Pathophysiology Flashcards
What causes the regression of the Müllerian duct?
Müllerian inhibitory substance produced by Sertoli cells
Wha cause the persistence of wolffian duct?
Testosterone produced by leydig cells
When do meiosis I and II happen during the women life?
Oogonia at puberty arrested at meiosis I
Meiosis II happen with fertilization
What gene on the Y chromosome direct the development of male gonads?
SRY gene
How does female puberty starts?
Start with sleep-dependent release and then pulsatile release of GnRH (modulated by CRH) from hypothalamus—>leads to pulsatile release of FSH and LH—>ovary makes estrogen—>breast development (thelarche) and first menstrual period (menarche)
The order of menstrual cycle?
Follicular phase (many follicles grow—>only one is dominant. Growing follicles secrete estrogen—>stimulate the growing of endometrium)—>ovulation (dominant follicle releases its mature oocyte for fertilization and implantation. Estrogen positive feedback on LH and FSH preovulation —>LH surge)—->luteal phase (luteinization of ruptured follicle to make corpus luteum. Progesterone surge)
What does corpus luteum release?
Estrodial and progesterone that inhibits the release of FSH and LH
Granulosa cells are stimulated by?
FSH. Aromatase in granulosa cells convert androgen from Theca cells to estradiol (main estrogen of non pregnant women)
Theca cells are stimulated by?
LH
What is the mechanism of oral contraceptive pills?
Estrogen and progestin block the LH surge thus prevent ovulation
What hormone does the placenta secretes?
hCG—>maintain corpus luteum till placenta can produce progesterone—>then hCG falls
It also produces hCS (promote energy supply of the fetus)
The fetus provides what to the mother?
Androgen—>then made into estrogen
How is milk release from the breast inhibited before the birth of the fetus?
High level of estrogen and progesterone blocks milk release—>after birth—>estrogen and progesterone level drop
What stimulates the ejection of milk?
oxytocin
What does it mean by counterregulatory state regarding to pregnancy?
Insulin resistance. Several blood glucose elevating hormones are produced during pregnancy to promote energy supply for the fetus, e.g. hCS. As a result, non diabetic woman can develop transient diabetes during pregnancy.
What is fetal macrsomia and what usually causes it?
Large fetal size. Usually caused by poorly controlled gestational diabetes—>might lead to C section
What are the risks associated with the separation of placenta from the uterine wall?
Hemorrhage. The body is adapted to be hyercoagulable during pregnancy to prevent hemorrhage, which results in bad thrombosis sometime
What is third trimester bleeding associated with?
Placenta previa/abruption
What is the primary/secondary ovarian insufficiency of amenorrhea?
Premature loss of follicles/lack of hormone stimulation of normal ovaries
What is the kind of estrogen for pregnant women?
Estriol
Sex-hormone binding globulin has higher binding affinity for testosterone or estrogen?
Testosterone (also estrogen stimulates the production of SHBG)
Pregnant women has respiratory alkalosis/acidosis?
Increase PaO2—>decrease PaCO2—>alkalosis
T4 and cortisol in pregnant women increase or decrease?
Increase
Best marker for menopause
elevated FSH
