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Pathologies of the Female Reproductive System Flashcards

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1
Q

What are some diseases of the female reproductive system?

A 
Hypogonadotropic hypogonadism.
Hyperprolactinemia.
PCOS.
Endometriosis.
Fallopian tube dysfunction.
Implantation failure.
Zona defects.
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2
Q

When can zona defects be recognised?

A

Only after egg retrieval.

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3
Q

Where does hypogonadism refer to?

A

A clinical syndrome.

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4
Q

As what does hypogonadism occur?

A

A result of ovarian failure.

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5
Q

What does hypogonadism cause?

A

The ovaries to produce less than physiologic levels of oestrogen.

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6
Q

Where does the fact that ‘hypogonadism cause the ovaries to reproduces less than physiologic levels of oestrogen’ lead to?

A

Undeveloped gonads.
Delayed puberty.
Failure to start/cessation of menstrual cycle.

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7
Q

What are primary causes of female hypogonadism often?

A

Genetic.

Autoimmune.

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8
Q

Why do secondary causes of female hypogonadism occur?

A

Because of cancer.
Medication.
Lifestyle issues.

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9
Q

How is functional hypothalamic amenorrhea commonly triggered?

A

By excessive exercise.
Nutritional deficiencies.
Psychological stressors.

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10
Q

What are the first steps to be taken for diagnosis of female hypogonadism?

A

Take medical history.

Measure oestrogen and gonadotropin hormone levels.

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11
Q

How can medical history and measurements of oestrogen and gonadotropin be used?

A

To narrow down the next steps for testing.

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12
Q

Why is hormone replacement an effective strategy?

A

It induces puberty/restores menstrual cycle.

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13
Q

What is prolactin?

A

A peptide hormone.

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14
Q

From where is prolactin released?

A

The anterior pituitary.

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15
Q

What does elevated oestrogen during pregnancy increase physiologically?

A

Lactotrophs size.

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16
Q

What does elevated oestrogen during pregnancy stimulate physiologically?

A

Secretion.

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17
Q

What does prolactin stimulate?

A

Mammary glands.

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18
Q

Why does prolactin stimulate mammary glands?

A

To produce milk.

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19
Q

For what does prolactin have supporting role?

A

Progesterone function.

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20
Q

What does prolactin decrease?

A

LH release.

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21
Q

What is the release of prolactin?

A

A balance between the stimulatory actions of 5HT and inhibitory actions of DA.

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22
Q

In what do the inhibitory actions of DA result?

A

A pulsatile release response.

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23
Q

What does kisspeptin release promote?

A

The release of GnRH hormone.

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24
Q

What does hyperprolactinemia suppress?

A

GnRH release via decreased kisspeptin release.

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25
What are the causes of hyperprolactinemia?
Physiological = suppress cycle during nursing. Stress = DA release inhibition. Drugs = cocaine, antidepressants-SSRIs, verapamil. Tumour.
26
What does verapamil block?
DA release.
27
What does DA agonist therapy represent?
The cornerstone of management of most patients with prolactinomas who require therapy.
28
What is DA agonist diagnosis and therapy?
Single measurement sandwich immunoassay.
29
How many nonpregnant females occur during DA diagnosis and treatment?
2-29 ng/ml.
30
How many pregnant females occurred in diagnosis and treatment of DA?
10-209 ng/ml.
31
How long is the tumour in DA diagnosis and treatment?
>200nl/ml.
32
What is PCOS?
The most common endocrine disorder in women.
33
How much currency does PCOS have in women?
6-20%.
34
With what is the syndrome associated?
``` Two or three of: infrequent/absent ovulation. morphological abnormalities of ovaries. hyperandrogenism. insulin resistance. ```
35
On what does PCOS is described?
Ultrasound scan.
36
As what is PCOS described?
The presence of 12 or more follicles in each ovary measuring 2-9 mm in diameter. Increased ovarian volume >10 ml.
37
What was the estimated economic impact pin 2004 in US of PCOS?
$4 Billion.
38
What is pathophysiology of female reproductive system?
complex. | not fully understood.
39
What is one hypothesis of the pathophysiology of female reproductive system?
That multiple developing follicles from elevated LH and lower FSH result in a higher population of thecal cells and androgen + oestrogen release.
40
How is the fact that 'elevated LH and lower FSH --> more thecal cells, androgen and oestrogen' helps?
Maintain altered LH/FSH ratio.
41
What does maintaining altered LH/FSH ratio prevent?
Ovulation.
42
To what do elevated androgens contribute?
Insulin resistance. | Hyperinsulinemia.
43
What do elevated insulin levels suppress?
Release of SHBG.
44
What will elevated free form of the androgens increase?
Body hair growth.
45
What is ideal but time consuming for diagnosis 7 treatment options?
The Measurement of free testosterone (T).
46
What is the Ratio of total T:SHBG?
Practical alternative.
47
What do not all women with hirsutism have?
Elevated T.
48
What is the treatment with oral oestrogen progessing?
To combined anti-androgen if needed.
49
What is the combination of anti-androgen with oral oestrogen, if needed?
Effective.
50
Why is clomiphene given?
To treat anovulation.
51
What does clomiphene inhibit?
Oestrogen negative feedback.
52
What does clomiphene stimulate?
FSH.
53
Why does clomiphene stimulate FSH?
To encourage complete maturation.
54
What do drugs with insulin resistance may improve?
Anovulation.
55
What are the daily injections of FSH?
Effective at inducing ovulation in patients resistant to other treatments.
56
What is endometriosis?
A disease characterised by cyclical bleeding with retrograde flux of endometrial tissues.
57
What are the causes of endometriosis?
Inflammation.
58
To what does inflammation from endometriosis contribute?
Pain. | Infertility.
59
Where doe endometrial-type mucosa occur in endometriosis?
Outside uterine cavity.
60
How much is the prevalence of endometriosis?
5-10%.
61
How much where the costs in 2008 for endometriosis?
10K euros/person.
62
As what are the causes of endometriosis described?
Unknown.
63
On what does endometriosis depend?
Oestrogen.
64
What is a possibility of endometriosis?
Retrograde menstruation. | Genetic predisposition.
65
What is Fallopian tube function?
An infection\. | Inflammation impair function/passage of gametes.
66
What are the causes of Fallopian tube function?
Primary ciliary dyskinesia. | Cystic fibrosis.
67
What is Cystic fibrosis?
Defects in mucus and bicarb production. | Upsetting passageway for gametes.
68
What is Implantation?
Reduced conception rates with infection/disease.
69
What are some diseases associated with implantation?
Uncontrolled diabetes. Subclinical hypothyroidism. Uncontrolled coeliac disease.
70
What is thrombophilia?
An increased clotting.
71
What is Heparin?
A treatment of thrombophilia.
72
What does Heparin do to treat Thrombophilia?
Reduces trophoblast invasion.
73
With what are Elevated NK cells associated?
Implantation failure.
74
What are the treatment strategies in elevated NK cells and implantation failure?
Not proven.
75
What can elevated androgens induce in PCOS?
Endometrial atrophy. | Loss of periods.
76
What can elevated insulin signalling cause?
Hyperplasia.
77
What do reduced levels of blastocyst integrin expression reduce?
The ability of blastocyst to interact with the uterine epithelium.
78
What is Zona pellucida?
A glycoprotein matrix.
79
Of what does ZP consist?
4 ZP proteins.
80
What does ZP protect?
The oocyte. Zygote. Blastocyst prior to implantation.
81
What does Zona serve?
An important purpose in protecting the egg from being penetrated by more than once sperm.
82
What cannot happen if polyspermy does occur?
Development.
83
What can mutations in ZP1, 2 and 3 genes cause in a normal oocyte?
Loss of zona. | Very thin zona.
84
What happens after IVF of oocyte with an abnormal zona?
Polyspermy. Abnormal cell division. Embryo is not viable.
85
What does a ZP3 mutation cause?
Empty follicle syndrome.
86
What happens in Empty follicle syndrome?
No oocytes are produced.
87
From what does loss of zona occur?
Heterozygous mutations in ZP2 and ZP3.
88
What polyspermy cannot be at IVF?
Prevented.
89
How many polar bodies are in a normally fertilised oocyte?
2.
90
How many pro-nuclei occur in a normally fertilised oocyte?
2.
91
What are polar bodies and pro-nuclei doing in a normally fertilised oocyte?
Overlapping in the middle.
92
What are the diseases of the female reproductive tract?
Varied.
93
What is an underlying hormonal defect in most cases?
Causative.
94
What are Diagnosis and Treatment in pathophysiology of female reproductive system?
Available.
95
Why does the mechanism of pathophysiology remains?
To be elucidated in many cases.

Medical Physiology (12 decks)

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