmann syndrome

A

Delayed puberty
primary amenorrhea
Infertility

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5
Q

Example of Hypogonadotropic Hypogonadism

A

Kallmann syndrome.

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6
Q

Mutated gene in Kallmann syndrome

A

Kal 1 gene

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7
Q

Neurotransmitter that decrease when hypothalamus is active

A

GABA and neuropeptides

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8
Q

Neurotransmitter that increase when hypothalamus is active

A

LPG - Leptin , Kisspeptin and Glutamate.

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9
Q

Low pulse freq of GnRH produces

A

FSH

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10
Q

HIgh pulse freq of GnRH produces

A

LH

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11
Q

Synthetic GnRH

A

Leuprolide
Triptorelin
Goserelin
Nafarelin

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12
Q

Leuprolide
Triptorelin
Goserelin
Nafarelin

A

Synthetic GnRH

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13
Q

Synthetic GnRH

A

HIgh first pass metabolism - not Given orally

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14
Q

Pulsatile synthetic GnRH is given in

A

Acts like normal GnRH

Delayed puberty and ovulation induction

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15
Q

Continuous synthetic GnRH is given in

A

Dec LH and FSH and in turn reduces Estrogen

Given in Hyperestrogenic conditions

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16
Q

Add back therapy

A

If GnRH is given for more than 6 months - Estrogen levels are very low - so causes menopause like symptoms
So E + P are given to counter it

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17
Q

LH receptors are present on

A

Females - Theca and granulosa cells

males - Leydig cells

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18
Q

FSH receptors are present on

A

Females - Granulosa cells

Males - Sertoli cells

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19
Q

T 1/2 of LH

A

20 mins

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20
Q

T 1/2 of FSH

A

3-4 mins

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21
Q

Receptor type of FSH, LH, GnRH, HCG

A

G protein coupled receptors

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22
Q

Receptor type of Progesterone and Estrogen

A

Nuclear receptor present in cytoplasm.

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23
Q

Synthetic LH and FSH

A

HMG - human menopausal gonadotropin
75 IU of FSH and 75 IU of LH
used for ovulation induction.

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24
Q

S/E of HMG

A

Multifetal pregnancy

OHSS

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25
Q

Natural Estrogen is

A

C18

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26
Q

Natural Progesterone is

A

C19

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27
Q

Synthetic progesterone is

A

C21

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28
Q

Androgens are

A

C21

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29
Q

MC estrogen in reproductive age

A

E2

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30
Q

MC estrogen in Menopause

A

E1

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31
Q

MC estrogen in pregnancy

A

E2

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32
Q

Most specific estrogen in Pregnancy

A

E3

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33
Q

Ratio of E2:E1

A

2:1

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34
Q

Ratio of E2:E1 in PCOS

A

1:2

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35
Q

Potency of natural estrogens

A

2>1>3>4

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36
Q

Least androgenic Effects are seen in which Gen of Progesterone

A

3rd gen

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37
Q

Anti androgenic effects are seen in which gen of progesterone

A

4th

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38
Q

Reason for Androgenic effects of Synthetic progesterone

A

Both are C21

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39
Q

3rd gen Synthetic Progesterone

A

Desogestrel
Norgestimate
Gestodene

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40
Q

4th gen Synthetic progesterone

A

Drospirenone

Cyproterone acetate

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41
Q

____ binds to SHBG

A

Estrogen

42
Q

Progesterone does not bind to

A

SHBG

43
Q

Sources of progesterone

A

Granulosa cells, Corpus luteum, Placenta

44
Q

Sources of Estrogen

A

Granulosa and theca cells, Corpus luteum and Placenta

45
Q

SHBG Inc by

A

Estrogen

46
Q

SHBG dec by

A

AI PG C

Androgens, Insulin, Progestin, GH, Cortisol

47
Q

Effects of Estrogen

A

Growth of non pregnant uterus

Proliferates endometrium

48
Q

Effects of Progesterone

A

Pregnant uterus support
Stops proliferation
Decidualization - Secretion and support

49
Q

IF Progesterone given for long time -

A

Endometrial atrophy.

50
Q

Endometrial biopsy in 1st half shows

A

Short Simple cystic tubular glands.

51
Q

Endometrial biopsy in 2nd half shows

A

Coiled - corkscrew or sawtooth appearance

filled with secretions.

52
Q

Endometrial biopsy @ ovulation shows

A

Subnuclear vacuoles

53
Q

Appearance of subnuclear vacuoles indicates

A

Ovulation

54
Q

1st sign of Ovulation on endometrial biopsy

A

Appearance of subnuclear vacuoles

55
Q

Cervical Mucus on day 8 appears as

A

Ferning

56
Q

Spinnbarkeit

A

Thin, water, copious, elastic appearance of Cervical mucus.

57
Q

Causes for ferning of cervical mucus

A

Inc Na, Cl, And estrogen

58
Q

Scanty or tacky appearance of cervical mucus is seen in

A

2nd phase of menstruation.

59
Q

Ferning disappears by

A

Day 18

60
Q

Estrogen predominates _____ cells in vaginal epithelium

A

Superficial cells

61
Q

____ cells are predominant under no hormonal stage

A

Basal or parabasal cells

62
Q

Progesterone predominant cells in vaginal epithelium are

A

Intermediate cells

63
Q

Sample for hormonal study should be taken from

A

Lateral wall of vagina - upper 2/3rd

64
Q

Sample for cytological study should be taken from

A

Posterior wall of vagina

65
Q

Maturation index

A

Parabasal/basal : Intermediate : superficial cells

66
Q

Maturation index at pregnancy

A

0:95:5

67
Q

Maturation index at postpartum

A

100:0:0

68
Q

Maturation index at menopause

A

100:0:0

69
Q

Maturation index at secretory phase

A

0:70:30

70
Q

Maturation index at pre-ovulatory phase

A

0:40:60

71
Q

Karyotypic index aka

A

cornification index = Number of cornified squamous cells.

72
Q

Cardioprotective hormone

A

Estrogen

73
Q

OCP are contraindicated in

A

Thromboembolism, Stroke and CAD

74
Q

Billings method of family planning

A

looking at cervical mucus thickness to determine ovulation.

75
Q

Appearance of Endometrium on USG in proliferative phase

A

thin white line

76
Q

Appearance of Endometrium on USG at ovulation

A

Trilaminar appearance

77
Q

Trilaminar appearance of Endometrium on USG

A

@ time of ovulation.

78
Q

Appearance of Endometrium on USG in Secretory phase

A

Thick white endometrium with a posterior enhancement .

79
Q

SERM

A

Selective estrogen receptor modulator drugs

80
Q

SERM example

A

Clomiphene citrate, Raloxifene, Tamoxifen, Ormeloxifene.

81
Q

Tamoxifen action on breast

A

Antagonistic action.

DOC for RX of Estrogen Receptor + Breast cancer

82
Q

DOC for RX of ER + Breast cancer

A

Tamoxifen

83
Q

Raloxifene action on breast

A

Antagonistic action.

DOC for Prophylaxis in Estrogen Receptor + Breast cancer.

84
Q

DOC for Prophylaxis in ER + Breast cancer.

A

Raloxifene

85
Q

Antagonistic action of Tamoxifen is seen in

A

Breast

86
Q

Antagonistic action of Raloxifene is seen in

A

Breast and uterine endometrium

87
Q

Raloxifene action on uterine endometrium

A

Antagonistic action

S/E - hot flushes.

88
Q

SERM are contraindicated in

A

Thrombosis, stroke, and CAD

89
Q

new combination to treat osteoporosis and hot flashes.

A

Bazedoxifene and estrogen

90
Q

Estrogen antagonists

A

Progesterone > continuous gnrh > Danazol > Gestrinone > Letrozole.

91
Q

Letrozole - MOA

A

aromatase inhibitor.

92
Q

Danazol - C/I

A

Not to be used in young female- S/E - Hirsutism

93
Q

Smoking inhibits

A

Aromatase

94
Q

SPRM

A

Selective progesterone receptor modulator

95
Q

SPRM - Example

A

Ulipristal

96
Q

ELLA -

A

Ulipristal - SPRM

97
Q

Progesterone Antagonist

A

Mifepristone.

98
Q

Uses of Ulipristal

A

Emergency contraception - Single dose - 30mg

Fibroids.

99
Q

RU486

A

Mifepristone.

100
Q

Drug used in Mx of Endometriosis

A

Mifepristone -

Brings about endometrial atrophy.

GYN (19 decks)

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