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J Endocrine > Reproduciton and sex steroids > Flashcards

Reproduciton and sex steroids Flashcards

(105 cards)

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1
Q

which hormone does ‘ovulation tests’ measure

A

LH

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2
Q

which layer of the uterus sheds during menstruation

A

endometrium

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3
Q

where does fertilisation occur

A

ampulla

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4
Q

first step of fertilisation, when receptors on egg undergo exocytosis

A

chemotaxis

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5
Q

what is it called when 1 sperm binds and polyspermy is prevented

what does it involve

A

zona reaction

increased Ca and enzymes

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6
Q

in males and females;
hypothalamus secrete GnRH which stimulates the production of … (2)

where

A

LH and FSH

anterior pituitary

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7
Q

in males

LH stimulates which cells

A

leydig cells

Lh = Leydig

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8
Q

in males

what do leydig cells secrete in response to LH

what is it used for
where

A

testosterone

spermatogenesis in the setoli cells

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9
Q

in males

FSH stimulates which cells

A

setoli cells

fSh = Setoli

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10
Q

in males

what happens in setoli cells in response to FSH

which hormone is needed for this to happen

where does it come from

A

spermatogenesis

testosterone

leydig cells (stimulated by LH)

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11
Q

dihydrotestosterone definition

presentation

A

too much testosterone production

enlargement of male sex organs, anabolism

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12
Q

oligomenorrhoea definition

A

<9 periods in a year (either irregular or infrequent >35 day cycles)

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13
Q

primary amenorrhoea definition

A

female >16 thats never had a period

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14
Q

secondary amenorrhoea definition

A

no period for >6months but has previously had a period

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15
Q

what must you always do for a female presenting with amenorrhoea

A

pregnancy test! (hCG)

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16
Q

aetiology of primary amenorrhea (3)

A

turners syndrome (XO)
congenital adrenal hyperplasia (CAH)
kallmans syndrome

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17
Q

genetics of turners syndrome

A

XO (one X chromosome only)

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18
Q

aetiology of secondary amenorrhoea (7)

A

menopause
pregnancy
polycystic ovarian syndrome (PCOS)
premature ovarian failure
hyperprolactinaemia
hypopituitarism (non functioning pituitary tumour)
hypothalamic dysfunction (over exercise, weight loss, low BMI, stress, illness)

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19
Q

most common aetiology of secondary amenorrhea (if pregnancy and menopause ruled out)

A

polycystic ovarian syndrome (PCOS)

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20
Q

how does hypothalamic dysfunction (from over exercise, weight loss, low BMI, stress, illness) cause amenorrhoea

A

loss of pulsatile production of GnRH from hypothalamus = no FSH/LH production

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21
Q

which aetiology of primary amenorrhoea presents with lack of sense of smell (anosmia)

A

kallmans syndrome (lack of GnRH)

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22
Q

presentation of primary amenorrhoea

A

absence of puberty (no breast development)

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23
Q

presentation of secondary amenorrhoea

A

loss of libido
painful intercourse
hirsutism (male facial hair pattern in females)

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24
Q

what is oestrogen levels in amenorrhoea

A

low

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25
what hormones (other than oestrogen) do you want to measure in amenorrhoea (2) why
LH and FSH to figure out if hypogonadism is primary or secondary
26
LH and FSH in primary hypogonadism causing amenorrhoea (eg premature ovarian failure, polycystic ovarian syndrome
high the problem is at the gonads
27
LH and FSH in secondary hypogonadism causing amenorrhoea eg pituitary tumour, hyperprolactinaemia
low the problem is that no LH and FSH are made in the first place
28
apart form LH and FSH levels, what test can you do to see if amenorrhoea is caused by primary or secondary hypogonadism explain the test what are the results for primary and secondary hypogonadism in this test
progesterone challenge test give progesterone for 5 days and see if you can cause a menstrual bleed primary hypogonadism = positive (no bleeding occurs, problem is the ovaries) secondary hypogonadism = negative (bleeding occurs, problem is further up)
29
what MSK condition is low oestrogen associated with
osteoporosis
30
is premature ovarian failure the same as early menopause
no they may still have eggs in premature ovarian failure its the ovary thats stopped working in menopause there are no eggs left
31
aetiology of premature ovarian failure (4)
idiopathic autoimmune (addisons) genetic chemo/radiotherapy
32
hormone levels in premature ovarian failure (LH, FSH, oestrogen)
high LH high FSH low oestradiol
33
treatment for premature ovarian failure
hormone replacement therapy (oral contraceptive)
34
treatment of someone with osteoporosis (from premature ovarian failure)
vit D supplements Ca bisphosphonates (alendronic acid)
35
treatment of premature ovarian failure that has caused infertility (and they want kids)
egg donation, IVF | adoption
36
does turners syndrome present in males or females
females (only one X chromosome)
37
kidney defect in turners syndrome (XO)
horseshoe kidney
38
nipples in turners syndrome (XO)
wide spaced
39
'pearl necklace' on ovaries
polycystic ovarian syndrome (PCOS)
40
risk factor for PCOS
diabetes (hyperinsulinaemia)
41
if you aren't a diabetic, why else can you get polycystic ovarian syndrome (PCOS)
genetics
42
in PCOS the things on the ovary surface aren't actually cysts, what are they
immature follicles
43
what does immature follicles in PCOS mean about progesterone what normally happens
no progesterone is released = low progesterone in blood mature follicles release progesterone
44
in PCOS decreased progesterone release from follicles (bc they are immature not mature) results in what clinical presentation (3)
amenorrhoea hirsutism (male facial hair pattern in females) infertility
45
initial pathophysiology of PCOS (high something affects something cells)
high LH or high insulin = affects theca and granulosa cells
46
Rotterdam criteria for PCOS, need 2/3 of;
``` oligomenorrhoea clinical hyperandrogenism (hirsutism, acne) polycystic ovaries on US ```
47
oestrogen in PCOS
normal (should be low but high insulin + androgens = oestrogen secretion = brings it back to normal)
48
progesterone in PCOS
low
49
androgens/testosterone in PCOS
high
50
PCOS lifestyle change
loose weight, diet
51
PCOS first line treatment why
antioestrogens (clomifene citrate) to improve fertility
52
PCOS second line treatment after weight loss and antioestrogens (3 - one a step up from weight loss, the other 2 is a step up from antioestrogens (one drug, one not))
metformin gonadotrophins (LH and FSH injections) surgery (drill holes) to induce ovulation
53
side effect of gonadotrophin therapy (LH and FSH injections used in PCOS)
multiple pregnancy with complications
54
male primary hypogonadism aetiology (1)
klinefelters (XXY)
55
male secondary hypogonadism aetiology (3)
pituitary disease kallmans prdaer willi syndrome
56
male hypogonadism with no sense of smell aetiology
kallmans
57
presentation of genetic male hypogonadism in teenager
no puberty (ask about shaving)
58
presentation of pituitary male hypogonadism in adult (2)
loss of libido (ejaculations, erections) | infertility
59
testosterone, LF, FSH in primary hypogonadism is it hyper or hypogonadotrophic hypogonadism
low testosterone high LF high FSH hypergonadotrophic hypogonadism
60
testosterone, LF, FSH in secondary hypogonadism is it hyper or hypogonadotrophic hypogonadism
low testosterone low LF low FSH hypogonadotrophic hypogonadism
61
treatment of hypogonadism in men >50
nothing
62
treatment of hypogonadism in men <50
testosterone replacement
63
when wouldnt you give testosterone in men with hypogonadism (2)
if >50 | if prostatic cancer (can make it worse)
64
gynaecomastia definition
enlarged breasts in men (different from fat!)
65
oestrogen in gynaecomastia
high
66
treatment of gynaecomastia (3)
treat underlying cause reassurance! anti-oestrogens
67
definition of infertility
failure to achieve pregnancy after 12 months of regular unprotected sex in a couple who have never had a child
68
primary infertility definition
infertility in a couple who have never conceived
69
secondary infertility definition
infertility in a couple who have previously conceived by pregnancy unsuccessful (miscarriage or ectopic pregnancy)
70
aetiology of infertility in females (8)
``` menopause anorexia kallmans hypogonadotrophic hypogonadism (pituitary tumour) PCOS premature ovarian failure (POF) infection endometriosis (narrowing of tubes) ```
71
what is endometriosis
when womb lining sheds and goes backwards into fallopian tubes = blocks them (retrograde menstruation)
72
aetiology of male infertility (5)
``` drugs - alcohol, tobacco idiopathic hypogonadotrophic hypogonadism (pituitary tumour, kallmans) klinefelters (XXY) chemo/radiotherapy ``` LOADS MORE!
73
what BMI is a risk factor for infertility (hence part of management plan)
high BMI want them to loose weight
74
investigations for female infertility
pelvic exam pelvic transvaginal ultrasound look at tubes (radiograph or laparoscopy)
75
investigation for male infertility
semen analysis (sperm count)
76
azoospermic definition
no sperm in semen
77
treatment for male infertility (2)
sperm bank | surgical sperm aspiration
78
treatment for female infertility for POF
egg donation
79
treatment for tubal disease causing female infertility
surgery to open up tube or IVF
80
treatment for hypothalamic/pituitary cause of female infertility
hormone replacement therapy
81
what type of hormone is oestrogen
steroid hormone
82
apart from theca/granulosa cells, where else can oestrogen be made (= cause of erectile dysfunction in men)
fat cells
83
where is progesterone made in female
corpus luteum
84
in females what does LH production cause where does this happen
androgen production theca cells
85
in females what cells do FSH stimulate what happens as a result
granulosa cells androgen production
86
apart from androgen production from granulosa cells, what else does FSH do in females
stimulates follicle maturation
87
LH and FSH cause androgen (then oestrogen) production and follicle maturation what does this overall result in
egg release
88
what does low oestrogen (start of follicular phase of menstrual cycle) do to LH by which mechanism
decrease it negative feedback
89
what does low oestrogen (start of follicular phase of menstrual cycle) do to FSH by which mechanism
increase it negative feedback
90
what does oestrogen do to the endometrium when
thickens it increasing oestrogen in follicular phase = preparing endometrium for ovulation
91
what does the LH spike in menstrual cycle trigger
ovulation
92
what is a 'dead follicle' called
corpus luteum
93
in which menstrual cycle phase is there follicles
follicular phase
94
in which menstrual cycle phase is there a corpus luteum
luteal phase
95
which 3 hormones does the corpus luteum produce
inhibin oestrogen progesterone
96
what does inhibin do to FSH (comes from the corpus luteum so in the luteal phase)
decreases it (= stops more follicles being stimulated to become leading follicles)
97
what does progesterone do to the hypothalamus (comes form the corpus luteum so in the first half of the luteal phase)
decreases secretion of GnRH
98
what does lutenising hormone (LH) do in the menstrual cycle
stimulate ovulation = cause the LUTEAL phase to occur (bc of the corpus LUTEUM)
99
in the second half of the luteal phase there is decreases progesterone bc the corpus luteum is degenerated what does this do to GnRH what is the overall result of this (generally speaking)
increase GnRH stimulated new ovulation cycle
100
why does the endometrium shed if no fertilisation (in terms of hormones)
all hormones are decreased = it cannot be maintained
101
what is the main thing that happens in the follicular phase of the menstrual cycle
development of stimulation follicle | FOLLICULAR phase = FOLLICLE stimulation
102
what is the main thing that happens in the luteal phase of the menstrual cycle
corpus luteum develops then degenerates | LUTEAL phase = corpus LUTEUM
103
what do follicles secrete that peaks at the end of the follicular phase of the menstrual cycle
oestrogen
104
what is the main hormone change in the follicular phase of the menstrual cycle what does this cause
LH peak ovulation (egg release)
105
what is the follicle without an egg called (after ovulation)
corpus luteum

J Endocrine (12 decks)

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