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YL2_Obstetrics 1 > Maternal Endocrinology > Flashcards

Maternal Endocrinology Flashcards

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1
Q

Estrogen secretion is maintained by

A

Rising hCG levels (in the first 2-4 weeks of pregnancy)

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2
Q

Estrogen secretions drops significantly by

A

7th week

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3
Q

This hormone prepares the endometrium for blastocyst implantation

A

Progesterone

Also maintains pregnancy

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4
Q

Human Chorionic Gonadotropin is detactable during

A

7-9 days after midcycle

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5
Q

Half life of hCG

A

36 hours

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6
Q

The alpha subunit of hCG is encoded by a single gene in chromosome

A

16

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7
Q

The beta subunit of hCG is encoded in Chromosome

A

19

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8
Q

Alpha subunit of hCG is smilar to which other hormones?

A

TSH,LH and FSH

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9
Q

At less than 5 weeks, hCG is expressed by

A

Syncytiotrophoblasts and cytotrophoblasts

Later: solely by syncytiotophoblast

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10
Q

Secretion of hCG peaks at

A

9 weeks AOG

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11
Q

Secretion of hCG peaks at

A

9 weeks AOG

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12
Q

It maintains the corpus luteum

A

hCG

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13
Q

Stimulates maternal thyroid and promotes uterine vascular vasodilation and smooth muscle relaxation

A

hCG

Also modulates maternal immune cell function during early stage of placentation

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14
Q

It stimulates fetal testicular testosterone secretion

A

HCG

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15
Q

Abnormal high hCG levels is seen in

A

GTD
Multifetal pregnancy
Erythroblastosis fetalis
Down Syndrome

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16
Q

A single, non-glycosylated polypeptide chain which shares amino acid sequence homology with hGH and hPRL

A

Human Placental Lactogen

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17
Q

Codes hPL

A

CSH1 and CSH2

GH-placental lactogen gene cluster located on chromosome 17

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18
Q

Synthesizes hPL at <6 weeks

A

Syncytiotrophoblastt and cytotrophoblast

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19
Q

The hormone hPL is demonstrable in the placenta within

A

5-10 days postconception

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20
Q

HPL hormone is detectable in the maternal serum at

A

3 weeks

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21
Q

Half-life of hPL

A

10-30 mins

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22
Q

How much hPL is produced by 34-36 weeks

A

1g/day

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23
Q

During late pregnancy, maternal serum concetration of hPL reach levels of

A

5-15 microgram/mL

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24
Q

What inhibits hPL?

A

PGE2 and PGF2-alpha

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25
What stimulates hPL?
Insulin and insulin-like growth factor
26
Function of hPL
Act on maternal physiology to ensure adequate nutrient delivery to the placenta ## FOOTNOTE Promotes lipolysis = increase FA levels Increase maternal insulin resistance Favors protein synthesis Stimulate B-cell proliferation
27
Highest expression of GnRH occurs during the
1st trimester ## FOOTNOTE Expressed by the **cytotrophoblast**
28
What hormone regulates **trophoblast hCG production** and **extravillous trophoblast invasion**
GnRH ## FOOTNOTE Via regulation of MMP-2 and MMP-9
29
Level of CRH in non-pregnant women
5-10 pmol/L
30
During the third trimester, the level of CRH reaches
100 pmol/L
31
The level of CRH during the last 5-6 week of pregnancy is
500 pmol/L
32
Which hormmone is attributed to the following functions: Enhances secretion of ACTH Induces smooth muscle relaxation in vascular and myometrial tissue Immunosupression Initiation of parturition
CRH
33
It acts in the **hypothalamus** to **inhibit CRH**
Glucocorticoids
34
Stimulates CRH gene expression
Glucocorticoids
35
This hormone is expressed in the placenta and may play an auocrine role in trophoblast survival via GHRH receptor
GHRH
36
Placental growth hormone synthesized by the syncytiotrophoblast. It is present in maternal plasma at 21-26 weeks and rises until 36 weeks. It has diabetogenic and lactogenic function
Human growth hormone variant (hGH-V)
37
**POMC** is produced by the
Pituitary and placental tissues
38
This homone is proteolytically cleaved into various hormones such as ACTH, Beta-lipotropic hormone, Melanocyte stimulating hormone and Beta-endorphin
Pro-opiomelanocortin (POMC)
39
Function of POMC
Maintains energy balance
40
Relaxin is expressed in
Human corpus luteum, decidua and placenta
41
These relaxin genes are transcribed in the corpus luteum
H2 and H3
42
H1 and H2 relaxin genes are transcribed in the
Decidua, placenta and membranes
43
This hormone is structurally similar to insulin and insulin-like growth factor. It functions in myometrial relaxation, uterin quiescence, post-partum regulation of ECM remodelling and enhances maternal GFR
Relaxin
44
True or False Parathyroid hormone-related protein is elevated in fetal circulation but not in maternal circulation
False
45
PHRP is found in
Myometrium, endometrium, corpus luteum and lactating mammary tissues
46
This hormone regulates genes involved in the transfer of calcium and other solutes and also contributes to mineral homeostasis in fetal bones, amniotic fluid and fetal circulation
Parathyroid Hormone-Related Protein ## FOOTNOTE This hormone is not produced in the parathyroid gland of adults
47
An **anti-obesity hormone** normally synthesized by adipocytes and also cytotrophoblast and syncytiotrophoblast. It regulates bone growth and immune function
Leptin
48
Promotes placental cell proliferation, protein synthesis and activation of immune tolerance and antiapoptotic tolerance
Placental leptin
49
True or False Fetal leptin correlates positively with birthweight
True ## FOOTNOTE Reduced levels contribute to adverse fetal metabolic programming in IUGR
50
A 36-AA peptide widely distributed in the brain
Neuropeptide-Y
51
Neuroopepttide-Y is solely synthesized by the
Cytotrophoblast
52
Regulates cellular functions that include placental development, trophoblast differentiation and invasion into the decidua
Transforming Growth Factor Beta Superfamily
53
Promotes syncytialization, extravillous trophoblast formation and invasion
Activin A
54
Enhances **invasion**
BMP2
55
It may direct embryonic stem cells towards **trophoblast lineage**
BMP4
56
Promotes syncytialization but inhibits invasion
Inhibin A
57
Progesterone decreases in production from the CL after how many weeks
6-7 weeks
58
When does the placenta assumes pogesterone production
8 weeks after the decreased production of progesterone by the CL
59
A 250 mg/day level of progesterone indicates a
Normal singleton pregnancy
60
A 600 mg/day progesterone production indicates a
Multifetal pregnancy
61
**Rate limiting enzyme** during the biosynthesis of **progesterone**
HMG-CoA reductase ## FOOTNOTE 3-hydroxy3-methylglutaryl coenzyme A reductase
62
Why is cholesterol or progesterone not a precursor for estrogen biosynthesis?
The human placenta do not express **steroid 17-alpha-hydroxylase/17,20-lyas (CYP17A1)** which then converts the 17-OH preogesterone to androstenedione
63
What serves as the precursor for estrogen?
DHEA and DHEA-S ## FOOTNOTE Produces by the maternal and fetal adrenal glands
64
To converts DHEA-S to estradiol, it needs 4 key enzymes. These are:
Steroid sulfates 3Beta-hydroxysteroid dehydrogenase type 1 (3BHSD) Cytochrome P450 aromatase (CYP19) 17B-hydroxysterod dehydrogenase type 1 (17BHSD1)
65
Which enzyme converts the conjugated DHEA-S to DHEA?
Steroid sulfates (STS)
66
Which enzyme converts DHEA to androstenedione?
3BHSD
67
Which enzyme converts DHEA to androstenedione?
3BHSD
68
Whihc enzyme converts anndrosteneidione to estrone?
CYP19
69
Estrone is connverted to estradiol via which enzyme?
17BHSD1
70
the major precursor of estrogens in pregnancy
DHEA
71
Quantitatively the most important source of placental estrogen precursors in human pregnancy is the
Fetal adrenal glands
72
What percent of the estradiol and estriol produced enters the maternal plasma?
>90%
73
What percent of the progesterone produced enters the maternal plasma?
>=85%
74
Progesterone is synthesized from
Cholesterol (LDL)
75
a paracrine regulator of differentiation or is a potential regulator of human growth hormone variant production
Ghrelin
76
Ghrelin is produced by the
Placental tissue
77
What hormone **stimulates syntesis** and **release** of placental **ACTH**
Placental CRH

YL2_Obstetrics 1 (2 decks)

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