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63 Cards in this Set

  • Front
  • Back
What parts of the body make up the HPG axis?
hypothalamus
anterior pituitary
gonads
What are the steps leading to the release of the ovarian and testicular hormones?
hypothalamus synthesize and secrete gonadotropin releasing hormone (GnRH)
GnRH stimulates anterior pituitary to release luteinizing hormone (LH) and follicle stimulating hormone (FSH)
LH and FSH stimulate gonads to release ovarian and testicular hormones
What modulates the secretion of GnRH?
neural input form CNS
circulating gonadal hormones
What type of secretion does GnRH have?
pulsatile
Why dose secretion of GnRH have to be pulsatile?
pulsatile stimulate release of FSH and LH
nonpulsatile inhibit release of LH and FSH
What are the clinical uses of GnRH?
diagnostic studies to distinguish between hypogonism due to pituitary or hypothalamus
What am I:
a GnRH analog
longer acting
used for non-pulsatile secretion to inhibit release of LH and FSH?
leuprolide
What type of pituitary cells are LH and FSH produced from?
gonadotrophs
What hormone is produced by the placenta?
human chorionic gonadotropin (hCG)
What is leuprolide used for?
diagnosis of prostate and ovarian cancer
What chain (alpha or beta) do all 3 gonadotrpins have in common?
alpha chain
What chain (alpha or beta) is different in each gonadotropin?
beta chain
What chain of the gonadotropin provides specificity for receptor interactions?
beta chain
What type of receptors are gonadotropin receptors?
g protein coupled
Which gonadotropin receptor binds to LH and hCG?
LH receptor
What am I:
in women, stimulate growth of ovariam follicles
in men, regulate spermatogenesis
FSH
What am I:
in women, regulate production of estrogen and progesterone, is required for ovulation
in men, stimulates lefdig cells of testest to produce testosterone
LH
What is the clinical use of LH and FSH?
women: ovulation induction
men: treatment of infertility
What ovarian hormone does not have positive feedback?
progesterone
Where do ovarian hormones feedback to?
hypothalamus
anterior pituitary
What hormone is produced by ovaries?
progesterone and estrogen
What are the natural estrogens?
17-beta-estradiol
estrone
estriol
What natural estrogen is the most biologically active?
estradiol
What natural estrogen is formed in the liver on in the peripheral tissues of some androgen?
estrone
What natural estrogen is produced in large amounts during pregnancy by the placenta and the fetal adrenal glands - is not found in men?
estriol
What type of receptors are estrogen receptors?
nuclear receptors
there are 2 types
What are circulating estrogens mostly protein bound to?
alpha globulin
sex hormone binding globulin
albumin
How do estrogens become unbound (activated)?
metabolized to active metabolite in liver
undergo entero-hepatic cycling in small intestine
What are the synthetic estrogens?
ethinyl estradiol
estradiol valerate
What are the clinical uses of synthetic estradiol?
oral contraceptives - increase oral effectiveness when compared to natural estrogens
hormone replacement therapy
What is the mechanism of action of estrogen?
free estrogen diffuse across membrane and bind to ER-alpha or ER-beta in the nucleus or cytosol
ER-estrogen dimerize and bind to ERE to regulate target gene transcription/translation
What are teh CV and CNS effects of estrogen?
maintain blood vessel function
increase bone density
increase liver synthesis of coagulation factors
behavioral and mood effects
What are the side effects of estrogen therapy?
uterine bleeding
carcinogenic action
increased blood coagulation factors
What are the renal effects of progesterone?
competes with aldosterone at minercortocoid recepter
decrease sodium reabsorption
What are the synthetic progestins?
hydroxyprogesterone
medroxyprogesterone
L-norgestrel
desogestrel
What are the clinical uses of progestins?
contraceptives
hormone replacement therapy
What is the MOA of progesterone?
similiar to estrogen, but with PR-alpha, PR beta, PRE
What are the endometrial effects of progesterone?
decreases estrogen-driven endometrial proliferation leading to developement of secretory changes in endometrial cells
What are the CNS effects of progesterone?
increase basal body temp
causes drowsiness
What is the side effect of progesterone?
increase bp
synthetic progestins have adrogenic effects
What are the combination oral contraceptives?
ethinyl estradiol
L-Norgestril
Desogestrel
What is the mechanism of action of combination oral contraceptives?
inhibits FSH and LH from anterior pituitary resulting in inhibition of ovulation
What results from the chronic use of combination oral contraceptives?
depressed ovarian function
decrease ovarian size
What are the side effects of combination oral contraceptives?
Nausea
edema
headache
DVT/PE, MI, stroke in smokers
reduce risk of endometrial and ovarian cancers with estrogen alone
what are the progestrin only contraceptives?
L-Norgestrel
medroxyprogestrone
What is the MOA of progestin only contraceptives?
thickening of cervical mucus and endometrial changes
What are the side effects of progestin only contraceptives?
irregular/unpredictable bleeding
acne
headache
mood changes
weight gain
What am I:
hormone replacement therapy used for postmenopausal women with a uterus
estrogen + progestin
What is the benefit of using estrogen + progestrin?
reduce risk of estrogen-induced uterine cancer
What am I:
hormone replacement therapy used for postmenopausal women without a uterus?
estrogen alone
What is the benefit of using estrogen alone in women without a uterus?
risk of estrogen-induced uterine cancer no longer exist
What estrogens are used for hormone replacement therapy?
ethinyl estradiol
conjugated equine estrogen (Premarin)
True or False:
premarin is a prodrug that is converted into estradiol
True
What is the side effects of equilin and equilenin (minor forms of premarin)?
cytotoxins that cause DNA damage
cause cancer
What is the major form of premarin?
estrone
What testicular hormone is the main stimulus for LH secretion?
testoterone
How is testerone activated?
coverted to dihydor-testosterone by 5-alpha-reductase
coverted to estradiol by aromatase
What is the MOA of testosterone and DHT?
binds to androgen receptors (AR)
results in changed protein synthesis
What has a higher binding affinity to androgen receptors, DHT or testosterone?
DHT
What is required for the development and function of male reproductive organs and development of male secondary sexual characteristics?
testoterone and DHT
Testosterone effect is mediated through what hormone?
estradiol
What are the anabolic steroids?
alkylated androgens
methytestosterone
oxandrolone
nandrolone
What are the side effects of anabolic steroids?
diminished fertility
hepatic dysfunction