[M6] Part 4: Gonadal Hormones Flashcards by Marlo Roque

Since gonadal hormones are also steroid hormones, the process of synthesis is also called ____

steroidogenesis

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male hormones

Testicular steroidogenesis

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female hormones

Ovarian steroidogenesis

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Steroidogenesis still requires ___

Cholesterol

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In the ___, testosterone is converted to estradiol and androstenedione is converted to estrone

ovaries

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In the ovaries, testosterone is converted to ___ and androstenedione is converted to ____

estradiol
estrone

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In the ovaries, ___ is converted to estradiol and ____ is converted to estrone

testosterone
androstenedione

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tissues aside from the testis and ovaries

Peripheral tissues

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In the peripheral tissues:

Testosterone is reduced to ___

dihydrotestosterone

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T/F: Testosterone is more potent than Dihydrotestosterone

FALSE; Dihydrotestosterone is more potent than testosterone

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Responsible for the masculinization of external genitalia

dihydrotestosterone

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In the peripheral tissues

_____ (___) are converted to testosterone

DHEA
Adrenal androgens

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In the peripheral tissues

Adrenal androgens (DHEA) are converted to ____

testosterone

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In the peripheral tissues

Estriol is hydroxylated to ____

estradiol

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In the peripheral tissues

___ is hydroxylated to estradiol

Estriol

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In the peripheral tissues

Conversion of androstenedione and testosterone to __ and ___, respectively

estrone
estradiol

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In the peripheral tissues

Conversion of ____ and ___ to estrone and estradiol, respectively

androstenedione
testosterone

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Enumerate the TRANSPORT PROTEINS

Sex Hormone-Binding Globulin (SHBG)
Corticosteroid-Binding Globulin (CBG)
Albumin

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TRANSPORT PROTEINS

Transports androgens and estrogens

Sex Hormone-Binding Globulin (SHBG)

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What does SBHG transports?

Androgens and Estrogens

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TRANSPORT PROTEINS

Delivers progesterone and glucocorticoids

Corticosteroid-Binding Globulin (CBG)

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What does CBG delivers?

Progesterone and Glucocorticoids

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____ of sex hormones are protein bound

98% – 99%

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___ of sex hormones are unbound or free

1% – 2%

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___ or __sex hormones are biologically active

Free unbound

Protein-bound sex hormones (can/cannot) diffuse into the ___, therefore, they cannot interact with their target cells

CANNOT vascular system

Principal androgen hormone in the blood regardless if female or male

TESTOSTERONE

TESTOSTERONE Among females, they are converted to ____

estrogen

Most potent androgen among males

TESTOSTERONE

TESTOSTERONE Synthesized by the ______ of ____

Leydig cells of testis

TESTOSTERONE In males, ___ are derived from the Leydig cells

95%

TESTOSTERONE The remaining 5% are derived from the conversion of ____ to ___ to ___

DHEA androstenedione testosterone

Production is controlled primarily by FSH and LH from the pituitary gland

TESTOSTERONE

TESTOSTERONE Production is controlled primarily by ____ and ___ from the pituitary gland

Follicle stimulating hormone (FSH) Luteinizing hormone (LH)

T/F: FSH and LH are both seen in male and female even though they are named in reference to menstrual cycle

true

TESTOSTERONE In males, ____ acts on the germinal stem cells while ___ acts on the Leydig cells

FSH LH

Sa Leydig cells, LH will stimulate the conversion of _____ to form

cholesterol testosterone

The concentration or amount of testosterone is also affected by several physiologic factors. enumerate (3)

Circadian rhythm Obesity Age

CONC. OF TESTOSTERONE Circadian rhythm Peak:

after waking up, usually 8am

CONC. OF TESTOSTERONE Circadian rhythm Lowest:

8 PM

↓ plasma testosterone

Obesity

gradual reduction of testosterone when a male is aging specially after 30 years old (↓ of 110 ng/dL per decade)

AGE

AGE gradual reduction of testosterone when a male is aging specially after___ (↓ of ___ per ___)

30 years old 110 ng/dL decade

Functions for growth and development of the reproductive system of males

TESTOSTERONE

TESTOSTERONE RV (serum):

3.9 – 7.9 ng/mL

_TESTOSTERONE Transport protein: ___ (50%) _________ (45%)

Albumin Sex hormone-binding globulin

TESTOSTERONE Transport protein: Albumin (___) Sex hormone-binding globulin (____)

50% 45%

T/F: Measurement of transport proteins is essential among males because the concentration of these binding proteins can determine the level of testosterone

True

Kung mataas ang ___, mataas din ang testerone

sex hormone binding globulin (SHBG)

Primary hypogonadism

Hypergonadotropic Hypogonadism

Low testosterone

Hypergonadotropic Hypogonadism

Elevated FSH or LH

Hypergonadotropic Hypogonadism

Impaired sperm production

Hypergonadotropic Hypogonadism

Results to infertility or sterility

Hypergonadotropic Hypogonadism

Enumerate the conditions associated with Hypergonadotropic Hypogonadism

Klinefelter’s Syndrome 5-Reductase Deficiency Myotonic Dystrophy Sertoli Cell-Only Deficiency Testicular Injury And Infection Testicular Feminization Syndrome

Also known as XXY

Klinefelter’s Syndrome

Klinefelter’s Syndrome a.k.a

XXY

Male patients with three sex chromosomes

Klinefelter’s Syndrome

Klinefelter’s Syndrome Male patients with ___ sex chromosomes

three

Klinefelter’s Syndrome Patients have:

small testicles, exhibit gynecomastia; and azoospermia

enlargement of the breast

Gynecomastia

presence of semen with no sperm cells

Azoospermia

converts testosterone to dihydrotestosterone

5-reductase

5-reductase converts testosterone to ____

dihydrotestosterone

↓ dihydrotestosterone

5-Reductase Deficiency

responsible for the masculinization of the external genitalia

Dihydrotestosterone

Patients have physical development similar to a female phenotype

5-Reductase Deficiency

Characterized by cryptorchidism

5-Reductase Deficiency

5-Reductase Deficiency Characterized by ___

cryptorchidism

Presence of ambiguous genitalia

cryptorchidism

Characterized by muscle dystonia

Myotonic Dystrophy

Myotonic Dystrophy Characterized by ___

muscle dystonia

Involuntary contraction of muscle

muscle dystonia

Myotonic Dystrophy Patients also exhibit:

testicular failure

Myotonic Dystrophy Patients also exhibit: testicular failure, especially at the ___ of life

4th decade

Also known as germ cell aplasia

Sertoli Cell-Only Deficiency

Sertoli Cell-Only Deficiency a.k.a

Germ cell aplasia

no cell growth

Aplasia

Sertoli Cell-Only Deficiency Patients present with:

Small testis azoospermia increased FSH;' and normal to decreased testosterone

During biopsy, testis will show absence of spermatozoa

Sertoli Cell-Only Deficiency

_Sertoli Cell-Only Deficiency During biopsy, testis will show absence of _____

spermatozoa

Testicular Injury And Infection Example:

mumps orchitis

Inflammation of the scrotum due to mumps infection

mumps orchitis

Most severe form of androgen resistance

Testicular Feminization Syndrome

Testicular Feminization Syndrome Most severe form of ___ resistance

androgen

There is normal level of testosterone but there is resistance

Testicular Feminization Syndrome

Yung mga target tissue ng testosterone hindi nagrereact in response to testosterone (walang receptors)

Testicular Feminization Syndrome

Testicular Feminization Syndrome Patients have:

Patients have female-like genitalia with intra-abdominal testis

Low testosterone

Hypogonadotropic Hypogonadism

Low or normal FSH or LH

Hypogonadotropic Hypogonadism

Enumerate the conditions associated with Hypogonadotropic Hypogonadism

Kallman’s Syndrome Hyperprolactinemia Type 2 Diabetes Age Opioid use Pituitary Disease Obstructive Sleep Apnea

Manifestation of hypogonadism at puberty

Kallman’s Syndrome

Kallman’s Syndrome Manifestation of ___ at puberty

hypogonadism

Kallman’s Syndrome Patients exhibit:

Cleft palate Cleft lip Red-green color blindness Deafness Cerebral dysfunction; and Anosmia

inability to smell; impaired olfactory sensors

Anosmia

Increase in prolactin can inhibit production of FSH and LH because it is an inhibitor of gonadotropin releasing hormone

Hyperprolactinemia

Hyperprolactinemia Increase in ___ can inhibit production of FSH and LH because it is an inhibitor of ____

prolactin gonadotropin releasing hormone

Insulin-resistance

Type 2 Diabetes

Also associated with inflammation

Type 2 Diabetes

Type 2 Diabetes Also associated with inflammation especially if there is an (inc/dec) in ___ and other inflammatory markers

increase CRP

There is gradual reduction of testosterone especially after 30 years of age

Age

Age There is gradual reduction of testosterone especially after ___

30 years of age

Long term use of narcotics, such as opioids, may lead to hypogonadotropic hypogonadism because opioid is a gonadotropin-releasing hormone (GnRH) inhibitor

Opioid Use

Opioid Use Long term use of ___, such as opioids, may lead to ________ because opioid is a _________ inhibitor

narcotics hypogonadotropic hypogonadism gonadotropin-releasing hormone (GnRH)

Meaning of DHEA

DEHYDROEPIANDROSTERON

Even though it is the principal adrenal androgen, it is a weak androgen

DEHYDROEPIANDROSTERON

DHEA It must be converted to a more potent androgen like the _____-

sulfated DHEA

Valuable assessment of adrenal cortex function

DEHYDROEPIANDROSTERONE (DHEA)

The most potent female hormone

ESTROGEN

Arises through structural alteration of testosterone molecule

ESTROGEN

ESTROGEN Functions:

promote breast, uterine, and vaginal development

Types of ESTROGEN

Estrone (E1) Estradiol (E2) Estriol (E3)

Types of ESTROGEN Most abundant form in post-menopausal women

Estrone (E1)

Types of ESTROGEN Estrone (E1) Most abundant form in ____ women

post-menopausal

Types of ESTROGEN Most potent estrogen

Estradiol (E2)

Types of ESTROGEN Principal estrogen form

Estradiol (E2)

Types of ESTROGEN Low level in menopausal women

Estradiol (E2)

Types of ESTROGEN Used to assess ovarian function

Estradiol (E2)

Types of ESTROGEN Form of estrogen that is increase among premenopausal women

Estradiol (E2)

Types of ESTROGEN Estradiol (E2): Form of estrogen that is increase among ____ women

premenopausal

Types of ESTROGEN Form found in maternal urine

Estriol (E3)

Types of ESTROGEN Estriol (E3): Form found in ___

maternal urine

Types of ESTROGEN Diagnostic significance: used as fetoplacental viability marker and down syndrome marker

Estriol (E3)

Types of ESTROGEN Estriol (E3): Diagnostic significance: used as _______________ and ______________

fetoplacental viability marker down syndrome marker

___ and ___ are the metabolites of intraovarian conversion of testosterone

Estrone estriol

Estrone and estriol are the metabolites of _____ conversion of ____

intraovarian testosterone

Down syndrome markers:

AFP hCG Estriol

Produced by corpus luteum

PROGESTERONE

PROGESTERONE Produced by ____

corpus luteum

Prime secretory product of the ovary

PROGESTERONE

Dominant hormone responsible for the luteal phase

PROGESTERONE

PROGESTERONE Dominant hormone responsible for the _____

luteal phase

Prepares the endometrium for embryo implantation

PROGESTERONE

PROGESTERONE Prepares the _____for embryo implantation

endometrium

Single best hormone to determine whether the ovulation has occurred

PROGESTERONE

PROGESTERONE Single best hormone to determine whether the _____ has occurred

ovulation

PROGESTERONE Deficiency: ______

failure of embryo implantation

Shedding of uterine lining from the previous cycle among non-pregnant women

MENSTRUAL CYCLE

MENSTRUAL CYCLE Shedding of _____ from the previous cycle among _____ women

uterine lining non-pregnant

Continuous, no starting point and end point

MENSTRUAL CYCLE

2 phases of Menstrual Cycle

Follicular phase Luteal phase

PHASE OF MENSTRUAL CYCLE Starts at the onset of menstruation

Follicular phase

PHASE OF MENSTRUAL CYCLE First day of menstruation is the end of the luteal phase

Follicular phase

PHASE OF MENSTRUAL CYCLE Follicular phase: ___ day of menstruation is the (end/start) of the ____

First end luteal phase

PHASE OF MENSTRUAL CYCLE (Follicular phase) ↑ FSH = (inc/dec) estrogen = ↑ LH (____)

↑ estrogen LH surge

PHASE OF MENSTRUAL CYCLE (Follicular phase) There is an increase in FSH which will stimulate an increase in ____

estrogen

Estrogen follows what type of feedback system?

positive feedback system

Increase in estrogen will cause an increase in _____

______ – increase in LH

LH surge

LH surge usually happens at the _____ (approximately) of the _____

14th day follicular phase

_____after the LH surge, _____ will start

36 hours luteal phase

Increase in LH will stimulate _____

ovulation

the release of ovum from the ovary

ovulation

It will also cause luteinization of the corpus luteum

Luteal phase

Luteal phase It will also cause luteinization of the ____

corpus luteum

Luteal phase Corpus luteum will secrete _____ which will prepare the ____ for implantation of _____

progesterone endometrium lining embryo

In the absence of fertilization, shedding will happen

Luteal phase

Luteal phase In the absence of ____, ______ will happen

fertilization shedding

Luteal phase Shedding usually occurs ___ after ____

14 days ovulation

Luteal phase Shedding usually lasts for _____

3 to 5 days

Luteal phase If there is ___, ____ will increase in the _____

fertilization hCG placenta

What is the preferred sample for Pregnancy test?

Urine

Why is urine the preferred sample for Pregnancy test?

kasi sa placenta napoproduce yung hCG

MENSTRUAL CYCLE ABNORMALITIES Enumerate

Amenorrhea Oligomenorrhea Menorrhagia

Absence of menses

Amenorrhea

Amenorrhea Absence of ____

menses

absence of menstruation at the age of 16

Primary amenorrhea

Primary amenorrhea absence of menstruation at the age of ___

women who had one menstrual cycle followed by the absence of menses for 3 to 6 months

Secondary amenorrhea

Secondary amenorrhea women who had ___ menstrual cycle followed by the absence of menses for _____

one 3 to 6 months

Infrequent, irregular menstrual bleeding

Oligomenorrhea

Interval ng menstrual cycle is 35 to 40 days

Oligomenorrhea

Oligomenorrhea Interval ng menstrual cycle is ____

35 to 40 days

Oligomenorrhea Normally, _____ lang ang interval starting from the ____

28 days 1st day

Menstruation that occurs for more than 7 days

Menorrhagia

Menorrhagia Menstruation that occurs for more than ___

>7 days

Excessive shedding

Menorrhagia

Enumerate the Associated conditions in Menstrual cycle

1. Hypergonadotropic Hypogonadism 2. Hypogonadotropic Hypogonadism 3. Polycystic Ovarian Syndrome (PCOS) 4. Hirsutism

Primary hypogonadism

Hypergonadotropic Hypogonadism

Ovarian failure

Hypergonadotropic Hypogonadism

Hypergonadotropic Hypogonadism ↓ female hormones, (inc/dec) FSH, ↑ to normal ____

↑ FSH ↑ to normal LH

Enumerate the conditions associated with Hypergonadotropic Hypogonadism

Menopause Premature Ovarian Failure Turner’s Syndrome

Normal physiologic event among females wherein tumitigil yung menstrual cycle

Menopause

Occurs usually at 45 to 55 years old among American women

Menopause

Menopause Occurs usually at ________ old among American women

45 to 55 years old

Hypergonadotropic Hypogonadism Genetic defect

Turner’s Syndrome

Absence of one X chromosome or partial X chromosome lang ang present

Turner’s Syndrome

Secondary hypogonadism

Hypogonadotropic Hypogonadism

Mababa ang female hormones dahil mababa ang gonadotropins

Hypogonadotropic Hypogonadism

Hypogonadotropic Hypogonadism is aka

gonadotropin deficiency

Also called as gonadotropin deficiency

Hypogonadotropic Hypogonadism

Examples of Hypogonadotropic Hypogonadism

a. Anorexia Nervosa b. Runner’s Amenorrhea c. Prolactinoma d. Athlete’s Triad

A Hypogonadotropic Hypogonadism that results to WEIGH LOSS

Anorexia Nervosa

Anorexia Nervosa may lead to ___

hypogonadotropic hypogonadism

A condition associated with females who undergo intense physical exercise which leads to absence of menses

Runner’s Amenorrhea

↑ prolactin = ___(inc/dec) ___ and ____

↑ prolactin = ↓ FSH and LH

Occurs among female and is characterized with amenorrhea, eating disorder, and osteoporosis

Athlete’s Triad

Athlete’s Triad is characterized by:

amenorrhea, eating disorder, and osteoporosis

Also known as enlarged ovaries

Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is aka

enlarged ovaries

Polycystic Ovarian Syndrome (PCOS) is Formerly called as ____

Stein-Leventhal syndrome

Common disorder among females characterized by having multiple ovarian cysts

Polycystic Ovarian Syndrome (PCOS)

Associated with infertility and other menstrual irregularities

Polycystic Ovarian Syndrome (PCOS)

Associated with infertility and other menstrual irregularities

Polycystic Ovarian Syndrome (PCOS)

Often overweight

Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) can be reversed with:

Weight loss Increased physical activity

Treatment for PCOS

metformin

Anti-diabetic drug

metformin

Patients who have PCOS have ____ (resembles ____)

insulin resistance ; type 2 DM

IN PCOS: ↑ insulin = ___(inc/dec) ___ =____, inhibits ___

↑ insulin = ↑ testosterone = virilization, inhibits ovulation

development of masculine traits among female patients (____)

Virilization hirsutism

Insulin sensitizer

metformin

metformin is an insulin sensitizer wherein it ___ (inc/dec) ____ of ____ to ___

Increases ; sensitivity ; cells ; insulin

T/F: All PCOS patients have ovarian cysts

F; NOT all PCOS patients have ovarian cysts

% of patients who don't have ovarian cysts

30%

A condition wherein there is Excess hair along the midline of the female body

Hirsutism

Hirsutism is Typically caused by an ___in ___

increase androgens

Assesses nine area in the female body:

Ferriman-Gallwey Scale

What are the 9 areas assess by the Ferriman-Gallwey Scale

Lips Chin Side burns Neck Chest Abdomen Upper back Lower back Thighs

Assesses hair thickness and pigmentation

Ferriman-Gallwey Scale

In Ferriman-Gallwey Scale, The scale is from ____

0 to 4

what is an indication that the patient has hirsutism

[M6] Part 4: Gonadal Hormones Flashcards

(222 cards)