Menstrual Physiology and Amenorrhea Flashcards Preview

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Flashcards in Menstrual Physiology and Amenorrhea Deck (75):
1

Which menstrual cycle days is the narrow window of endometrial receptivity to blastocyst implantation?

Days 20-24

2

Which cell secretes small amount of progesterone that cause LH release?

Granulosa cells

3

Inhibin B inhibits what hormone?

FSH release

4

Inhibin B is produced by the

Granulosa cells

5

What cell produces androstenediol?

Theca cells

6

What promotes theca cells to produce androstenedione?

LH

7

Drop in FSH is due to

Inhibin B and rise in estradiol

8

The drop in FSH leads to

Failure of other follicles to develop

9

Primary oocyte is formed when?

5th month AOG

10

The primary oocyte divides and arrested in what stage until the onset of puberty?

Prophase

11

The primary oocyte will complete the 1st meiotic division during

The onset of puberty

12

What does the granulosa cell secrete?

Progesterone and inhibin B

13

What oocyte is formed upon completion of meiosis 1?

Secondary oocyte

14

Release of the first polar body occurs during

Ovulation

15

Secondary oocyte is arrested in what phase until fertilization

Metaphase 2

16

This hormone level rises in parallel to the growth of a dominant follicle

Estrogen

17

Site of FSH receptor expression

Granulosa cells

18

Increase in FSH during what phase stimulates in increase in FSH receptors to convert androstenedione into estradiol

Late luteal phase

19

This hormone induces remodeling of the ovarian extracellular matrix to allow release of the mature oocyte

LH

20

Corpus luteum regresses how many days after ovulation?

9-11 days

21

Secondary rise in estrogen and progesterone peak occurs during what phase

Mid luteal phase

22

The most biologically potent naturally occurring estrogen secreted by the granulosa cells

17 B estradiol

23

What progesterone receptors are involved in subnuclear vacuole formation?

PR A
PR B

24

Phase in the endometrial cycle that consists of striaght to slightly coiled tubular glands that are lined by pseudostratified columnar epithelium

Proliferative phase

25

Which layer is shed and regenerated in the endometrium?

Functionalis layer

26

What day of menses is the woman in when the epithelial surface of the endometrium has been restored

Day 5 of menses

27

This period in the proliferative phase is where there are longer curving glands and numerous mitotic figures

Midproliferative phase

28

Mid proliferative phase corresponds to what days in the menstrual cycle?

Day 8-10

29

In late proliferative phase this layer has more crowded glands and denser stroma

Basalis

30

This phase occurs when there are COILED glands and the endometrium is lined by simple columnar

Early secretory phase

31

This phase has serrated, dilated glands and lined by short columnar cells

Late secretory

32

Dating of the early secretory phase is based on what structure

Glandular epithelium

33

1st signs of ovulation in the early secretory phase

Presence of subnuclear vacuoles and pseudostratification

34

On Day 17, glycogen accumulates in what part of the endometrium?

Basal portion

35

On day 18, the vacuoles move to what portion of the endometrium

Apical

36

Dating of mid to late secretory phase is based on this structure

Endometrial stroma

37

What days in the menstrual cycle is also known as the window of implantation

Days 21-24

38

These are luminal protrusions on the apical cell surface that appears in preparation for blastocyst implantation

Pinopodes

39

Chemotactic activating factor for neutrophils seen in late premenstrual phase endometrium

IL-8

40

Invading leukocytes activate these proteases from the MMP family that produces intense vasoconstriction and endometrial changes the promote endometrial destruction

MMP 1 and 3

41

This hormone(?) substance promotes vasoconstriction, myometrial contractions and up regulation of proinflammatory responses

Prostaglandins

42

This prostaglandin promotes vasoconstriction of the spiral arteries

PGF2- alpha

43

Specialized, highly modified endometrium of pregnancy and is a function of hemochorial placentation

Decidua

44

Blastocyst implantation phase where there is initial contact of blastocyst to uterine wall

Apposition

45

Blastocyst implantation phase where there is increased physical contact of blastocyst to uterine wall

Adhesion

46

Blastocyst implantation phase where there is penetration and invasion of syncitiotrophoblast and cytotrophoblast into the endometrium, 1/3 of myometrium and uterine vasculature

Invasion

47

Decidual layer directly beneath the blastocyst implantation

Decidua basalis

48

Decidual layer that overlies the enlarging blastocyst and initially separates it from the uterine cavity

Decidua capsularis

49

Decidua capsularis is prominent during what month of pregnancy?

2nd

50

Decidua vera is the combination of which layers of the decidua?

Capsularis and parietalis

51

At what AOG is the gestational sac completely filling the uterine cavity

14-16 weeks AOG

52

Decidual later where spiral arteries persists

Layer that is responsive to vasoactive agents

Decidua parietalis

53

Layer where spiral arteries are invaded by cytotrophoblasts

Decidua basalis

54

Earliest sign of puberty

Breast budding
Thelarche

55

This hormone affects LH pulsatility and restore menstrual cycle

Leptin

56

Cut off age to investigate if no thelarche yet

13 years old

57

Stage of breast growth where there is breast budding

Stage 2

58

Stage of breast growth where there is enlargement without separation of breast contours

Stage 3

59

Stage of breast growth where there is secondary mound

Stage 4

60

Stage of pubic hair growth where there is labial hair present

Stage 2

61

Stage of pubic hair growth where there is spread over mons pubis

Stage 3

62

Stage of pubic hair growth where there is slight lateral spread

Stage 4

63

Term that describes no menses due to anatomic disorders interfering with the outflow of menses

Cryptomenorrhea

64

Primary amenorrhea occurs when there are no menses by the age of _____ or no menses within how many years of breast development

No menses by 15 years old or 5 years after breast development

65

Secondary amenorrhea occurs when skipped menses are occurring longer than

6-12 months

66

Hypogonadotrophic hypogonadism where there is inadequate GnRH synthesis that leads to anosmia, increased growth in long bones and greater wingspan to height ratio but normal height

Kallmann syndrome

67

What is the first thing to do when a patient comes to you with no breast development?

Measure FSH and LH

68

What is the first thing to do when a patient comes to you with breast development but with no menses?

Ultrasound of uterus

69

This enzyme is deficient so no synthesis of sex steroid develops and the female external genitalia develop

17 alpha hydroxylase or 17,20 desmolase

70

Most common non-PRL secreting neoplasm causing hypoestrogenic amenorrhea

Chromophobe adenoma

71

Non neoplastic pituitary cell destruction due to hypotensive episode during pregnancy

Sheehan

72

Non neoplastic pituitary cell destruction unrelated to pregnancy

Simmonds

73

Menopause before age 40

Premature ovarian failure

74

Disease where there is obliteration of the endometrial cavity leading to intrauterine adhesions or synechiae mosr often due to endometrial curretage

Asherman syndrome

75

Also called stein-leventhal syndrome

PCOS