Reproductive System Flashcards
(142 cards)
1
Q
Estrogen receptor agonist
A
Ethinylestradiol
2
Q
Estrogen receptor agonist and antagonist (SERM)
A
Tamoxifen,Raloxifene, clomiphene
3
Q
Estrogen receptor antagonist
A
Fulvestrant
4
Q
Aromatase inhibitors
A
Anastrozole
5
Q
Synthetic progesterone analogue (progestins)
A
Medroxyprogesterone,Levonorgestrel,Dydrogesterone
6
Q
Antiprogestins
A
Mifepristone
7
Q
Estrogen effects
A
Endometrial and mammary gland proliferation (increase tumor risk),inhibits osteoclast activity, increase blood coagulation,promote water and electrolyte retention, decrease glucose tolerance,affect blood lipid level, increase bile lithogenicity
8
Q
Progestins effects
A
Inhibit endometrial proliferaiphase and stimulate mammary gland proliferation (increase tumor risk),promote use of adipose tissue for energy metabolism, increase blood coagulation some prevent water retention,impair glucose tolerance,affect blood lipid level,do not affect bile lithogenicity
9
Q
Both estrogen and progesterone are bad for
A
DM, hypercholesterolemia, obesity patients due decrease glucose tolerance,increase lipid content in blood
10
Q
Both progesterone and estrogen provide feedback inhibion on
A
Release of FSH/LH secretion in adenohypophysis.also have effect on hypothalamic release of GnRH
11
Q
Combination oral contraceptive (both estrogen and progesterone) fn
A
Change cervix environment,altered transportation of egg,sperm and fertilizer ovum, unfavorable endometrial environment
12
Q
Estrogen and progesterone receptors are seen in
A
All organs mainly ovary,uterus,vagina,bones,breast, hypothalamus, pituitary gland, blood vessels
13
Q
Estrogen receptors are
A
ER alpha and beta
14
Q
Progesterone receptors are
A
PR-a and B
15
Q
Both estrogen and progesterone receptors are
A
Nuclear receptors
16
Q
Estrogen and progesterone cause
A
Estrogen and progesterone regulated gene transcription
17
Q
Testesterone,5alpha dihydrotestosterone (DHT) receptor
A
Intranuclear Androgen receptor (ARs)
18
Q
Symptoms of menopause
A
Hot flushes,nausea, headache, tachycardia,sweating , palpitations,night sweats
19
Q
Increase in Gn RH and gonadotropin during menopause is due to
A
Decrease in feedback inhibition by estrogen
20
Q
Symptoms of menopause are caused due to
A
Activation of thermoregulatory centers of hypothalamus by gonadotropin which is uncontrolled
21
Q
Hormone replacement therapy can be done to
A
Reduce symptoms of menopause
22
Q
Women with hysterectomy may use
A
Estrogen therapy
23
Q
Women with preserved uterus can use
A
Combined estrogen and progesterone HRT
24
Q
Combined therapy for uterus preserved women helps to reduce
A
Risk of endometrial Cancer
25
Hypogonadism treatment
HRT
26
Primary hypogonadism cause
Growth and puberty delay,which cause dysfunction of hypothalamus, pituitary gland and some genetic disorders
27
Secondary hypogonadism is caused by
Chronic diseases like tumor, hyperprolactinemia that affects GnRH secretion,also some medication,dooungs and radiation
28
Endometriosis
Endometrial implantation outside uterus cause severe pelvic pain
29
Endometriosis treatment
Hormonal therapy with progestins or GnRH agonists or surgery if necessary
30
Hormonal therapy with progestins will
Reduce the proliferation of endometrium and it also shrinks the endometrium ,which is good for endometriosis
31
GnRH agonists
First increase the amount of FSH and LH ,but then downregultes it in continuous use
32
Combined oral contraceptive eg
Levonorgestrel (contain both estrogen and progesterone
33
Targets of COC
Hypothalamus, pituitary gland, endometrium,ovary, cervix
34
COC fn
Inhibit both FSH and LH release and thereby prevent follicle maturation eliminate preovulatory LH wave and suppressed ovulation
35
Progestins additional fn
Affect cervical secretion,inhibits endometrial proliferation,inhibits ovarian and uterine peristalsis
36
COC indication
Endometriosis,acne, dysmenorrhoea, premenstrual syndrome
37
Dysmenorrhoea
Painful menstrual cramps
38
Premenstrual syndrome
Emotional,physical and behavioural changes 1 or 2 weeks before menstruation
39
Single phase COC
Fixed dose of estrogen and progesterone throughout the cycle
40
Progestins high dose
Completely inhibits follicle dev and ovulation,changes cervical mucus properties And cause endometrial changes
41
Intermediate dose of progestin
Inhibit ovulation,but doesn't affect follicle dev
42
Low dose progestin cause
Doesn't completely inhibits ovulation and give intrauterine contraceptive effect
43
POC full form
Progestin only regular oral contraceptive
44
POC is better contraceptive for women with
Cardiovascular disease and risk of dev of thrombosis,age over 35,smokers,lactating women,women with migraine type headache
45
POC (Progestin )effect
Thisckend cervical wall,inhibits endometrial proliferation, reduce tubal and uterine peristalsis
46
Emergency contraception is
High dose of progestins taken over next 72 hour after intercourse
47
Ethinylestradiol effect
Replace endogenous hormone,increase bone mineral density, estrogen replacement ,inhibits follicular maturation and ovulation, Hormonal suppressive effect
48
Clinical use of estrogen
Estrogen replacement therapy in menopause and postmenopause, hypogonadism
49
Ethinylestradiol has more bioavailability than
Estradiol
50
Estradiol is widely used in
Topical pharmaceutical formulation
51
Side effects of ethinylestradiol
Deep vein thrombosis,risk of dev of endometrial or breast cancer
52
Estrogen has positive effect on
Breast,endometrium and bone tissue
53
Only SERM that has positive effect on breast tissue
Estrogens
54
Tamoxifen has positive effect ion
Endometrium and bone ,but negative effects on breast tissue
55
Raloxifene has positive effect Only on
Bone tissue,it has negative effects on endometrium and breast
56
In estrogen and SERM ,positive effect on endometrium is given by
Estrogen and tamoxifen
57
In estrogen and SERM , positive effect on bone tissue are done by
Estrogen, tamoxifen and Raloxifene
58
Difference in tissue sensitivity to SERM is caused by
Difference in localisation of receptor, effect of transcriptional cofactors on receptor (coactivators and corepressors)
59
Dominant cofactor determine
Agonist or antagonist effect on SERM
60
Tamoxifen is
ER antagonist in breast tissue and partial agonist in endometrium and bone
61
Tamoxifen do not stimulate
DNA synthesis, but inhibit cell division causing regression of malignant cells(Antiproliferative)
62
Tamoxifen indication
Breast cancer
63
Tamoxifen SE
Deep vein thrombosis, endometrial hyperplasia
64
Raloxifene action
Partial ER agonist in bone tissue,ER antagonist in endometrium and breast tissue (anti resorptive effect), Decrease LDL
65
Indication of raloxifene
Osteoporosis prevention and therapy
66
SE of raloxifene
Deep vein thrombosis
67
Clomiphene
ER antagonist in hypothalamus and adenohypophysis, partial ER agonist in ovaries, stimulate release of FSH and LH(blocks negative feedback), stimulate formation and maturation of ovarian follicle and ovulation
68
Indication of clomiphene
Anovulatory cycle, ovulation stimulation
69
SE of clomiphene
Overstimulation of ovaries
70
Fulvestrant (ER antagonist in all tissue) action
Inhibit intracellular dimerization and binding of ER to ER element and downregultes ER density (Antiproliferative)
71
Fulvestrant indication
Breast cancer
72
Androstenedione produced from adipose tissue (cholesterol) is converted to estrone by
Aromatase in post menopause,which is further converted to estradiol
73
Anastrozole (aromatase inhibitor) action
Decrease estrogen synthesis ,so Antiproliferative
74
Indication of anastrozole
Breast cancer in menopause
75
SE of anastrozole
Decrease bone mineral density
76
Medroxyprogesterone (progesterone receptor agonist) action
Inhibit proliferation phase, thickens cervical mucus,interfer with tubal and uterine peristalsis -so hormone suppressive effect
77
Medroxyprogesterone use
Progestin contraception, endometriosis
78
SE of medroxyprogesterone
Impaired menstrual bleeding, decrease bone density due to its antiestrogenic effect and glucocorticoid activity of it,that inhibit osteoblast
79
Levonorgestrel (progesterone receptors agonists) action
Inhibit proliferation phase, thickens cervical mucus,impairs peristalsis in tubule and uterus -hormone suppressive effect , inhibits ovulation
80
Indication of Levonorgestrel
COC,POC
81
In Levonorgestrel used in IUD
Ovulation is not inhibited, contraceptive effect only in uterus
82
Levonorgestrel used as Emergency contraception,basic mechanism is
Inhibition of ovulation, rather than POC mechanism
83
Dydrogesterone (progestin receptor agonist) action
In uterus forms endometrial secretory phase in estrogen filled uterus,provide protection against elevated estrogen induced endometrial hyperplasia
84
Dydrogesterone has no contraceptive effect
On therapeutic dose
85
Dydrogesterone inhibits
Estrogen receptor synthesis in endometrium
86
Indication of Dydrogesterone
Conditions caused by endogenous progesterone deficiency like dysmenorrhoea, endometriosis, impending abortion ,... Hormonal replacement therapy
87
All progesterone receptors agonists have
Antiestrogenic effect
88
Levonorgestrel and medroxyprogesterone has
Androgen action
89
Antiandrogenic action is given by
Cyproterone only
90
Levonorgestrel and medroxyprogesterone has both
Antiestrogenic action and Androgen action
91
Cyproterone has both
Antiestrogenic action and antiandrogenic action
92
Levonorgestrel is not recommended for
Women with hyperandrogenism
93
Antiandrogenic effect of progestins helps against
Acne vulgaris (cyproterone)
94
Mifepristone (progesterone receptors antagonist) action
It is is also glucocorticoid receptor antagonist,blocks progesterone effect on endometrium, stimulate prostaglandin release and thereby cause myometrium contractions
95
Mifepristone use
Termination of pregnancy in first trimester,hypercortisolism(in high dose)
96
Mifepristone SE
Severe vaginal bleeding
97
LH stimulate release of testesterone from
Leydig cells
98
In prostate cells testesterone is converted to 5 alpha dihydrotestosterone by the enzyme
5 alpha reductase
99
5alpha dihydrotestosterone (DHT) has
10 fold more affinity to receptor than testesterone
100
Testesterone is converted to estrogen in peripheral tissue by
Aromatase
101
Aromatase also control LH secretion by
Negative feedback along with androgens
102
Effects of testesterone
Stimulate spermatogenesis, promote erythropoiesis, increase skeletal muscle mass and strength,maintain bone mineral density
103
Androgen receptor agonists
Testesterone and nandrolone
104
Androgen receptor antagonist
Flutamide
105
Androgen receptor antagonist and Progestin receptor agonist
Cyproterone
106
5 Alpha reductase inhibitor
Finasteride
107
Benign prostate hyperplasia
Benign Stromal and epithelial cell hyperplasia in periurethral area of prostate,cause urinary tract disorder, conservative therapy used
108
Hyperandrogenism/polycystic ovarian syndrome
Elevated levels of male hormones in women
109
PCOS risks and symptoms
Miscarriage, pregnancy complications, Hirsutism, acne,adipositate
110
Testesterone action
Androgenic action in prostate and testicles , protein anabolic action in muscle,bone, hematopoiesis,liver)
111
Testesterone has
First pass effect
112
Use of testesterone
Hypogonadism
113
Nandrolone (Androgen receptor agonists) has
Enhanced anabolic effect and reduce androgenic effect ,is a testesterone derivative
114
Andrew action
Stimulate erythropoietin secretion,increase BOne mineral density, promote protein synthesis, stimulate carbohydrate and lipid metabolism
115
Nandrolone used a d
Doping drug -prohibited
116
Use of nandrolone
Refractory anemia, osteoporosis (not used in women due to virilizing effect)
117
High doses of anabolic steroids may cause secondary cause of hypogonadism and infertility due to
Inhibition of gonadotropin secretion, testesterone formation and spermatogenesis
118
Prostate cells without Androgen will undergo
Apoptosis
119
Androgen receptor antagonist are of 2 types
Non steroidalor pure anti androgens like flutamide
Steroidal anti Androgen like cyproterone
120
Steroidal anti Androgen also have properties of
Progestin
121
Flutamide action (anti Androgen non steroidal)
Antiproliferative
122
Use of Flutamide
Prostate cancer (together with GnRH receptor agonists)
123
SE flutamide
May increase LH secretion due to feedback mechanism
124
Cyproterone (steroidal Androgen receptor antagonist and Progestin receptor agonist ) action
Inhibition of Androgen activity in target tissue, action of Progestin receptor agonist inhibits LH secretion through feedback,inhibits testesterone synthesis - so Antiproliferative and anti gonadotropic effect
125
Use of cyproterone
Prostate cancer, Hirsutism and severe acne in women(hyperandrogenisity)
126
Contraindications of cyproterone
Pregnancy
127
Finasteride (5 alpha reductase inhibitor) action
Prevent conversation of testesterone to DHT,triggers prostate epithelial cell apoptosis,so decrease prostate size and urination disorders, it has both antiandrogenic and Antiproliferative effect
128
Use of finasteride
Benign prostate adenoma or hyperplasia,androgenic alopecia, Hirsutism in women
129
SE of finasteride
Decrease in libido and erectile dysfunction
130
Contraindications of finasteride
Pregnant women or women who is going to be pregnant
131
While using transdermal testesterone gel(androgel) should be advised to avoid
Skin to skin contact with pregnant women
132
While prescribing Androgen to male patients advice that
Cholestatic hepatitis and jaundice may occur with low doses of Androgen
133
Sildenafil use
Primary hypertension and erectile dysfunction
134
Women with migraine are not advised to use estrogen because
Increased risk of stroke
135
Medroxyprogesterone injection has SE
Depression
136
Sildenafil (Viagra)SE
Dev of chest pain or dizziness
137
Raloxifene a ta on estrogen receptor in
Bone ,endometrium
138
Interactions of sildenafil with nitrates cause
Fatal hypotension
139
Androgens are used for
Symptomatic treatment of male deficiency,female libido, endometriosis, postmenopausal symptoms, increased muscle mass
140
Estrogen effects
Main bone density by increasing bone reabsorption, maintain normal structure of skin and blood vessels
141
Progesterone inhibits endometrial proliferation phase.True or false
False
142
Pheromones are examples of
Ectohormone
