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BRS (RF) > Sex hormones > Flashcards

Sex hormones Flashcards

1
Q

What is the definition of puberty?

A

Maturation of reproductive organs; production of sex steroids (Oestradiol/Testosterone); development of secondary sexual characteristics and attaining the capability to reproduce

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2
Q

What is thelarche?

A

Onset of breast development

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3
Q

What is Gonadrche?

A

Activation of gonads by HPG axis

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4
Q

What is menarche?

A

The first occurrence of menstural cycles

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5
Q

What is adrenarche?

A

Adrenal androgen productiion

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6
Q

When does adrenarche occur in comparison to Gonadrche?

A

onset 2 years before Gonadrche

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7
Q

What is pubarche?

A

Onset of pubic hair development

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8
Q

What are the main effects of oestradiol?

A

Breast development, hair growth (Pubic & axillary), sweat gland composition, skin oiliness/acne
Changes to external genitalia

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9
Q

What is the first strage of thelarche?

A

Elevation of papilla

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10
Q

What is stage 3 thelarche?

A

Further enlargement of breast and papilla, separation of their contours

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11
Q

What is stage 5 of thelarche?

A

Adult: Mature breast, projection of papilla only as areola conforms to breast contour

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12
Q

What are the main effect of testosterone?

A

Deepening of voice
Hair growth, pubic, axillary & facial
Sweat gland composition, skin oiliness and acne
Changes to externa genitalia

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13
Q

For which gender is the age of onset earlier?

A

Females

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14
Q

What is the age of onset for females?

A

8-13 years

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15
Q

What is the age of onset for boys?

A

9-14 years

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16
Q

Which stage occurs first in females? Adrenarche or menarche?

A

Adrenarche

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17
Q

What is the first sign for females?

A

Thelarche

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18
Q

What is the latest female pubertal sign?

A

Menarche

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19
Q

What is the age of onset of puberty for males?

A

9-14 years

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20
Q

What is the average testicular size for prepubertal males?

A

4 mls

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21
Q

What is adult size of testicular volume?

A

15mls

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22
Q

Which molecule is an adrenal androgen which increases with age?

A

DHEA

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23
Q

Which gonadotrophs are released during gonadrche?

A

FSH & LH

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24
Q

Which neurones are associated with the hypothalamus and control pulsatility?

A

Kisspeptin neurones

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25
Q

What is the role performed by kisspeptin neurones?

A

Regulate the pulsatile secretion of Gonadotrophin-releasing hormone (GnRH) from parvocellular hypothalamic neurones into the primary capillary plexus within the median eminence

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26
Q

Which circulation do hypothalamic hormones circulate within?

A

Hypophyseal-pituitary circulation

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27
Q

Which hormones are released upon GnRH stimulation?

A

LH & FSH

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28
Q

Which cells secrete LH and FSH?

A

Gonadotrophs

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29
Q

Where are gondatrophs situated?

A

Anterior pituitary gland

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30
Q

Which organs are stimulated by the action of LH & FSH?

A

Testes and ovaries

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31
Q

When is there an increase in GnRH pulsatility?

A

During Gonadrche there is an increased nocturnal GnRH pulsatility, towards a new equilibrium steady rate during adulthood

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32
Q

What happens to the HPG axis during childhood?

A

There is quiescence

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33
Q

What is mini puberty?

A

Stimulates the early development and maturation of sex-organs –> Increased risk of Mal-descent of the testes & micro-penises

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34
Q

What is the consequences of mini-puberty?

A

Mal-descent of testes and micro-penises

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35
Q

What is the consequence of a continuous non-pulsatile administration of GnRH?

A

Causes decreased LH/FSH secretion

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36
Q

Delayed onset of puberty is more common with which gender?

A

Males

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37
Q

What term describes an early onset of puberty?

A

Precocious

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38
Q

What is the precocious age of onset for females?

A

<8 years

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39
Q

What is the average delayed age of onset for males?

A

14 years

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40
Q

When does menarche occur after thelarche?

A

2.3 years, immediately after peak height velocity

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41
Q

What is the mean age for menarche?

A

12.7 years (Range 10.7-16.1 years)

42
Q

What is amenorrhoea?

A

Absence of periods

43
Q

What is the definition of primary amenorrhoea?

A

Later than 16 years is regraded as abnormal, delayed menstrual cycle onset

44
Q

What is secondary amenorrhoea?

A

Common for irregular/anovulatory periods for initial 18 months. Periods begin, however cease for 3-6 months

45
Q

What is the average number of annual periods with patients experiencing secondary amenorrhoea?

A

3

46
Q

What is oligo-menorrhoea?

A

Irregular or infrequent periods > 35 day cycles (4-9 cycles annually)

47
Q

How long is a standard menstrual cycle?

A

28 day cycle

48
Q

What is the first phase of the menstrual cycle?

A

Follicular phase

49
Q

Which hormone rises during the follicular phase?

A

FSH

50
Q

What is the average number of follicles that grow during the follicular phase?

A

2-3 follicles

51
Q

What hormones are produced by the follicular phase?

A

Inhibin and E2

52
Q

What effect is exerted by inhibin and E2 on FSH secretion?

A

Negative feedback effect on FSH secretion on the hypothalamus and on the anterior pituitary gland

53
Q

What happens to non-dormant follicles during the follicular phase?

A

They undergo atresia

54
Q

What term is used to describe a dominant follicle?

A

Graafian follicle

55
Q

What happens to the E2 concentration during the follicular phase?

A

E2 concentration continues to increase, positive feedback switch exerted by E2

56
Q

What effect is exerted by a positive feedback switch by E2?

A

Induces luteinising hormone surge

57
Q

What happens due to the induction of LH?

A

Stimulates ovulation, secretion of the mature secondary oocyte from the Graafian follicle

58
Q

What is the term used to describe the remnant follicle upon ovulation of secondary oocyte?

A

Corpus luteum

59
Q

What phase follows the follicular phase?

A

Luteal phase

60
Q

Which hormone develops the corpus luteum?

A

LH

61
Q

Which hormone is released from the corpus luteum?

A

Progesterone

62
Q

Which hormone maintains the endometrium lining?

A

Progesterone

63
Q

What test can be conducted to identify ovulation?

A

Progesterone level test for mid-luteal phase

64
Q

What effect does progesterone have?

A

Maintains endometrium lining

65
Q

What effect does decreased progesterone have on FSH?

A

Reduced negative feedback, stimulates FSH levels, oestradiol is secreted

66
Q

Why does the corpus luteum degrade?

A

Due to absent HCG stimulation

67
Q

The reduction of progesterone results in what?

A

Shedding of the endometrium lining - mensural cycle occurs

68
Q

What hormone is tested in pregnancy tests?

A

Beta HCG

69
Q

Which receptors are activated by beta HCG?

A

LH and FSH receptors - continues to support the corpus luteum - secretes progesterone

70
Q

Which hormonal receptor is stimulated by elevated progesterone levels?

A

TSH receptor –> Thyrotoxicosis

71
Q

What happens to pulsatility due to progesterone release?

A

Negative feedback, therefore decrease pulsatile effect of GnRH

72
Q

What is hypogonadism?

A

Is concerned with decreased oestrogen and testosterone concentrations within and females respectively –> Associated with reduced gonadal function (Trauma to organs, infections (Mumps))

73
Q

What is primary hypogonadism in males?

A

Reduction in testosterone (low E2) secretion from testes, and reduced oestrogen secretion from ovaries. Subsequent reduction in gonad-hormones result in reduced exertion of negative feedback onto the gonadotrophs – increased lH/FSH

74
Q

Describe the LH/FSH levels for patients with primary hypogonadism?

A

LH/FSH levels are elevated

75
Q

During menopause which hormones are at lower concentrations?

A

E2, oestrogen and inhibin

76
Q

During menopause which hormones are elevated?

A

FSH and LH

77
Q

What are the common causes of primary hypogonadism in males?

A

Infection
Trauma
Cancer of testes

78
Q

What is secondary hypogonadism?

A

Due to hypothalamic and pituitary disorders -> Reduced secretion of FSH & LH from anterior pituitary gonadotrophs

79
Q

How can a pituitary adenoma lead to secondary hypogonadism?

A

Elevated production of prolactin, exerts negative inhibition on kisspeptin causing downstream inhibition and pulsatility on GnRH -> Reduced gonadotrophin release –> Low e2 and testosterone, oestrogen

80
Q

What is menopause?

A

Oestradiol deficiency

81
Q

What are 7 main consequences of menopause?

A

Skin dryness; hair thinning
Hot flushes; sweating; sleep disturbances
Mood disturbance
Osteoporosis: Decreased bone mineral density (BMD); E2 stimulates osteoblasts.
Sexual dysfunction: Vaginal dryness, decreased libido
Weight gain
Amenorrhoea: No periods for 1 year+; cessation of fertility; climacteric: Irregular periods in the years approaching menopause.

82
Q

What are the treatments for menopause?

A

Oestrogen replacement –> Hormone replacement therapy

83
Q

How can hyperplasia cancer be reduced during hormonal therapy?

A

Oestrogen stimulates the endometrium; combination of progesterone facilitates endometrium maintenance  Preventing the risk of endometrial hyperplasia/cancer.

84
Q

What is the median age for menopause?

A

51 years

85
Q

When does gametogenesis occur?

A

Occurs at puberty (gonadrche)

86
Q

How long is the spermatogonia pool lifespan?

A

Poo available for subsequent spermatogenic cycles throughout life generating continuous fertility

87
Q

What meiotic phase are primary oocytes within primordial follicles halted in?

A

Prophase 1

88
Q

What happens to primordial follicles?

A

Undergo atresia

89
Q

Which hormone is secreted by Sertoli cells within ovaries can be used to test ovarian reserve?

A

Anti-Mullerian hormone (AMH)

90
Q

What happens during pre-menopause?

A

Premature ovarian failure (POF), conception can happen in 20%

91
Q

How is premenopausal diagnosed?

A

Elevated FSH > 2,5iU/L

92
Q

What are the 3 main causes of pre-menopause?

A

Autoimmune
Genetic :Fragile X syndrome, Turner’s
Cancer therapy: Radio/chemo therapy

93
Q

What does the free testosterone hypothesis suggest?

A

Sex-hormone binding globulin is reduced and becomes unavailable , thus reducing free testosterone availability

94
Q

Which plasma protein is bioactive testosterone bound to?

A

Albumin

95
Q

When is testosterone levels high during the day?

A

During the morning

96
Q

When should testosterone levels be measured?

A

before 11am

97
Q

What pattern is exhibited by testosterone?

A

Diurnal rhythm

98
Q

What are the main symptoms of testosterone deficiency?

A

Symptoms of deficiency: Sexual dysfunction (Reduced libido); erectile dysfunction (loss of early morning erections); hair growth (frequency of shaving); energy levels; mood disturbances, body composition (Increased fat, reduced muscle mass, gynaecomastia (breast enlargement in males)); spermatogenesis (high levels of intratesticular testosterone required); bone health (Conversion to oestrogen).

99
Q

Which enzyme converts testosterone into 17B-estradiol?

A

Aromatase

100
Q

Which enzyme converts androstenedione to oestrogen?

A

Aromatase

101
Q

Which enzyme converts testosterone into DHT?

A

5-alpha-reductase

BRS (RF) (38 decks)

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