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46 Cards in this Set

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in female fetal development, since there are no androgens, what regresses that must be present for male genitalia to develop?
wolffian duct regresses since there is no testosterone (wolffian in male turns into male genitalia)
without ____________, the mullerian duct turns into what in the female?
antimullerian hormone from sertoli cells; the upper female reproductive tract
without hormone ______________, the external genitalia will appear female.
DHT (dihydrotestosterone); also a 5alpha reductase will cause external female genitalia (but that's an enzyme!)
what layer of the uterus is sensitive to estrogen and progesterone?
explain mitosis, meiosis I and II in the female.
mitosis occurs in a female fetus where there is a production of ~7M oogonia; then the 1st meiosis occurs at 8-9weeks of gestation and the oogonia are called primary oocytes. for each primary oocyte that goes undergoes meiosis, only one functional oocyte is produced. the other two or three cells produced are called polar bodies. at birth there are about 2M primary oocytes present which will decrease to about 400,000 just before puberty and then decrease even more with each cycle/ovulation. a follicle that is mature and about to ovulate is called a graafian follicle. meiosis II won't occur unless fertilization occurs.
explain what the ovarian follicle (reproductive unit) is made of.
contains a single oocyte (ovum/egg) with a layer of granulosa cells enclosed in a thin layers of extracellular matrix (basal lamina) = ovarian follicle; once it grows larger and is ready for ovulation it is called a graafian follicle
where does the oocyte get its estrogen from?
thecal cells produce androgens which get converted to estradiol after it flows into the granulosa compartment (since granulosa cells have aromatase activity)
the corpus luteum is the yellow body that is left over after the mature follicle is ovulated. what is it dependent on for survival? what does the corpus luteum secrete to maintain pregnancy?
LDL cholesterol; corpus luteum secretes progesterone that allows the pregnancy to continue
what hormone is higher in the system, estrogen or progesterone?
progesterone is always higher; its just that estrogen has more active receptors
there are two cycles to describe the female menstrual cycle. what are they and what do they describe?
OVARIAN CYCLE: has a follicular phase (describes what happens to the oovum) and a luteal phase (maintains progesterone levels in case of fertilization and implantation); ENDOMETRIAL CYCLE: describes the menstrual, proliferative, and secretory phases (describes the endometrial lining changes)
starting with menses, name the phases and the days that coorespond to the endometrial cycle.
1) menstrual cycle (day 1-5); 2) proliferative phase (5-14); 3) secretory phase (after ovulation ~day 15 - day 28)
what hormone surges to stimulate ovulation?
estradiol increases stimulates LH surges around day 11-13; then estradiol has negative feedback on GnRH to reduce LH and FSH
what hormone is the highest during the secretory phase?
progesterone (lots from corpus luteum)
in what phase is estradiol highest?
spikes with LH surge around pre-ovulation and in the secretory phase
changes in what hormones cause menses?
decrease in estradiol and increase in FSH
what is the purpose of the corpus luteum and what is it made of? what happens if no fertilization occurs?
provides progesterone necessary for implantation of the zygote into the uterus. made of 80% granulosa cells (FSH stimulates to convert androgens (from thecal cells) to estradiol by aromatase) and 20% thecal cells; if its not fertilized it will regress in about 14 days and form a scar (corpus albicans)
in what endometrial phase is the uterine lining the thickest?
secretory phase
what endometrial phase does sloughing occur?
menstrual phase
what two factors do the granulosa cells make that either negatively or positively feedback to the anterior pituitary?
FSH stimulates the granulosa cells to produce either inhibin (negative feedback) or activin (positive feedback) to AP - this will decide whether to secrete more FSH
what is needed to convert cholesterol to prenenolone in the production of steriod hormones?
Side Chain Clevage (type of desmolase)
there are 3 types of estrogens in the female at different times in the lifespan. Explain each of them.
E1(estrone - a metabolite of 17B-estradiol): primary estrogen during menopause (results from the conversion of adrostenedione (from adrenals) converted by aromatase); E2(17B-Estradiol) pre-menopausal: occurs from conversion of testosterone -> estradiol by aromatase; E3(estriol): during pregnancy (conversion of androstenedione into E3 by aromatase - to elimate estrogen so fetus doesn't get too much estrogen; neonatal androgenation - disruption of normal cycling of GnRH)
what does estradiol do to the body (outside of the repro system)?
fat deposition (subc fat in women - hips, thighs, breast); increase vascularization of skin; increase in bone density (estrogen causes decreased osteoclastic activity)
what does estradiol do to the female sex organs?
at puberty, it increases the size of the fallopian tubes, uterus and vagina, external genitalia deposition of fat in the mons pubis; the epithelium changes from cuboidal to stratified squamous; proliferation of cells and endometrial glands; thinning of cervical mucous (progesterone will cause a thick cervical mucus)
what type of receptors does estrogen have and what are the acute molecular effects of estrogen?
nuclear receptors alpha and beta; acutely, they increase intracellular calcium, stimulate Nitrous oxide system to produce vasodilation; upregulates synthesis of estrogen and progesterone receptors; also an antioxidant
what progesterone receptor antagonist causes abortion and inhibits hyperhydrocortisolism?
define puberty.
transition from noncyclic, relatively quiescent reproductive endo system to a reproductive state that is cyclic. it begins with pulsatile GnRH/LH secretion during REM sleep
what determines age at puberty?
genetics, nutrition, geographic location, exposure to light, body composition, fat deposition, exercise (menarche has been occurring earlier in US and EU in the past few decades - i think increase in fat and hormones in diet); distance from the equator, higher altitudes: early onset
Name the 4 phases in the female sexual response.
1) excitement phase (parasymp. NO regulated); 2) plateau phase (increase HR, BP, respiratory rate, muscle tension) 3) orgasmic phase 4) resolution phase (faster than men's phase) don't require refractory time
FSD (female sexual dysfxn) may be as high as 45% with many mechanisms. name some treatments.
counseling, testosterone, viagra, avlimil (herbs- licorice, sage, black cohosh root, capsicum pepper, isoflavones)
There are many methods of contraception in females. explain the rhythm method.
calculating ovulation (day 13-15); temperature decreases and then increases slightly following ovulation. mucus discharge changes
There are many methods of contraception in females. explain oral estrogens and progestins.
the Pill is usually a combo of estrogens and progestins: ESTROGENS: (maintence) decrease androgenic effects, suppress GnRH, FSH, LH- prevent ovulation; PROGESTINS: increase cervical mucus and inhibit motility of sperm and the endometrium is not conducive to implantation
There are many methods of contraception in females. explain implant contraceptives.
norprogestins or "norplant" high dose progestins; last 5 years (goes under skin in the arm)
There are many methods of contraception in females. explain Depoprovera, IUD, and barrier methods.
Depo: shot, lasts 3 months, inhibits ovulation, implantation; IUD: small T device that is implanted in the uterus that prevents implantation of a zygote; BARRIER METHOD: diaphragm with spermidcidal jelly; condoms
There are many methods of contraception in females. What is a postcoital contraceptive?
RU-486 is used within 72 hours of unprotected sex; won't allow implantation into the uterus
Define Menopause.
ovaries become obsolescent; no estradiol production; no period for 12 months; average age 51.4; exogenous steroids can cause premature menopause
explain the HERS study. what does it stand for?
HERS: Heart and Estrogen/progestin Replacement Study: study looked at secondary prevention of CHD with estrogen replacement; study was 4.1 years duration; in first year, significant increase in coronary events; NO OVERALL DIFFERENCE in CHD endpoints with HRT or placebo over 4.1 yrs
WHI (women's health initiative) agrees with the HERS study in saying...
"HRT regimen should not be initiated or continued for primary prevention of CHD"
WHat are SERMs?
Selective Estrogen Receptor Modulators have both agonistic and antagonistic effects depending on tissue (ie. raloxiphene and tamoxiphen - anti-estrogen for Breast CA; actually a weak estrogen that inhibits the more active estrogen)
name the term that refers to fibroids in the uterus; its a smooth muscle tumor that is estrogen dependent.
Name the term that refers to uterine tissue outside the uterus.
endometriosis (painful, responds to E2(estradiol) Tx: give GnRH continuously to downregulate GnRH receptors but causes hypoestrogenism
what is the condition that is characterized by an acute, life-threating illness caused by menstrual(tampons, barrier contraceptives) and non-menstrual methods(burns, insects, wounds).
TOXIC SHOCK SYNDROME;the cause are exoproteins produced by staphyllocus A or B
name the clinical symptoms that are associated with Toxic Shock syndrome.How would you treat it?
hypotension, rash, multiorgan dysfunction (renal, myocardial), desquamation (flaking of the skin); Treat with: antibiotics (po or IV), drain wound, give fluids and vasopressors for hypotension
what is the genotype and phenotype of turner's syndrome?
XO, female phenotype; one sex chromosome being biologically active; ovary needs both active XX chromosomes - get streak gonads; normal until puberty
what causes hyperprolactinemia?
lack of suppressive dopamine on the anterior pituitary; increase in TRH (hypothyroid pt) can also cause prolactin release
what are the clinical manifestations of hyperprolactinemia on the male and female?
Female: 30-80% galactorrhea, menstrual irregularity, infertility; MEN: <30% galactorrhea, impotence, visual field abnormalities, headache, extraocular muscle weakness, anterior pituitary malfunction
clinically, how would a woman present with polycystic ovarian syndrome and describe it?
it is an insulin resistant problem; over production of androgens; pts present with acne and hirsutism