T1 - Menstrual Cycle (Josh)

Question 1

What are the phases of the Endometrial Cycle?

Answer 1

Proliferation

Secretory

Ischemic

Menstrual

Question 2

Endometrial Cycle is influenced by which mechanism?

Answer 2

Hypothalmic-Pituitary-Ovarian Axis feedback mechanism

Question 3

What are the hormones during the Endometrial Cycle?

Answer 3

Estrogen

Progesterone

Question 4

Which phase of Endometrial Cycle?

A significant rich layer of myometrium and blood vessels develops to cover the endometrial cavity.

Answer 4

Proliferative Phase

Question 5

Which phase of Endometrial Cycle?

characterized by a deepening and maturing of the succulent layer of endometrium for implantation.

Answer 5

Secretory Phase

Question 6

Which phase of Endometrial Cycle?

First day of menstral cycle is day 1

Shedding of functional 2/3 of endometrium

Answer 6

Ischemic Phase

Question 7

The Proliferative Phase correlates w/ which phase of the Ovarian Cycle?

Answer 7

Follicular Phase

Question 8

The Proliferative Phase depends on the dominance of which hormone?

Answer 8

estrogen

which is stimulated from ovarian follicles

Question 9

Can the Proliferative Phase adequately support life?

Answer 9

no

cannot adequately support an implanted ovum

Question 10

Which phase creates the layer than supports the developing zygote?

Answer 10

Secretory phase

Question 11

During the Secretory Phase, the corpus luteum produces which hormone?

Answer 11

Progesterone

Question 12

What happens during the secretory phase if pregnancy does NOT occur?

Answer 12

corpus luteum regresses

ischemia of endometrium develops and cyclic menstrual bleeding begins

Question 13

What are the phases of the Ovarian Cycle?

Answer 13

Follicular Phase (Pre-ovulatory)

Ovulation

Luteal (Post-ovulatory)

Question 14

Toward the end of the normal menstrual cycle, what happens to blood levels of ovarian hormones (estrogen and progesterone)?

Answer 14

decline

*** these low levels trigger the hypothalamus to begin a new ovarian cycle by secreting GnRH

Question 15

When the hypothalamus releases Gonadotropin-releasing Hormone (GnRH), where does it go?

Answer 15

to the anterior pituitary to stimulate the release of LH and FSH, which go to the ovary

Question 16

During the Follicular Phase, which hormone is dominant?

Answer 16

FSH

***stimulates the development of ovarian graffian follicles

***one of these follicles develops into a mature ova

***surge of LH causes this mature ova to be released from ovary

Question 17

What does the surge of LH do?

Answer 17

causes the mature ova to be released from ovary

Question 18

Why would the developing follicles produce estrogen and progesterone in large amounts?

Answer 18

these hormones prepare the endometrial lining of the uterus for implantation of a zygote

Question 19

When does ovulation occur?

Answer 19

14 + or - 2 days before next menstrual flow

Question 20

What sparks ovulation?

Answer 20

marked surge of LH and a smaller peak of estrogen

***when these hormones peak, ovulation occurs within 24-36 hrs

Question 21

Clinical signs of Ovulation

Answer 21

 BBT: sharp increase in body temperature.

 Vaginal mucus becomes thin and stretchable (spinnbarkeit).

 Cervical mucus Ph changes from acidic…to more alkaline.

 Mittelschmerz a subjective feeling of slight abdominal discomfort.

 Progesterone plasma level increases to about 3 mg/mL (about 3 days post ovulation)

Question 22

During the Luteal Phase, the corpus luteum secretes lots of Estrogen and Progesterone.

Which is dominant?

Answer 22

Progesterone

***peak about 8-10 days after ovulation, about the time a fertilized ovum would be implanted in the endometrium if pregnancy has occuredd

Question 23

Avg menstrual cycle is — days.

Answer 23

28

Question 24

Menstrual flow normally lasts –

Answer 24

4-7 days

Question 25

Therapeutic mgmt for Dysmenorrhea during menstruation?

Answer 25

Mild analgesics Hormonal therapy (birth control) Heating pad on abdomen Rest and mild exercises ****note: birth control is best unless trying to get pregnant

Question 26

Oral contraceptives may --- menstrual flow. IUDs may --- menstrual flow.

Answer 26

decrease increase

Question 27

S/S of Premenstrual Syndrome (PMS)

Answer 27

HA Bloating Tenderness and swelling of breasts Food cravings Depression Irritability

Question 28

--- is an early sign of pregnancy or can be a symptom of menopause or some pathology.

Answer 28

Primary Amenorrhea

Question 29

When is menopause diagnosed?

Answer 29

1 year after last menstrual period

Question 30

What is the transition period during which ovarian function and hormone production decline?

Answer 30

Climacteric

Question 31

What type of amenorrhea is this? reflects a problem in the central hypothalamic-pituitary axis so that hormone production is inadequate.

Answer 31

Hypoganoadotrophic Amenorrhea ****May also be related to stress or inappropriate body fat to lean ratio.

Question 32

Treatment for Dysfunctional Uterine Bleeding

Answer 32

Estrogen Therapy Danazol (synthetic testosterone)

Question 33

--- is tissue resembling endometrial tissue, but located OUTSIDE the endometrium in the pelvis.

Answer 33

Endometriosis ***painful

Question 34

Treatment for Endometriosis

Answer 34

Pain mgmt Hormonal antagonist to suppress endogenous estrogen/GnRH/FSH/LH Surgical intervention (TAHBSO)

Question 35

What triggers the Ovarian/Hypothalamus/Pituitary feedback mechanism?

Answer 35

Low blood levels of estrogen trigger the hypothalamus to start the menstrual cycle all over again. Hypothalamus secretes GnRH --> stimulates the pituitary gland --> Anterior Pituitary secretes FSH and LH --> stimulates a primary follicle on the ovary to begin maturing.

Question 36

Anterior Pituitary Hormones: --- causes the primary follicle to mature. --- surge causes the follicle to be released from surface of ovum.

Answer 36

FSH LH

Question 37

After ovulation, what is the follicle crater called? q

Answer 37

corpus luteum

Question 38

What is the function of the Corpus Luteum?

Answer 38

secretes copious amonts of estrogen and progesterone (progesterone is dominant)

Question 39

The Follicular Phase of the ovarian cycle corresponds with which phase of the endometrial cycle?

Answer 39

Proliferative ***both are preovulatory

Question 40

What hormone is dominant in the preovulatory stage (Follicular and Proliferative)?

Answer 40

Estrogen

Question 41

The ---- phase of the ovarian cycle and the secretory phase of the endometrial cycle occur simultaneously.

Answer 41

Luteal

Question 42

What hormone is dominant in the secretory phase?

Answer 42

progesterone

Question 43

Which stage of the endometrial cycle can support an implanted zygote?

Answer 43

secretory

Question 44

In what three places is the hormone estrogen produced?

Answer 44

Ovarian follicle Corpus Luteum Placenta

Question 45

Ovulation occurs at the end of which phases?

Answer 45

Proliferative (Endometrial Cycle) Follicular (Ovarian Cycle)

Question 46

Amenorrhea: Which circumstances should be evaluated?

Answer 46

1) absence of both menarche and secondary sexual characteristics by age 14 2) absence of menarche by age 16 3) 3 to 6 mth absence of menses after a period of menstruation

Question 47

Secondary Dysmenorrhea

Answer 47

acquired menstrual pain that develops later in life than primary dysmenorrhea, typically after age 25

Question 48

What are S/E of Danazol (synthetic testosterone)?

Answer 48

masculinizing traits (weight gain, edema, decreased breast size, oily skin, hirsutism, deep voice) amenorrhea hot flashes vaginal dryness insomnia decreased libido migraine dizziness fatigue depression

Question 49

Danazol is contraindicated in whom?

Answer 49

liver disease ***use w/ caution with cardiac and renal disease ***used less frequently b/c of side effects