Reproductive Endocrinology & Disorders Flashcards
(121 cards)
1
Q
where does oogenesis begin?
A
in utero (as foetus)
2
Q
when is oogenesis completed?
A
fertilisation
3
Q
when does oogenesis cease?
A
at menopause
4
Q
what is a primordial germ cell?
A
earliest recognisable germinal cell
5
Q
what is a primordial germ cell capable of?
A
mitosis
6
Q
where does a primordial germ cell migrate to and when?
A
genital ridge by week 6 of embryo development
7
Q
what is oogonia?
A
completion of last pre-meitotic division to oocytes
8
Q
what are primary oocytes?
A
1st meiotic division
9
Q
what are secondary oocytes?
A
2nd meiotic division
10
Q
how many types of polar bodies are there?
A
2 (sperm & egg)
11
Q
what do both polar bodies have in common?
A
relatively small
contain little cytoplasm
12
Q
what does the presence of 2 polar bodies signify?
A
sperm entry & completion of 2nd meiotic division (fertilisation)
13
Q
when is the number of eggs in a female highest?
A
before birth
14
Q
what happens to the number of eggs in a foetus just before birth?
A
rapidly decreases
15
Q
can an ovary produce eggs after the age of 20/30 if it has been damaged?
A
no as no stem cells present - born with finite number of eggs
16
Q
what is the average length of ovarian cycle?
A
28 days
17
Q
how many phases does an ovarian cycle have & what are they?
A
2
- follicular phase
- luteal phase
18
Q
what happens during the follicular phase?
A
Maturation of egg, ready for ovulation at midcycle – ovulation signals end of follicular phase
19
Q
what happens during the luteal phase?
A
Development of corpus luteum.
Induces preparation of reproductive tract for pregnancy (if fertilisation occurs)
20
Q
what is a primary follicle?
A
Before birth, the primary oocyte is surrounded by a single layer of granulosa cells
21
Q
what is each primary follicle capable of producing?
A
a single ovum
22
Q
what happens to primary follicles until puberty?
A
degenerate to scar tissue at some stage before ovulation
23
Q
atresia
A
scar tissue
24
Q
luteinisation
A
transformed to the corpus luteum
25
what hormone does corpus luteum produce?
progesterone
26
which hormone is secreted in the follicular phase?
oestrogen
27
which hormone is secreted in the luteal phase?
progesterone
28
if no fertilisation has occurred how long would the corpus luteum survive?
no longer than 14 days after ovulation
29
what signals the start of new follicular phase?
degeneration of corpus luteum signals
30
what hormones does the anterior pituitary secrete?
FSH
| LH
31
what does the hypothalamus secrete & what does it act on?
GnRH
| anterior pituitary
32
what dies the FSH act on?
ovary
33
what does LH act on?
ovary
34
what does FSH do?
stimulates development of follicles
35
what does LH do?
stimulates follicle maturation, ovulation & development of the corpus luteum
36
what do FSH + LH stimulate?
secretion of oestradiol & ovulation
37
what do theca cells produce?
androgen
38
what is androgen converted to & where?
to oestradiol
| by the granulaosa
39
what does oestrogen do to the anterior pituitary?
suppresses FSH production
40
what forms the corpus luteum?
remaining granulosa that have proliferated
41
what do theca cells convert androgen to?
oestrogen
42
oligomenorrhea
reduction in frequency of periods to less than 9/year
43
primary amenorrhoea
failure of menarche by the age of 16 years
44
secondary amenorrhea
cessation of periods for >6 months in an individual who has previously menstruated
45
menarche
first menstrual cycle
46
what are the physiological causes of amenorrhoea?
pregnancy
| post-menopausal
47
amenorrhea
abnormal absence of menstruation
48
what should you consider in primary amenorrhea?
congenital problems
49
what ovarian problems can cause secondary amenorrhoea?
PCOS
| Premature ovarian failure
50
what are oestrogens?
class of steroid hormones which control the development & maintenance of female sexual characteristics
51
where does glandular oestrogen synthesis?
in the granolas & theca cells of the ovaries as well as the corpus luteum
52
what is the rate limiting step of the production of oestrogen?
conversion of cholesterol to pregnenalone
53
what does oestrogen production fluctuation match?
thickness of endometrium
54
what uterine problems can cause secondary amenorrhoea?
uterine adhesions
55
uterine adhesions
problems with shedding endometrium due to adhesions
56
what pituitary problems can cause secondary amenorrhoea?
high PRL
| hypopituitarism
57
give some examples of oestrogen deficiency
flushing
libido
dyspareunia
58
dyspareunia
difficult or painful sexual intercourse
59
anosmia
loss of sense of smell
60
what would anosmia suggest?
kallman's
61
what is Kallman's due to?
failure of production of GnRH
62
what would a thick endometrium suggest?
polycystic ovaries
63
what would a thin endometrium suggest?
decreased oestrogen
64
what investigations should all patients with oligo/amenorrhea have?
LH, FSH, oestradiol
| thyroid function, prolactin
65
what is female hypogonadism identified by?
low levels of oestrogen
66
primary hypogonadism
problem with ovaries
67
secondary hypogonadism
problem with hypothalamus or pituitary
68
what would a high LH/FSH suggest in primary hypogonadism?
hypergonadotrophic hypogonadism
69
give an example of a cause of primary hypogonadism
premature ovarian failure
70
give an example of secondary hypogonadism
high PRL
| hypopituitarism
71
what would an FSH > 30 suggest?
post-menopausal
72
give some examples of causes of POF
chromosomal abnormalities
gene mutations
autoimmune disease
iatrogenic
73
POF
premature ovarian failure
74
what chromosomal abnormalities could cause POF?
Turner's syndrome
| Fragile X
75
what gene mutations could cause POF?
FSH/LH receptor
76
what autoimmune diseases are associated with POF?
Addison's
thyroid
APS1/2
77
what are the iatrogenic causes of POF?
radiotherapy
| chemotherapy
78
what characterises secondary hypogonadism?
low estradiol and low/norma LH or FSH
79
what hypothalamic problems could cause secondary hypogonadism?
functional hypothalamic disorders
Kallman's syndrome
IHH
80
IHH
idiopathic hypogonadotrophic hypogonadism
81
what other things could cause secondary hypogonadism?
Prader-Willi
Haemachromatosis
pituitary problems
82
what is IHH identified by?
absent or delayed sexual development associated with inappropriate low levels of gonadotrophin and sex hormone levels in absence of anatomical / functional defects of hypothalamic-pituitary gonadal axis
83
what is the only clinical difference between IHH and Kallman's?
anosmia in kallman's
84
what is the major defect in IHH?
inability to activate pulsatile GnRH secretion during puberty
85
Kallman's syndrome
A genetic disorder characterised by a loss of GnRH secretion + anosmia or hyposmia
86
hyposmia
reduced ability to smell & detect odours
87
which sex is Kallman's dynamo more common in?
males
88
what can cause loss of LH/FSH stimulation?
non-functioning pituitary macroadenoma
empty sella
pituitary infarction
89
non-functioning pituitary macroadenoma
pituitary tumour
| pressure effects lead to hypopituitarism
90
empty sella
small or no pituitary gland normal pituitary function except loss of FSH/LH
91
what can cause hyperprolactinemia?
micro/macro prolactinoma
| drugs
92
PCOS
polycystic ovarian syndrome
93
what are the oestrogen levels like in PCOS?
normal
94
what is the rotterdam criteria?
2 of:
menstrual irregularity
hyperadrogenism
polycystic ovaries
95
what is the rotterdam criteria used for?
diagnosis of PCOS
96
hirsutism
excess hair; usually used when referring to women with male pattern hair distribution
97
what is hirsutism caused by?
androgen excess at hair follicles
98
what can cause androgen excess at hair follicle?
- excess circulating androgen
| - increased peripheral conversion at the hair follicle
99
what can cause hirsutism?
```
PCOS
familial
idiopathic
non-classical congenital adrenal hyperplasia
adrenal/ovarian tumour
```
100
CAH
congenital adrenal hyperplasia
101
what is CAH?
an inherited group of disorders charaterised by a deficiency in one of the enzymes necessary for cortisol synthesis
102
what is the inheritance pattern of CAH?
autosomal recessive
103
when is classic CAH typically diagnosed?
infancy
104
what is classic CAH due to?
21alpha-hydroxylase deficiency
105
what is non-classic CAH due to?
partial 21alpha-hydroxylase deficiency
106
what does non-classic CAH usually present with?
hirsutism
menstrual disturbance
infertility due to anovulation
107
when does non-classic CAH usually present?
adolescence/adulthood
108
anovulation
he failure of the ovary to release ova over a period of time generally exceeding 3 months
109
what is the karyotype of Turner syndrome?
22X
110
name some features of turner syndrome
short stature
webbed neck
shield chest with wide spaced nipples
cubitus valgus
111
XX gonadal dysgenesis
absent ovaries but no chromosomal abnormality
112
what is the most common congenital form of primary hypogonadism?
klinefelter's syndrome
113
what's they karyotype of klinefelter's syndrome?
47 XXY
114
what could cause gynaecomastia?
```
physiological
drugs
tumours
endocrine disorders
systemic illness
hereditary disorders
```
115
oligomenorrhea
cycles > 35 days
116
GnRH
gonadotrophin releasing hormone
117
what is GnRH synthesised by?
neurons in hypothalamus
118
what kind of release does GnRH exhibit?
pulsatile release
119
what does GnRH do?
stimulates FSH & LH
120
what happens to insulin in PCOS?
diminished biological response to a given level of insulin
121
twin-twin transfusion syndrome
unbalanced vascular communications within placental bed
