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62 Cards in this Set
- Front
- Back
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What are types of contraception? (9) |
fertility awareness male methods vaginal methods hormonal--combined, progesterone only, injectables/implants intrauterine permanent post-coital |
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What is the Pearl Index? |
failure rate = total accidental pregnancies x 1200 / total months exposure (per 100 woman years) |
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What are ovum and sperm fertilisability? |
ovum--12-14 hours sperm 3-4 dyas (up to 7) |
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What is the mechanism of lactational amenorrhoea? |
sudden fall in oestrogen and progesterone allows lactogenic effect of prolactin by decrease in dopamine inhibition |
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What are the 3 main mechanisms of action of the combine oral contraceptive pill? |
1) oestrogen blocks follicular maturation and LH surge 2) decreased sperm penetrability of cervical mucous 3) decreased blastocyst receptivity of endometrium |
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What are the main effects of the progesterone only pill? |
main effects on cervical mucous and endometrial receptiveness |
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What is the mechanism of action of depoprovera? |
inhibits follicular activity |
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What is the mechanism of action of implanon? |
ovulation inhibition cervical mucous blocking |
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What is the mode of action of IUDs? |
main inhibits fertilisation implantation blocking copper is anti-sperm |
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What cells produce testosterone in males? |
leydig cells |
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what cells make antimullerian hormone which causes regression of ipsilateral Mullerian ducts? |
sertoli cells |
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What is each half of the scrotum lined by? |
tunica vaginalis |
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What is the pathway of sperm? |
seminiferous tubules --> efferent ductules --> epididymus --> vas deferens --> ejaculatory duct |
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What acts on leydig cells to produce testosterone? |
GnRh Lh |
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What does FSH do in males? |
stimulates Sertoli cells to produce androgen binding protein that draws testosterone into the seminiferous tubules |
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What negatively feedsback on LH? what are the implications? |
testosterone excess testosterone reduces sperm count |
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Where are sperm stored? |
cued of the epididymous and the ampulla of the vas |
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What is the progression of spermatogenesis and spermatogenesis from spermatogonia to spermatazoa? |
spermatogenesis spermatogonia --> primary spermatocyte --> secondary spermatocyte spermiogenesis spermatid --> spermatozoa |
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What are the stages of fertilisation of the oocyte starting with capacitation? |
capacitation--function & structural changes in sperm hyperactivated sperm acrosome reaction--influx of Ca into sperm fusion of sperm with oocyte cortical reaction--block to polyspermy completion of meiosis induced pronuclei fuse (syngamy) |
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Describe implantation |
--fertilised ovum-->zygote --slow cleavage in tube --surrounded by thick zone pellucid --morula inter uterus on day 3 --blastocyst on day 4-5 --implantation on day 6-7 |
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What does the inner cell mass of a blastocyst form? |
embryo |
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What forms the placenta and membranes? |
trophectoderm |
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What is apposition? |
initial adhesion to uteriine wall |
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what is adhesion? |
increased contact with uterine epithelium after appostition |
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what is invasion? |
penetration and invasion |
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What layer does the trophoblast invade in uterus for placental development? |
inner third of myomeetrium |
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What produces hCG |
mostly from synctiotrophoblast |
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What pregnancy hormone is diabetogenic? |
human placental lactogen |
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What hormone is important in controlling metal lung maturation and the timing of birth? |
placental ACTH |
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What relaxes the myometrium and causes pelvic aching? |
relaxin |
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What takes over from the ovary for progesterone production? |
placenta |
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What are the issues to consider in infertility? |
sex--2-3xs per week from day 10 of cycle sperm ovulation tubes/endometriosis pre-pregnancy counselling |
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What is Klinefelter's? |
47XXY |
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How is anovulation treated? |
progesterone withdrawal then clomiphene |
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How is prolactinoma treated? |
bromocryptine-->dopamine agonist |
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Name some IVF prognostic factors (7) |
Age ovarian reserve--FSH levels, AMH level, Antral follicle count smoking submucosal fibroids removal of hydrosalpinges |
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What is microinjection/intra cytoplasmic sperm injection used for? |
successful for treating male sub fertility low sperm count poor motility testicualr sperm |
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Describe the progression through the ovary cycle of the follicle |
primordial follicle --> primary follicle --> secondary follicle --> antral follicle -->dominant follicle |
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What triggers ovulation? |
rapid increase in estradiol level which is no longer inhibitory at pituitary positive feedback to generate LH surge |
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What is the luteal phase? |
progesterone dominant phase transient drop in oestrogen if no pregnancy, corpus lute regresses with drop in hormone production and blood supply if pregnancy, hCG replaces LH to stimulate lutein cells |
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What causes menstruation? |
progesterone levels drop and glands collapse spiral arteries constrict leading to local ischaemia |
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define amenorrhoea |
absent menses |
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define oligomenorrhoea |
infrequent > 35 days |
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define polymenorrhoea |
frequent <24 days |
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define metrorrhagia |
irregular intervals |
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define menorrhagia |
abnormally long >7 days heavy >80 mL |
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define dysfunctional uterine bleeding |
anovulatory bleeding |
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Endometrial responses to steroid hormones estrogen/progesterone withdrawal |
end of ovulatory cycle cyclic HRT or combined oral contraceptive pill |
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Endometrial responses to steroid hormones estrogen withdrawal |
mid cycle bleed after ovulation neonatal menstruation |
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Endometrial responses to steroid hormones estrogen breakthrough |
chronic anvolution with unopposed oestrogen stimulation |
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Endometrial responses to steroid hormones progesterone withdrawal |
progesterone withdrawal test prior to ovulation induction with clomiphene cyclical progesterone for endometrial protection for prevention of uterine cancer in anovulatory women |
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Endometrial responses to steroid hormones progesterone breakthrough |
deptroprovera breakthrough bleeding on combined pill |
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in pregnancy what is the increased uterine mass due to? |
hypertrophy not new myocytes |
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What up regulates nitric oxide in pregnant women to mediate vasodilation? |
estradiol |
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What is the cause of increased cardiac output? |
fall in systemic vascular resistance mainly increased stroke volume (increased contractility), but also increased heart rate |
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Why does haemoglobin concentration fall in pregnant women? |
blood volume increases by more than red cell mass |
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What acts centrally to increase sensitivity to CO2? |
progesterone |
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define menopause |
permanent cessation of menstrual cycle |
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define perimenopause |
from first clinical/biological/endocrinological features of approaching menopause |
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define menopause transition |
period of time prior to menopause when variability in cycle is increased |
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define climacteric |
phase of life encompassing transition from reproducing to non-reproductive state puberty and menarche climacteric and menopause |
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menopause transition average age of onset age range of 95% of women average duration duration for 95% of women |
average age of onset 46 age range of 95% of women 39-51 average duration 5 years duration for 95% of women 2-8 years |
