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REPRODUCTIVE > REPRODUCTIVE- Physiology > Flashcards

REPRODUCTIVE- Physiology Flashcards

1
Q

Source of Estrogen

A

Ovary
Placenta
Adipose tissue

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2
Q

Estrogen produced by ovaries

A

17β estradiol

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3
Q

Which estrogen is produced in placenta?

A

Estriol

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4
Q

Estrogen produced in Adipose tissue

A

Estrone via aromatization

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5
Q

Order of potency of Estrogen

A

Estradiol> Estrone > Estriol

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6
Q

What are the functions of Estrogens in the body?

A

DEvelopment of Genitalia and breast, female fat distribution

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7
Q

Functions of Estrogen

A

Growth of follicle, endometrial proliferation, ↑ myometrial excitability

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8
Q

What is upregulated by estrogen?

A

Upregulation of estrogen, LH, and progesterone receptors

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9
Q

Who feedback inhibit estrogen?

A

FSH and LH, then LH surge

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10
Q

What effect does estrogen has on prolactin?

A

Stimulation of prolactin secretion then ↑ transport proteins, SHBG

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11
Q

Effect of estrogen on cholesterol

A

↑ HDL; ↓ LDL

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12
Q

During preganacy how are estrogens affected?

A

50-fold ↑ in estradiol and estrone

1000 fold ↑ in estriol

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13
Q

Which is the indicator of fetal well being?

A

Estriol

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14
Q

Where are estrogen receptors expressed?

A

In the cytoplasm; translocate to the nucleus when bound by ligand

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15
Q

How is the secretion of GnRH in order to stimulate FSH and LH?

A

Pulsatile

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16
Q

Which cells are stimulated by FSH in women?

A

Granulosa cell

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17
Q

Which enzyme is stimulated by FSH in order to produce Estrogen?

A

Aromatase

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18
Q

How do Granulosa cell produce estrogen?

A

From androstenedione, aromatase stimualtes the conversion to Estrogens and the free them

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19
Q

Which cells are stimulated by LH?

A

Theca cell

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20
Q

Which enzyme is stimulated by LH?

A

Desmolase

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21
Q

How do Theca cells produce Estrogen?

A

From Cholesterol thanks to desmolase, it becomes Androstenedione, next the androstenedione goes to Granulosa cell and becomes Estrogen

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22
Q

Source of Progesterone

A

Corpus luteum, placenta, adrenal cortex, testes

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23
Q

Which effect does progesterone has on the endometrium?

A

Stimulation of endometral grandular secretions and spiral artery development

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24
Q

Which hormone maintain the pregnancy?

A

Progesterone

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25
Q

What is the effect of progesterone in the myometrium?

A

↓ myometral excitability

Uterine smooth muscle relaxation (preventing contractions)

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26
Q

What is the effect of progesterone in the cervix?

A

Production of thick cervical mucus, which inhibits sperm entry into the uterus

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27
Q

Effect of progesterone in temperature?

A

↑ body temperature

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28
Q

Which female hormone inhibits gonadotropins (LH, FSH)?

A

Progesterone

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29
Q

What is the effect of progesterone related to estrogen?

A

↓ estrogen receptor expressivity

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30
Q

Which hormone prevents endometrial hyperplasia?

A

Progesterone

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31
Q

What is the effect of fall in progesterone after delivery?

A

Disinhibits prolactin → lactation

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32
Q

After delivery, what is the indicative of ovulation?

A

↑ progesterone

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33
Q

How can a Tanner stage be assigned?

A

Independently to genitalia, pubi hair, and breast (eg. a person can have Tanner stage 2 genitalia, Tanner stage 3 pubic hair)

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34
Q

Tanner stagers of sexual development

A

I. Childhood (perpubertal)
II. Pubic hair appears, breast bud form
III. Pubic hair darkens and become curly; penis size/length ↑; breast enlarge
IV. Penis widht ↑, darker scrotal skin, development of glans; raised areolae
V. Adult; areolae are no longer raised

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35
Q

What is Pubarche?

A

When the pubic hair appears

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36
Q

What is thelarche?

A

When breast bud form

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37
Q

Whichare the three phases of Menstrual cycle?

A

Proliferative phase
Secretory phase
Menstruation

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38
Q

Which ovarian phase corresponds to Proliferative phase?

A

Follicular

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39
Q

Which ovarian phase corresponds to Secretory phase?

A

Luteal

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40
Q

What happens in the ovary during Proliferative phase?

A

Maturing graafian follicle

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41
Q

Which are the Three ovarina phases?

A

Follicular
Ovulation
Lutheal

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42
Q

Meanwhile the endomtrail Secretory phase is done, what happens in the ovary?

A

Corpus luteum formation

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43
Q

Which ovary action leads to menstruation?

A

Regressing corpus luteum

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44
Q

Which ovarian phase can vary in length?

A

Follicular phase

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45
Q

Which ovarian phase is constant? and how many days?

A

Luteal phase is usually a constant 14 days

Ovulation day+ 14 days= menstruation

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46
Q

When does folicular growth is faster?

A

During 2nd week of proliferative phase

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47
Q

Which hormone stimulates endometrial proliferation?

A

Estrogen

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48
Q

Which hormone maintains endometrium to support implantation?

A

Progesterone

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49
Q

What is the effect of ↓ progesterone?

A

↓ fertility

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50
Q

What is Oligomenorrhea?

A

> 35 day cycle

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51
Q

What is polymenorrhea?

A
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52
Q

What is Metrorrhagia?

A

Intermenstrual bleeding: Frequent but irregular menstruation

53
Q

What is Menorrhagia?

A

Heavy menstrual bleeding

54
Q

When is consider Menorrhagia?

A

> 80 mL blood loss or > 7 days of menses

55
Q

Heavy, irregular menstruation at irregular intervals

A

Menomatrorrhagia

56
Q

Physiology of Menstruation

A

↑ estrogen → LH surge → Ovulation → Progesterone (from corpus luteum) → Progesterone levels fall → Menstruation (via apoptosis of endometrial cells)

57
Q

When do primary oocytes begin meiosis I?

A

During fetal life

58
Q

When do primary oocytes complete meiosis I?

A

Just prior ovulation

59
Q

So… if primary oocytes begin meiosis I during fetal life and complete meiosis I until ovulation, in which phase are they trapped?

A

Meiosis I is arrested in prophase I for years until Ovulation (1º Oocytes)

60
Q

Until when are 2º Oocytes stay in Meiosis II?

A

Meiosis II is arrested in metaphase II until fertilization

61
Q

How long does a 2º Oocyte last unfertilized until it degenerates?

A

1 day

62
Q

When does the replication of oogonium dipoil occurs?

A

In the interphase

63
Q

What is increased during ovulation?

A

↑ Estrogen, ↑ GnRH receptors on anterior pituitary

64
Q

Physiology of Ovulation

A

Estrogen surge then stimulates LH release → ovulation (rupture of follicle)

65
Q

What is the ovulation?

A

Rupture of follicle

66
Q

During ovulation which hormone induces ↑ temperature?

A

Progesterone

67
Q

What is Mittelschmerz?

A

Refers to transient mid- cycle ovulatory pain

68
Q

What is associated to Mittelschmerz?

A

With peritoneal irritation (eg. swelling/rupture, fallopian tube contraction)

69
Q

What mimics Mittelschmerz?

A

Appendicitis

70
Q

Where does Fertilization most commonly occurs?

A

In upper end of fallopian tube (the ampulla)

71
Q

When does fertilization occurs?

A

Within 1 day of ovulation

72
Q

When does the implantation whitin the wall of the uterus occurs?

A

6 days after fertilization

73
Q

What do Syncytiotrophoblast secrete?

A

hCG

74
Q

When is hCG detected in blood?

A

1 week after conception

75
Q

When is hCG detected on home test in urine?

A

2 weeks after conception

76
Q

What disinhibits lactation?

A

After labor, the ↓ in progesterone and estrogen

77
Q

What is required to maintain milk production?

A

Suckling, since ↑ nerve stimulation ↑ oxytocin and prolactin

78
Q

What are the functions of Prolactin?

A

Induces and maintains lactation and ↓ reproductive function

79
Q

What are the functions of Oxytocin?

A

Assists in milk letdown; also promotes uterine contraction

80
Q

When os breatmilk recommended?

A

Is the ideal nutrition for infants

81
Q

What immunology benefits does Breastmilk contain?

A

Maternal immunoglobulins, macrophages, and lymphocytes

82
Q

What is the importance of Maternal immunoglobulins in breast milk?

A

Confers passive immunity

83
Q

Which Maternal immunoglobulins is confer in breast milk?

A

Mostly IgA

84
Q

Which are the benefits of Breastmilk?

A

Reduces infant infections and is associated with ↓ risk for the child to develop asthma, allergies, diabetes mellitus and obesity

85
Q

What does Exclusively breastfed infants require?

A

Vitamin D supplementation

86
Q

What risk for the mother are decreased with Breasfeeding?

A

↓ Maternal risk of breast and ovarian cancer

87
Q

What does Breastfeeding facilitates?

A

Facilities mother child bonding

88
Q

Which is the source of hCG?

A

Syncytiotrophoblast of placenta

89
Q

What is the function of hCG?

A

Maintains the corpus luteum (and thus progesterone) for the 1st trimester by acting like LH (otherwise no luteal cell stimulation and abortion results)

90
Q

During the 2nd and 3rd trimesters what happens to the corpus luteum?

A

The placenta synthesizes its own estriol and progesterone and the corpus luteim degenerates

91
Q

Which subunit of hCG is similar to others?

A

α subunit

92
Q

Who have identical α subunit structure to hCG?

A

LH, FSH, and TSH

93
Q

Which subunit of hCG is unique?

A

β subunit

94
Q

Which hCG subunit is detected in pregnacy tests?

A

β subunit

95
Q

When is hCG increased?

A

In multiple gestations and pathologic states

96
Q

Pathologic states with increased hCG

A

Hydatidiform mole

Choriocarcinoma

97
Q

Which hormone is affected in menopause?

A

↓ Estrogen production

98
Q

What explains ↓ Estrogen production in menopause?

A

Due to age linked decline in number of ovarian follicles

99
Q

Which is the average age of onset for menopause?

A

51 years (earlier in smokers)

100
Q

What usually precedes Menopause?

A

By 4-5 years of abnormal menstrual cylces

101
Q

Which estrogen is mainly afected in menopause?

A

Estrone

102
Q

What is the main source of estrogen after menopause?

A

Becomes peripheral conversion of androgens, ↑androgens → hirsutism

103
Q

What is specific for menopause?

A

↑↑ FSH

104
Q

What explains ↑↑ FSH in menopause?

A

Loss of negative feedback on FSH due to estrogen

105
Q

Hormonal changes of Menopause

A

↓ estrogen, ↑↑ FSH, ↑ LH (no surge), ↑ GnRH

106
Q

Clinical findings of Menopause

A 
HAVOCS
Hot flashes
Atrophy of the Vagina
Osteoporosis
Coronary artery disease
Sleep disturbances
107
Q

What does Menopause before age 40 indicates?

A

Premature ovarian failure

108
Q

When does Spermatogenensis begin?

A

At puberty with spermatogonia

109
Q

How long does is take for spermatogenesis to reach full development?

A

2 months

110
Q

Where does Spermatogenesis occur?

A

In seminiferous tubules

111
Q

What is produced in Spermatogenesis?

A

Spermatids that undergo Spermiogenesis to form mature spermatozoon

112
Q

What is Spermiogenesis?

A

Loss of cytoplasmic contents, gain of acrosomal cap

113
Q

In which situations is seen impaired tail motility that can lead to infertility?

A

In ciliary diskinesia/ Kartagener syndrome

114
Q

Who are consider androgens?

A

Testosterone, dihydrotestosterone (DHT), androstenedione

115
Q

Which androgens are produced in testis?

A

DHT and testosterone

116
Q

Where is androstenedione produce?

A

In adrenal glands

117
Q

Order of androgen potency

A

DHT> testosterone > androstenedione

118
Q

Functions of Testosterone

A

Differentiation of epididymis, vas deferens, seminal vesicles (genitalia except prostate)
Growth spurt: penis, seminal vesicles, sperm, muscle, RBCs
Deeping of voice
Closing of epiphyseal plates (via estrogen converted from testosterone
Libido

119
Q

Early functions of DHT

A

Differentiation of penis, scrotum, prostate

120
Q

Late functions of DHT

A

Prostate growth, balding, sebaceous gland activity

121
Q

Which enzyme converts Testosterone to DHT?

A

5α reductase

122
Q

Which drug inhibits 5α reductase?

A

Finasteride

123
Q

Which is the mechanism of action of Finasteride

A

Inhibits 5α reductase which converts testosterone to DHT

124
Q

In male, which enzyme converts androgens to estrogen?

A

By cytochrome P-450 aromatase

125
Q

Where can we find cytochrome P-450 aromatase?

A

Primarily in adipose tissue and the testis

126
Q

What is the function of cytochrome P-450 aromatase?

A

In male converts androgens to estrogen

127
Q

Is the key enzyme in the conversion of androgens to estrogen

A

Aromatase

128
Q

What is the effect of eExogenous testosterone?

A

Inhibiton of hypothalamic-pituitary-gonadal axis → ↓ intratesticular testosterone → ↓ testicular size → azoospermia

REPRODUCTIVE (5 decks)

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