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52 Cards in this Set
- Front
- Back
describe the time course of menstrual cycle
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1. follicular phase (approx 14 days), 2. ovulatory phase, 3. luteal phase (always 14 days b/c dependent on secretion of hCG to survive)
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describe GnRH pulsatile secretions and E2 feedback between follicular and luteal phase
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follicular phase: E2 positive feedback; GnRH is high freq/low amplitude; after LH surge, changes to E2 negative feedback to inhibit GnRH/LH/FSH and switch uterus to secretory phase; GnRH is low freq/high amplitude enough to sustain CL for 8-12d
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what components does the corpus luteum secrete
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E2 and prg
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how does hypothalamus switch by to positive E2 feedback
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after CL dies, drop in E2/prg levels switch to positive feedback > increase in GnRH pulse > increase LH/FSH > stimulate new follicles > secrete more E2
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explain how graafian follicle initiates LH surge
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follicle that has most FSH receptors becomes graafian follicle; in late stage, graafian follicle is very sensitive to FSH, and makes lots of E2 > LH surge
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describe coordination between theca/granulosa cells for estradiol secretion
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LH > theca > stimulate desmolase to convert cholesterol to androstenedione >> this diffuses into granulosa cell; FSH > granulosa > stimulate aromatase to convert weak androgen to estradiol
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what is effect of E2 on granulosa cells
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increase FSH receptors and stimulate granulosa cell proliferation
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describe formation of corpus luteum
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1. FSH induces expression of LH receptors on granulosa cells > LH surge causes leutinization of theca/granulosa cells > CL secretes E2/prg > inhibits GnRH pulsatile secretion
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what happens during overstimulation of GnRH receptors
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receptors downregulate through endocytosis, cascade inhibition, and GnRH receptor transcription downregulation
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what is the current treatment for precocious puberty and mechanism of action
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administer GnRH to downregulate receptors and keep hormones at pre-puberty levels
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describe effects of E2/prg on female reproductive system during follicular/luteal phase
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1. follicular phase > only E2 > uterus: proliferation, uterine contractions; cervix: muscles relax, watery secretion; fallopian tube: cilia beat towards uterus, oviduct contractions toward ovary; 2. luteal phase > E2 > uterine vasculature; prg > uterine secretory phase; cervix: hardens with thick mucus; inhibit uterine contractions
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what is the role of hCS (human chorionic somatotropin)
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secreted from trophoblast, stimulates placenta wall growth
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describe timing of fertilization to implantation
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1d fertilization, 3d oviduct transport, 1d wait in uterus
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what is the effect of E2 on endometrium
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maintains endometrium and promotes expression of oxytocin
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at what time is hCG detectable
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d8 of implantation
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describe changes in endometrium necessary for parturition from pregnancy to late-pregnancy
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during pregnancy, prg > E2 receptor, so prg inhibits uterine contractions; late-pregnancy, there is elevated E2 and estrogen intermediates, and E2 > prg receptors > removes the inhibition on uterine contractions
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what hormone stimulates expression of oxytocin receptors
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estradiol
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what hormone inhibits uterine contractions during pregnancy
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progesterone (prg)
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describe mechanism of parturition
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1. expression of oxytocin receptors on uterine wall increases toward end of pregnancy; high release of oxytocin toward end of pregnancy induces labor; 2. CRH-binding protein produced during pregnancy prevents CRH from acting, but CRH-BP drops near end of pregnancy > CRH binding and prostaglandin release stimulate uterine contractions
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explain premature birth and CRH
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premature births/labor tend to have lower CRH-BP
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describe the types of dysmorphology: 1. variation of normal, 2. minor malformation, 3. major malformation
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1. normal variation in human population, >4%; 2. <4%, cosmetic problem; 3. <4%, cosmetic and functional problem
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define malformation, deformation, dysruption
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malformation: primary defect due to genetic problem; deformation: caused by external force; dysruption: interruption of developmental process
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define association, sequence, syndrome
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association: most common cause of multiple problems, where two diagnoses found together more often than coincidence; sequence: initialy problem causes all the rest; syndrome: features that run together and have common cause
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pathogenesis of pierre robin sequence
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primary defect is small jaw > pushes tongue backwards > disrupts closure of hard palate > cleft palate
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what do abnormalities of the hand hint at
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possible problem with organs
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pathogenesis of phocomelia and one pharmacological cause
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malformation of long bones, causing short limbs; can be caused by thalidomide (sedative that inhibits angiogenesis)
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what is the most sensitive time period of development
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wk3 to wk8
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what is most common congential defect of the mouth
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cleft lip/palate
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what do abnormalities of the ear signify
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high association with renal problems
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clinical signs of kleinfelter
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long legs, short trunk
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clinical signs of marfan
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long arms
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clinical signs of neurofibramatosis
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1. lisch nodules; 2. cafe au lait spots --- NF is autosomal dominant
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how does hormonal contraception work
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high dose of E2/prg inhibit LH/FSH secretion > inhibit ovulation
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list some general classes of female contraceptive
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1. high hormonal E2/prg to inhibit GnRH and ovulation; 2. IUD to maintain cervix in inflammatory state > prevent implantation; 3. long-term implantation/injection
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list risk factors for hormonal contraceptives
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1. increase breast cancer; 2. increase BP, stroke, MI; 3. increase chance of forming blood clots
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effects of prg on endometrium
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thins endometrium and places it into hibernative state > reduced risk of cancers here
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what state is the egg cell at during ovulation phases
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primary oocytes frozen in prophase i > stimulation of follicles > only graafian follicle makes it out to stop at metaphase ii and become secondary oocyte
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explain sperm from cervix to egg
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sperm bind to fallopian tube to be capacitated > penetrate corona radiata and bind to zona pellucida
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describe proliferation of trophoblast upon implantation
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splits into two cell types; 1. cytotrophoblast is inner layer, contains the stem cells for outer layer; 2. syncytiotrophoblast invades endometrium via proteolysis, receives nutrients via diffusion
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decidual reaction generates what three layers from the endometrium
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1. decidua basalis, 2. decidua capsularis, 3. decidua parietalis
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describe generation of three cavity/sac in embryo
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1. embryonic disc makes a. epiblast (amnion) and b. hypoblast (yolk sac); 2. extraembryonic mesoderm invades lower part of the 'shell' to make the chronic cavity
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what tissue secretes hCG
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syncytiotrophoblast
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how is uteroplacental circulation established
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1. after chronionic cavity is developed, syncytioblast continues to erode endometrium and form lacunae, will reach radial arteries and blood will spill into lacunae; 2. cytotrophoblast grow primary villi into syncytioblast, extraembryonic mesoderm (lining chorionic cavity) grow into secondary villi, then mesoderm grows blood vessels into the villi and connect to fetus
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what compounds can pass through the placental membrane
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HIV, some viruses, alcohol, antibodies, hormones
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describe blood vessel system of umbilical cord
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two arteries carry low pO2 blood; one vein carry high pO2 blood
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define chorion frondosum and cotyledon
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chorion frondosum -- part of the decidua capsularis not fused with parietalis; cotyledon -- villus on chorion to increase surface area
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during development, what does each give rise to: 1. pronephros, 2. mesonephros, 3. metonephros
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1. rudimentary/non-functional kidney; 2. most degenerate except mesonephric duct (wolffian duct), paramesonephric duct develops laterally; 3. uteric bud from cloaca penetrates blastema
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where is lining of bladder/urethra derived from; where is muscle/connective tissue from
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endoderm, mesoderm
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where is cervix and vaginal plate derived from
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cervix -- mesoderm; vaginal plate -- endoderm
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how is the vaginal plate formed
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from fusion of paramesonephric ducts
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how is menopause defined
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amenorrhea for at least one year; decreased E2/prg due to progressive failure of ovarian function
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explain hormone replacement therapy (E2 and prg)
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ovaries stop making hormones; give E2 to replace lost estrogen, but also give prg to prevent uterus/endometrium from proliferating, otherwise E2-only increases risk of endometrial and breast cancer (but reduce risk of heart disease)
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