Ovarian Aging and Menopause

Question 1

First appearance of primordial germ cells in yolk sac occurs during which week?

Answer 1

week 4

Question 2

By week ____, germ cells arrive at the genital ridge.

Answer 2

week 6

Question 3

T/F the rate of follicular atresia is not fixed and becomes more rapid approximately 10-15 years prior to menopause.

Answer 3

T

Question 4

clinical correlates of more rapid loss of follicles

Answer 4

reduced odds of pregnancy, fewer follicles grow per cycle, menstrual cycle irregularity

Question 5

Menopause

Answer 5

the point in time when permanent cessation of menstruation occurs following loss of ovarian activity –> retrospective diagnosis/natural or surgical

Question 6

Perimenopause/menopausal transition

Answer 6

menstrual irregularity duration of approx 4 years

Question 7

Biochemical characteristics of menopause

Answer 7

elevated fsh/lh, low estrogen

Question 8

Factors related to age of onset of menopause

Answer 8

smoking, family, possible dietary habits, alcohol consumption,

Question 9

Total and LDL cholesterol levels are higher/lower in premenopausal women than in men

Answer 9

lower –> levels rise with age and after menopause

Question 10

____ syndrome increases during perimenopause and postmenopause

Answer 10

metabolic syndrome

Question 11

T/F menopause onset is related to accelerated bone loss and osteoporosis

Answer 11

T

Question 12

Women typically experience ___ years of hot flashes if not treated after onset of menopause.

Answer 12

5 years

Question 13

Tx of symptoms of menopause

Answer 13

hormone replacement, ssri, antihypertensive, behavioral

Question 14

premature ovarian insufficiency

Answer 14

cessation of ovarian function < age 40 –> elevated lh/fsh on two occasions one month apart with low estradiol

Question 15

prevalence of premature ovarian insufficiency

Answer 15

1%

Question 16

why do you need low estradiol to determine premature ovarian insuffiency?

Answer 16

because if both fsh/estradiol are high, person might be about to ovulate vs having lost regulation of gonadotropins due to poi

Question 17

An abnormality in or absence of one x chromosome resulting in ovarian failure is called ____

Answer 17

turner’s syndrome –> 45x or mosaic with 46xx/45x

Question 18

Clinical features of turner’s

Answer 18

premature ovarian failure, delayed puberty, renal anomolies, cardiovascular and associated autoimmune disorders

Question 19

MOA turner’s syndrome on premature ovarian failure

Answer 19

excessive rapid atresia of oocytes occurs starting in utero and streak gonads depleted of follicles develop

Question 20

T/F both x chromosomes are active in ovary to ensure normal development (exception to lyonization)

Answer 20

T

Question 21

gonads depleted of oocytes and gonads are colloquially known as ____

Answer 21

streak gonads

Question 22

Older/younger exposure to chemotherapy/radiation has the greatest impact on early menopause

Answer 22

older –> fewer follicles on reserve

Question 23

Why are alkylating agents especially damaging?

Answer 23

not specific to any particular stage of cycle

Question 24

Risks of hormone replacement tx

Answer 24

dvt

Question 25

Benefits of hormone replacement tx

Answer 25

quality of life, osteoporosis and cardiovascular disease prevention