Reproductive Disorders Flashcards
(154 cards)
1
Q
the corpus lute produces __________
the placenta produces ___________________
A
progesterone
estrogens and progesterone
2
Q
5a reductase
A
catalyzes the formation of DHT from testosterone in the prostate gland, seminal vesicles, epididymides, skin, hair follicles, liver and brain
3
Q
DHT is considerably
A
more potent agonist than testosterone for androgen reeptor
4
Q
which hormones are responsible for the gonads?
A
GnRH –> FSH and LH –> gonads
5
Q
testes do not synthesize
A
aldosterone and cortisol
6
Q
enzyme that converts testosterone to estradiol
enzyme that converts androstenedione to estrone
A
aromatase (both)
7
Q
enzyme that converts androstenedione to testosterone
A
17b - hydroxysteroid dehydrogenase
8
Q
enzyme that converts testosterone to dihydrotestosterone
A
5a - reducatase
9
Q
chromosomal sex
A
determination of an individual’s sex based on the combination of sex chromosomes in their cells
10
Q
genetic sex is established at
A
fertilization by the kind of sperm that fertilizes the ovum
11
Q
when do the gonads begin to attain sex characteristics?
A
7th week
12
Q
indifferent state of sexual development
A
early genital systems in two sexes are similar
13
Q
Y chromosome
A
SRY (sex determining region Y)
gene codes for the testis determining factor
14
Q
in the absence of SRY there are
A
no testes
15
Q
X chromosome
A
DSS (dosage sensitive sex reversal)
double dose gene
16
Q
how many DSS genes are required for the ovaries to be fully functional?
A
2
17
Q
SRY
A
transcription factor
master gene for testes development
18
Q
SRY possibly acts in conjugation with ____________ which induces ________________
A
SOX9
testes differentiation
19
Q
SRY and SOX9 induce the testes to secrete _____________ that causes the tubules from the mesonephric duct to ________________
A
fibroblast growth factor 9
penetrate the gonadal ridge
20
Q
without penetration of the gonadal ridge by the tubules,
A
differentiation of the testes does not continue
21
Q
SRY directly or indirectly through SOX9 up regulates production of
A
stetoidogenesis factor 1
22
Q
stetoidgenesis factor 1 (SF1) stimulates
A
differentiation of stertoli and Leydig cells
23
Q
SF1 and SOX9 increase anti-Mullerian hormone leading to
A
regression of the paramesonephric ducts
24
Q
SF1 upregulates
A
the genes for enzymes that synthesize testosterone
25
gonadal development occurs ___________ in females
slowly
26
what forms into the ovarian medulla
irregular cell clusters are replaced by a vascular storm --> formation
27
surface epithelium of the female gonad, unlike males, ________________ giving rise to a ________________________ in the 7th week
continues to proliferate
second generation of cords (cortical cords)
28
cortical cords
penetrate the underlying mesenchyme but remain close to the surface
29
descendants of the surface epithelium form
follicular cells
30
germ cells (females) develop into
oogonia
31
when do cortical cords split into isolated cell clusters
4th month
32
sex differentiation depends upon the formation of two important hormones
secretion of AMH
secretion of androgens
33
what degenerates when there is secretion of AMH?
what degenerates when there is absence of testosterone?
mullerian duct
wolffian duct
34
if testes are developing normally,
Sertoli cells produce AMH
leading cells start secreting androgens
35
if ovaries are developing normally,
no production of androgens (loss of wolfarian ducts)
ovaries do not produce AMH, develop Mullerian ducts
36
three categories of sex organs
gonads
internal sex organs
external sex organs
37
gonads (testes or ovaries)
develop first
produce ova/sperm and secret hormones
38
when is the critical period of sexual development for the gonads?
gestational weeks 7-12
39
gonads develop as a function
of the presence or absence of SRY gene
40
when do the testes develop? what part degenerates?
for the ovaries?
7th week, outer portion
11th week, inner portion
41
mullerian system
females
composed of mullein ducts that later become the uterus, fallopian tubes and the upper part of the vagina
42
wolffian system
males
composed of wolffian ducts that later become epididymis, vas deferens, seminal vesicles
43
androgen insensitivity syndrome
genetic mutation that prevents the formation of androgen receptors
abnormal process - lack of masculinization
44
what would an XY male with androgen sensitivity syndrome look like?
female external genitalia
has a woman's body but not internal female sex organs
45
persistent mullerian duct syndrome
failure to produce anti-mullerian hormone
absence of receptors for this hormone
46
what would an XY male with persistent Müllerian duct syndrome look like?
defeminization does not occur but masculinization does
both sets of internal sex organs
47
turner's syndrome
individuals only have one sex hormone (X)
develop into females but no ovaries since XX needed
48
Pubery
development of secondary sex characteristics
49
when does puberty occur
when the hypothalamus begins to secrete gonadotropin releasing hormone (GnRH)
50
what does GnRH release
follicle stimulating hormone (FSH)
Luteinizing hormone (LH)
51
what affects the age of puberty?
nutrition
(thinner - presence of leptin --> puberty later)
52
main function of the male reproductive system
produce and deliver sperm to the female reproductive system
53
how many sperm does a healthy male typically produce?
1500/s
54
testes
make sperm and testosterone
produce 100+ million sperm/day after puberty
sperm develop best few degrees below 98.6
55
seminiferous tubules
tightly coiled tubes inside the testes where sperm are made
contain Sertoli cells to convert spermatocytes to spermatozoa
56
SRY initiates differentiation of ______________________ and these produce _________________ which causes _______________
epithelial cells to Sertoli cells
anti mullerian hormone
deterioration of the Müllerian duct (defeminization)
57
Mesenchyme cells differentiate into _____________ which produce _______________ responsible for the development and differentiation of the _________________
leydig cells
androgens
wolffian duct
58
5-dihydrotestosterone
responsible for masculine development of external genitalia
59
in response to LH, ______________ produce testosterone
Leydig cells
60
in response to FSH and testosterone, _________________ support spermatogenesis
Sertoli cells
61
prostate gland
accessory sex organ that contains 5a reductase
62
inhibitors of 5a reductase
finasteride
therapy for benign prostatic hypertrophy
63
why do the testes descend into the scrotum after birth?
because sperm need a cooler temperature to develop
64
sperm are delivered into the ________________ where they must remain for at least ____________ for mobility to develop, then pass into the __________________
epididymis
18 hours
vas deferens
65
seminal vesicles produces ________________
prostate gland produces _________________
fructose-rich fluid
milky fluid (semen)
66
because boys begin their final growth spurt later than girls,
they have a longer period of steady growth
usually attain a greater adult height
67
what are testosterone plasma levels before puberty?
very low
68
after puberty, there is progressive more frequent and greater amplitude of
GnRH release
69
Azoospermia
no sperm count in ejaculate
2% of the general male population
loss of small proportions of AZF region
70
obstructive azoospermia (post testicular azoospermia)
no sperm are seen in the semen due to ejaculatory duct obstruction, which allows exit to the exterior
71
Testicular feminization (Androgen Insensitivity syndrome/Morris syndrome)
affects the development of a child's genitals and reproductive organs
born XY but abnormalities lead to resistance to actions of androgen hormones
72
Kallmann Syndrome (KS)
Delayed or absent puberty and impaired sense of smell
73
KS at puberty
Do not develop secondary sex characteristics
No facial hair, deep voice, periods, breasts, growth spurts
74
a child born with ASI is generally ___________, but the external appearance of their genitals may be
male
female or somewhere between male and female
75
ASI can be
complete (appears to be a woman) or
incomplete (various sexual ambiguities)
76
Can someone with KS have children?
Not without treatment
77
characteristics of ASI
normal breast development
narrow hips
little armpit/pubic hair
absence of uterus
testicular atrophy
short vagina with blind termination
78
Klinefelter's syndrome
can be dominant or recessive (XXY)
1 in 400 males
caused by nondisjunction
often under diagnosed
79
What causes KS?
Failure of hypothalamus to release GnRH at appropriate time, GnRH releasing neurons do not migrate to correct location
Mutation in X-linked KAL1 gene
80
can Klinefelter's syndrome be treated?
yes with male hormones
81
Klinefelter's syndrome characteristics
lower IQ than sibs
tall stature
poor muscle tone
reduced secondary sex characteristics
gynaecomastia
small testes/infertility
82
because there is low _______ in Klinefelter's syndrome, this may lead to
IQ
language difficulties, slow motor development, learning and language problems
83
Treatment for males with KS
Repeated GnRH injections promote spermatogenesis
Combine hCG injections with FSH
84
Mutations in SRD5A2 gene
Cause 5-alpha reductase deficiency
gene responsible for making the enzyme
85
Testosterone gets converted into ____ by ____ then binds to ____ receptor and triggers ____ ____.
DHT
5-alpha reductase
androgen
hair loss
86
5-alpha reductase leads to normal growth and function of the
the prostate are contingent on this to reduce testosterone to DHT
87
Overabundance of DHT
Benign prostatic hyperplasia (BPH)
Prostate cancer
88
Inhibition of 5-AR
Useful in treatment of BPH in reducing risk of prostate cancer
89
congenital anomalies of the penis
hypospadias
agenesis of external geniralia
bifid penis and double penis
micropenis
90
congenital anomalies of the testes
undescended testes (cryptochidism)
hydrocele
scrotal anomalies
91
the basic etiology of ASI is a
loss of function mutation in the androgen receptor gene localized on the X chromosome
92
gene responsible for short stature in Klinefelter syndrome
SHOX (short stature homeobox containing gene)
93
in kallmann syndrome, why is there failure of the hypothalamus to release GnRH?
the cells responsible for production of GnRH did not migrate from the olfactory epithelium to the pituitary gland
94
treatment of females with KS
hormone therapy to stimulate the ovaries mildly
95
5 a reductase inhibitors can be used to treat
hair loss
96
when there is absence of AMH, there is development of ________________ which leads to the formation of
Müllerian ducts
uterus, fallopian tubes, and upper vagina
97
Organ most affected during GDM
Placenta
Need glucose to feed placenta
98
estradiol leads to the formation of
clitoris
labia minora and majora
lower vagina
99
estradiol secondary sex characteristics
increased size of female sex organs
enlarged breasts
skeleton changes
increased protein deposition and metabolic rate
increased fat deposition
hair distribution
thickening of skin
electrolyte balance
100
Glucose in normal pregnancy
Slow down of insulin sensitivity
Slight increase in glucose
Normal levels after birth
101
Glucose in GDM pregnancy
Extreme slow down of insulin
Extreme increase in glucose
May remain high after birth
102
progesterone secondary sex characteristics
inc glandular function of uterus
inc glandular secretions of fallopian tubes
swelling of breasts
103
Miscarriage
Spontaneous abortion before 24 weeks gestation
104
theca cells
produce androgens that diffuse into the granulosa cells
105
Ectopic pregnancy
Implantation of blastocytes into lining of fallopian tube instead of endometrium
Embryo not viable
106
FSH acts on granulosa cells to stimulate
aromatase activity, which converts androgens to estrogens
107
why can't granulosa cells produce androgens?
they lack the enzyme that converts progesterone to androgens
108
Vaginal bleeding in third trimester
Placenta previa
Placenta abruption
109
similarities between theca cells and granulosa cells
LH receptors
110
theca cells lack aromatase which means they cannot synthesize
estrogens
111
Trophoblastic Diseases (GTD)
Molar pregnancy most common
112
can granulosa cells produce estrogens?
yes!
they have aromatase
113
estrogens and progestins exert _______________________ on the anterior pituitary and hypothalamus depending on ________________
negative and positive feedback
the stage of the ovarian cycle
114
Complete molar pregnancies
Tumor develops from tissue that forms after fertilization
Typically benign
115
inhibin
negative feedback effect on the anterior pituitary
116
the ovarian cycle is divided into
follicular and luteal phase
117
Preeclampsia
Persistent high blood pressure during pregnancy
118
follicular phase is marked by
increasing levels of estrogen
119
the luteal phase is marked by
increased progesterone levels
120
ovulation
transition period between follicular and luteal phase
121
Preeclampsia is associated with
proteinuria
122
estrogens are predominant _______________
progestins are predominant ______________
prior to ovulation
after ovulation
123
Eclampsia
Preeclampsia + tonic-clonic seizures
124
which hormone is increased largely right before ovulation?
LH
125
Cure for preeclampsia
delivery of fetus and placenta
126
during the late follicular phase and ovulation, what is going on with LH and estrogen?
high estrogen output
positive feedback of estrogen causes LH surge
surge of LH leads to ovulation
127
Main symptom of preeclampsia
Edema
128
during the early to mid luteal phase, what is going on?
decrease in LH causes rapid atrophy of corpus luteum
corpus lute secrets estrogen, progesterone and inhibin which inhibits release of gonadotropins (GnRH)
129
Severe physical change during menopause
Osteoporosis and decreased bone strength
130
during the late luteal phase, what is going on?
corpus luteum dies
decrease in estrogen, progesterone and inhibin
131
Amenorrhea
Absence of menstruation or missed menstrual periods
132
Most common cause of amenorrhea
Pregnancy
133
Hormonal imbalances that can lead to amenorrhea
PCOS
Thyroid malfunction
Pituitary tumor
Premature menopause
134
progesterone withdrawal causes
menstrual bleeding
135
spinnbarkeit tests
ability of cervical mucus to stretch a distance before breaking
136
Structural problems that can lead to amenorrhea
Uterine scarring
Lack of reproductive organs
Abnormal vagina
137
ferning test
cervical mucus is collected on clean glass slide, allowed to dry
if it forms a pattern that resembles the fronds of a fern, the person is in ovulation
138
Primary amenorrhea
Have not started period after puberty
139
estrogen and progesterone hormonal contraceptives inhibit
LH, FSH, and GnRH secretion, preventing ovulation
140
Secondary amenorrhea
Had normal periods that suddenly became absent
141
additional role of progesterone in hormonal contraceptives
thickens cervical mucus to prevent passage of sperm into uterus
changes uterine lining to inhibit implantation
142
Dysmenorrhea
pain accompanying menstruation
too much PGF2a (primary)
endometrial tissue outside uterus (secondary)
143
Menorrhagia
excessive vaginal bleeding
144
Metrorrhagia
irregular or overlong vaginal bleeding
bleeding/spotting between periods
145
The ____ are most affected during primary amenorrhea
ovaries
146
The ____ is least affected during primary amenorrhea
pituitary
147
The ____ is most affected during secondary amenorrhea
hypothalamus
148
The ____ is least affected during secondary amenorrhea
Uterus tract
149
Polycystic ovary syndrome (PCOS)
Higher levels of male hormones, androgens, and type II diabetes more at risk
150
Symptoms of PCOS
Menstrual irregularities
Cysts
Weight gain
Excess hair
Acne
Skin/mood changes
151
Polycystic ovary cannot make
mature follicles
Follicles remain immature and eggs fail to be released regularly
152
PCOS pathophys
Increased androgen and insulin are main players here
153
Turner Syndrome (TS)
One copy of X chromosome is missing/altered in females
154
Most common feature of TS
Short stature
Do not undergo puberty
