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Reproductive
FA complete review part 2 Physiology
| Question | Answer |
|---|---|
| What is the source(s) of Estrogen? | Ovary, placenta, and adipose tissue |
| Which type of estrogen is produced by the ovaries? | 17B-estradiol |
| What form of estrogen is produced by the placenta? | Estriol |
| Type of Estrogen produce by adipose tissue | Estrone via aromatization |
| What process is necessary for adipose tissue to produce estrogen in the form of estrone? | Aromatization |
| 17B-estradiol is produced by the _______________. | Ovaries |
| The from Estriol (of estrogen) is produced by the ______________. | Placenta |
| Which is the form of estrogen with the greatest potency? | Estradiol |
| Which source of estrogen produces the estrogen with the highest potency? | Ovaries as they produce estradiol |
| Estradiol > Estrone > estriol | Potency of estrogen from highest to lowest |
| List of functions of Estrogen: | 1. Development of genitalia and breast, female fat distribution 2. Growth of follicle, endometrial proliferation, and increased myometrial excitability 3. Upregulation of estrogen, LH, and progesterone receptors; Feedback inhibition of FSH and LH, then LH surge; stimulation of prolactin secretion 4. Increase transport proteins, SHBG; Increase HDL; decrease LDL |
| How is Estrogen related to structures and proliferations associated with viable pregnancy environment? | It promotes the growth of the follicle, Promotes endometrial proliferation Incrases myometrial excitability |
| Which receptors are upregulated by Estrogen? | Estrogen, LH, and progesterone receptor |
| Estrogen's feedback inhibition of FSH and LH causes ---> | LH surge |
| Effect of estrogen on prolactin | Stimulation of prolactin secretion |
| Increasing levels of estrogen have what effects on HDL and LDL? | Increases HDL and decreases LDL |
| What occurs to estradiol and estrone levels during pregnancy? | Increases a 50-fold |
| Which type of estrogen is used as an indicator of fetal well-being? | Estriol |
| How are estriol levels affected by pregnancy? | Increase in 1000-fold |
| Where in the cell are estrogen receptors located? | Cytoplasm |
| What are the common sources for progesterone? | Corpus luteum, placenta, adrenal cortex, and testes. |
| What are the functions of Progesterone? | 1. Stimulation of endometrial glandular secretion sand spiral artery development 2. Maintenance of pregnancy 3. Decrease myometrial excitability 4. Production of thick cervical mucus, which inhibits sperm entry into uterus 5. Increase body temperature 6. Inhibition of gonadotropins (LH, FSH) 7. Uterine smooth muscle relaxation 8. Decrease estrogen receptor expression 9. Prevents endometrial hyperplasia |
| The fall of progesterone after delivery causes: | Disinhibits prolactin lead to lactation |
| Lactation is due to: | Fall of progesterone after delivery causes disinhibition of prolactin |
| Increased levels o progesterone is indicative of? | Ovulation |
| Ovulation will be indicated by an increase in ______________ levels. | Progesterone |
| Progesterone is Pro----- | ProGESTATION |
| Prolactin is Pro ------ | Pro-LACTATION |
| Which hormones causes stimulation of endometrial glandular secretions and spiral artery development? | Progesterone |
| Which hormone maintains pregnancy? | Progesterone |
| The production of thick cervical mucus by progesterone is to: | Prevent sperm entry into the uterus |
| Which cholesterol derived hormone increases body temperature? | Progesterone |
| How does progesterone prevent contractions? | Uterine smooth muscle relaxation |
| Which hormone causes a decrease in estrogen receptor expression? | Progesterone |
| ________________ preventes endometrial hyperplasia. | Progesterone |
| Progesterone cause inhibition of _______________________. | Gonadotropins (LH and FSH) |
| Primary oocytes begin and complete formation during __________. | Meiosis I |
| At which phase are Primary Oocytes arrested? | Meiosis I Prophase I |
| Secondary oocytes are arrested in ------> | Meiosis II Metaphase II until fertilization |
| Meiosis I prophase I has | Primary oocytes |
| Meiosis II metaphase II has | Secondary oocytes |
| What needs to happen to a secondary oocyte in order to finish its maturation? | Fertilization |
| What is the N and C composition of a Primary Oocyte? | Diploid (2N, 4C) |
| What is the number of sister chromatids in a Primary Oocytes? | 46 sister chromatids |
| What needs to occur to a primary oocyte in order to advance from Meiosis I prophase I to become a secondary oocyte? | Ovulation |
| Number of sister chromatids in a secondary oocyte? | 23 |
| 1N, 2C describes the composition of what stage of oogenesis? | Secondary oocyte |
| Primary oocytes are _____________. | Diploid |
| Secondary oocytes and Ovum are ______________. | Haploid |
| How many polar bodies are seen in stage of a secondary oocyte? | 1 Polar body |
| Secondary oocyte is fertilized. It undergoes further maturation. What is the final number of polar bodies produced? | A total of 3 polar bodies |
| In respect to oogenesis, a 1N, 1C describes what stage? | Ovum |
| What is ploidy? | Number of complete sets of chromosomes in a cell |
| How many complete sets of chromosomes are in a diploid cell? | 2 |
| How many possible different autosomal alleles can be produced by a diploid organism? | 2 |
| What does the letter "N" in 2N, 4C mean? | Two homologous (diploid) unreplicated chromosomes |
| In connotation "2N, 4C", what does the 4C mean? | C= number of sister chromatids. Thus, 2 sets of homologous chromosomes with 2 sister chromatids each = 4C |
| Mnemonic for phases of Mitosis | I Party More At The Club |
| Ovulation is the---> | Rupture of follicle |
| Term used for rupture of follicle after LH surge | Ovulation |
| Path of Ovulation process | Increased Estrogen and GnRH receptors on anterior pituitary lead to LH surge (release) ----> ovulation |
| What is a common features of ovulation, that is progesterone induced? | Increase in temperature |
| What is Mittelschmerz? | Transient mid-cycle ovulatory pain |
| Mid-cycle ovulatory pain. Dx? | Mittelschmerz |
| Mittelschmerz is often confused with _________________. | Appendicitis |
| What causes peritoneal irritation, leading to Mittelschmerz? | Follicular swelling/rupture, fallopian tube contraction |
| How long is the Luteal phase in days? | 14 days |
| Ovulation day + 14 days = | Menstruation |
| Which menstrual cycle phase can vary in length? | Follicular phase |
| Which week of the menstrual cycle represents the fastest follicular growth? | 2nd week of follicular phase |
| What hormone is known to stimulate endometrial proliferation? | Estrogen |
| _______________ maintain endometrium to support implantation. | Progesterone |
| Which hormone is known to create environment suitable for implantation? | Progesterone |
| A decrease in progesterone leads to a decrease in ----> | Fertility |
| What hypothalamic hormone stimulates the anterior pituitary to secrete LH and FSH? | GnRH |
| Anterior pituitary hormones associated strongly with the menstrual cycle? | FSH and LH |
| The Menstrual cycle can be divided into two main sub-cycles, which are? | Ovarian cycle and the Uterine cycle |
| Which are the phases of the Ovarian cycle? | Follicular phase and Luteal phase |
| What are the phases of the Uterine cycle? | Menses, Proliferative, Secretory, and back to Menses |
| Initial menses and Proliferative phase of the uterine cycle, occurs at the same time as which ovarian phase? | Follicular phase |
| The Luteal phase is during which uterine cycle phase? | Secretory phase |
| How long would the Uterine Secretory phase is ? | 14 days approximately |
| At what point of the Uterine cycle are the Spiral arteries the longest/largest ? | Mid-secretory phase |
| Which Uterine phase has the smallest or less dense Spiral arteries along the endometrium? | Early proliferative phase |
| At what point of the menstrual cycle, approximately, is Estrogen at its highest level, with respect to the Ovarian/Uterine cycles? | Late Follicular phase of Late Proliferative Uterine phase |
| On what day of the menstrual cycle does ovulation occur? | 14th |
| What is produced (hormone) by the developing follicle in the early Follicular stage? | Estrogen |
| On what follicular phase are corpus luteum found or present? | Luteal phase |
| What is the last form of the follicle, after the Luteal phase? | Corpus albicans |
| Progesterone levels are at its highest during which point of the menstrual cycle? | Mid Luteal phase (or mid Uterine secretory phase) |
| What does AUB/HMB mean? | Abnormal Uterine Bleeding/Heavy Menstrual bleeding |
| AUB/IMB means? | Abnormal Uterine Bleeding/ IntraMenstrual Bleeding |
| What are the two categories of causes of Abnormal Uterine bleeding? | Structural and Non-structural |
| What are the Structural causes of abnormal uterine bleeding? | PALM: Polyp, Adenomyosis, Leiomyoma, or Malignancy/hyperplasia |
| What are the Non-structural causes of Abnormal uterine bleeding? | COEIN: Coagulopathy, Ovulatory, Endometrial, Iatrogenic, Not yet classified |
| What are terms to describe abnormal uterine bleeding, not longer recommended? | Menorrhagia, oligomenorrhea, or dysfunctional uterine bleeding |
| Where is the MC site for Fertilization? | Upper end of Fallopian tube (the ampulla) |
| Where is the ampulla in terms of fertilization location? | Upper end of the Fallopian tube |
| How long after ovulation does fertilization occurs? | Within 1 day |
| How many days afer fetiizaton does implantation occurs? | 6 days |
| Common site for implantation after fertilization | Within wall of the uterus |
| What hormone is secreted by Syncytiotrophoblasts and is detectable in blood after 1 week from conception? | hCG |
| hCG is detected in blood after ___________________. | A week since conception |
| How long after conception can hCG be detected in urine? | 2 weeks after conception |
| A home pregnancy test can be used as early as? | 2 weeks after conception |
| How is Gestational age calculated? | From date of last menstrual period |
| Calculated from date of last menstrual period | Gestational age |
| Calculated from date of conception | Embryonic age |
| Gestational age - 2 weeks = | Embryonic age |
| How is Cardiac output adapted in pregnancy? | Increased by increasing preload and decreased afterload, with increased HR |
| List of physiologic adaptations during pregnancy? | - Increase in cardiac output - Anemia - Hypercoagulability - Hyperventilation |
| During which weeks of pregnancy, does the hCG peaks? | 8-10 weeks |
| Which hormone secretion increases over the course of pregnancy? | Placental hormone |
| What is the reason that a pregnant woman experiences hyperventilation as an physiological adaptation? | Eliminate fetal CO2 |
| How is anemia created in a pregnant person? | Increase in plasma cells and decrease in RBCs |
| What is the main source of human chorionic gonadotropin? | Syncytiotrophoblast of placenta |
| What is the hCG function in relation to the 8 to 10 weeks of pregnancy? | Maintain corpus luteum by acting like LH |
| hCG has identical _____ subunit to LH, FSH, and TSH. | alpha-subunit |
| Which is the subunit that differentiates hCG from LH, FSH, and TSH? | beta-subunit |
| Which hormones shared identical alpha subunit with hCG? | LH, FSH, and TSH. |
| Reason a pregnant woman may develop hyperthyroidism? | Elevated levels of hCG, which may mimic TSH. |
| What does a pregnancy test detect ? | B-subunit of hCG |
| What are conditions that present with elevated hCG? | 1. Multiple gestations 2. Hydatidiform moles 3. Choriocarcinomas 4. Down syndrome |
| An decreasing level of hCG may indicate : | Ectopic/failing pregnancy, Edwards syndrome, and Patau syndrome |
| Which trisononimes are associated with low levels of human chorionic gonadotropin? | Edwards syndrome and Patau syndrome |
| Which common trisomy is associated with a high level of hCG? | Down syndrome |
| What is another name for Human Placental lactogen? | Chorionic somatomammotropin |
| Source of human placental lactogen | Syncytiotrophoblast of placenta |
| What is the main function of human placental lactogen? | Stimulates insulin production; overall increase insulin resistance |
| What is the consequence of maternal hypoglycemia? | Due to insulin resistance it leads to lipolysis, which preserves available glucose and amino acids for the fetus. |
| How is Gestational diabetes developed? | Occur if maternal pancreatic function cannot overcome that insulin resistance |
| Insulin resistance in pregnancy is related to which hormone? | Human placental lactogen |
| Two very important hormones produced by the Syncytiotrophoblast of placenta? | 1. human chorionic gonadotropin (hCG) 2. human placental lactogen |
| What is the APGAR score criteria based on? | A. appearance P. pulse G. grimace A. activity R. respiration |
| Assessment of newborn vital signs following delivery via a 10-point scale evaluated at 1 minute and 5 minutes. | APGAR score |
| Pink appearance has how many points in APGAR grading? | 2 |
| Pale or blue baby has a _____ score on appearance in APGAR scoring. | 0 |
| How many points are given to newborn with blue extremities only, in the appearance assessment in respect to APGAR score? | 1 |
| APGAR scores are from ____ to ___. | 0----2 |
| What is APGAR score requires further evaluation? | < 7 |
| What is the criteria in Grimace? | 2 points ---> Cries and pulls away 1 point ------> Grimaces or weak cry 0 point ----> No response to stimulation |
| In order to get a 2 point score in Pulse APGAR, the HR must be? | > 100 |
| Pulse APGAR score 0, it means? | No pulse |
| A HR of 89 bpm in newborn, will give how many APGAR points? | 1 point |
| What is a risk of low APGAR scores event after 5 minutes? | Long-term neurologic damage |
| No breathing gives how many APGAR score points? | 0 |
| What is the type of respiration description that will give 1 APGAR point? | Slow, irregular breathing |
| Newborn has arms and legs flexed. How many points are given in the APGAR scale? | 1 point |
| A child that does not regularly meet standard milestones is a candidate for? | Assessment for potential developmental delay |
| What age range is considered an infant? | 0-12 months |
| When is a human considered a toddler? | 12-36 months |
| Time range for Preschool age? | 3-5 years |
| What are the main 3 categories into milestones are divided? | Motor, Social, and Verbal/Cognitive |
| What are the primitive reflexes in an infant? | 1. Moro 2. Rooting 3. Palmar 4. Babinski |
| At what month is Moro reflex commonly disappeared? | 3 months |
| When is the approximate time in which the primitive rooting reflex disappear? | 4 months |
| Which primitive reflex is loss approximately at 6 months of age? | Palmar reflex |
| Which primitive reflex is lost/disappear at 3 months of age? | Moro reflex |
| Babinski sign is often present up to the _______ month of life. | 12 |
| When is the Babinski sign expected to disappear? | 12 month |
| If a baby has intact Rooting reflex, it means he or she was born how long ago? | Less than 4 months ago |
| What are milestones that test/evaluate posture? | 1. Lifts head up prone 2. Rolls and sits 3. Crawls 4. Stands 5. Walks |
| An infant is approximately how old to lift the head up prone? | 1 month |
| A baby is able to rolls and sits at what age? | 6 months |
| At point is an infant should start crawling? | 8 months |
| A baby that just started standing up, what is the approximate age? | 10 months |
| Normal age to start walking of an infant? | 12-18 months |
| Age of an infant passes a toys hand to hand? | 6 months |
| Pincer grasp is seen with: | 10 months |
| A baby starts pointing objects at what age? | 12 months |
| Social smile is seen at: | 2 months |
| Stranger anxiety is seen at: | 6 months |
| Separation anxiety is evident at what age? | 9 months |
| What is the approximate age in months in which a baby starts orientein to voice? | 4 months |
| Orients to voice | 4 months |
| Milestone. Oriented to name and gestures. Age? | 9 months |
| Milestone. Age of human in which there is object permanence? | 9 months |
| By what age, should parents may expect child to say "mama" and "dada"? | 10 months |
| What are motor milestones seen in a Toddler? | 1. Takes first steps - 12 mo 2. Climbs stairs - 18 mo 3. Cubes stacked 4. Cutlery - feeds self with fork and spoon by 20 mo 5. Kicks ball - 24 mo |
| What motor activity may be seen around 2 years old? | Kicks ball |
| What is the recreation part of a toddler milestones? | Parallel play by 24-36 months |
| At which stage of development of human, is rapprochement presented? | 24 month toddler |
| By what age does a human recognizes or realizes its own gender? | 36 months |
| How many words are usually known by a toddler? | 200 words by age 2 years |
| How old is a human that starts driving a tricycle? | 3 years old |
| By what age can a person stant copying lines or circles, and draws stick figures? | 4 years old |
| What can be expected, in motor milestones, by age 5? | Grooms self |
| Age by which a person begins having friends? | 4 years old |
| What age can a mother leave comfortably spends part of the day away from her? | 3 years old |
| A child telling a story with details may be expected how old to be? | 4 years old |
| A person with a vocabulary approximately 1000 -word extensive, is around what age? | 3 years old |
| How many grams define a low birth weight? | 2,500 grams |
| What are common causes of a low birth weight? | Prematurity and intrauterine growth restriction (IUGR) |
| What is a common event/action occuring after parturition and delivery of placenta? | Lactation due to rapid decrease in progesterone |
| Maintenance of lactation is due to: | Suckling, since increase nerve stimulation leads to increase oxytocin and prolactin secretion. |
| What is the function of Prolactin? | Induces and maintains lactation and decrease reproductive function |
| What are the functions of oxytocin? | 1. Assist in milk letdown 2. Promotes uterine contractions |
| Until what age is breast milk the ideal nutrition? | < 6 months of age |
| Breast milk contains: | Maternal immunoglobulins (mostly IgA), macrophages, and lymphocytes. |
| What conditions are less likely to occur to infant that is fed with Breast milk? | Decrease risk to develop asthma, allergies, diabetes mellitus, and obesity. |
| What is recommended to supplement children exclusively breast milk fed? | Vitamin D and Iron |
| What are the benefits to the mothers that breastfeed? | Decrease maternal risk of breast and ovarian cancer and facilities mother-child bonding. |
| How is menopause diagnosed? | Amenorrhea for 12 months |
| Decrease Estrogen production due to age-linked decline in number of ovarian follicles + amenorrhea for 12 months. Dx? | Menopause |
| What is the average age for menopause? | 51 years old |
| What activity tends to anticipate age onset for menopause? | Smoking |
| What occurs with the peripheral Estrogen (estrone) after menopause? | Converts into androgen, which elevated levels of androgen leading to hirsutism. |
| Which hormone is severely increased in menopause? | FSH |
| What are the hormonal changes in Menopause? | Decrease estrogen Mild increase in LH and GnRH Significant/Large increase in FSH |
| Which hormone is decreased in levels in menopause? | Estrogen |
| Does estrogen increase or decrease with menopause? | Decrease |
| What symptoms are seen with Menopause? | Hot flashes, Atrophy of the Vagina, Osteoporosis, Coronary artery disease, Sleep disturbances. |
| What is suggested by menopause before the age of 40? | Primary Ovarian insufficiency (premature ovarian failure) |
| Common androgens: | Testosterone, dihydrotestosterone (DHT), androstenedione |
| What form or type of androgen is the one with the highest potency? | DHT |
| Potency of androgens (highest low lowest)? | DHT > testosterone > andorstenedione |
| What are the sources of androgens? | - Testis --> DHT and testosterone - Adrenal - androstenedione |
| List of functions of testosterone: | 1. Differentiation of epididymis, vas deferens, seminal vesicles 2. Growth spur: penisn, seminal vesicles, sperm, muscle, RBCs 3. Deepening of voice 4. Closing of epiphyseal plates 5. Libido |
| What are the early DHT functions? | Differentiation of penis, scrotum, and prostate |
| What are the late DHT functions? | Prostate growth, balding, sebaceous gland activity |
| What enzyme converts testosterone to DHT? | 5a-reductase |
| What medication inhibits 5a-reductase? | Finasteride |
| Inhibition of 5a-reductase prevents: | Conversion of testosterone into DHT |
| How are androgens converted into estrogen in males? | By cytochrome P-450 aromatase in adipose tissue and penis primarily. |
| What is the key enzyme in the conversion of androgens to estrogen? | Aromatase |
| Aromatase is the key enzyme of: | Converting androgens into estrogen |
| Which "type" of testosterone is inhibited by Exogenous testosterone? | Intratesticular testosterone which leads to decrease testicular size and eventually azoospermia. |
| Testosterone helps differentiation of _______________ male genitalia. | Internal |
| What is the only internal male sexual organ not differentiated by Testosterone? | Prostate |
| When does spermatogenesis begins? | At puberty |
| How long does full development of spermatogonia take? | Two full months |
| In which structure does spermatogenesis occur? | Seminiferous tubules |
| Spermatogenesis produces ---> | Spermatids |
| What process does an spermatid needs to undergo , in order to fully mature into spermatozoon? | Spermiogenesis |
| What is the ploidy and number of chromatids (C) of an mature spermatozoon? | Haploid (1N, 1C) |
| The most apical part of the sperm's head is called the ___________. | Acrosome |
| What is the X and Y chromosomal status of a Secondary spermatocyte? | Either XX or YY. |
| In total, how main Haploid Spermatids are produced in spermatogenesis? | 4 |
| What is the composition of a sperm (spermatid) before undergoing spermiogenesis? | 23 single (sex-X or Y); Haploid 1N, 1C |
| What conditions are commonly seen by impair sperm motility? | Infertility such in Ciliary dyskinesia/Kartagener syndrome |
| How many Tanner stages are currently listed? | 5; Tanner stage I-V |
| What are the characteristics of Tanner stage I? | - No sexual hair - Flat-appearing chest with raised nipple |
| What Tanner stage is considered Pre-pubertal? | Tanner stage I |
| A 6 year old child is most likely in which Tanner stage, if healthy? | Tanner stage I |
| What are the features of Tanner stage II? | - Pubic hair appears (pubarche) - Testicular enlargement (male) - Breast bud forms (thelarche) [female] |
| What is Pubarche? | Initial appearance of pubic hair |
| What is thelarche? | Breast bud formation in females |
| Pubarche + Thelarche, are seen most commonly in which Tanner stage? | Tanner stage II |
| What years of age are usually covered or part of Tanner stage II? | ~8 - 11.5 |
| A human around ages of ~11.5-13 years old, is most commonly coursing which Tanner stage? | Tanner stage III |
| What approximate years of age are covered in Tanner stage III? | 11.5-13 years old |
| What are the features of Tanner stage III? | - Coarsening of pubic hair - Penis size/length (male) - Breast enlarges, mound forms (female) |
| In which Tanner stage, the females experience breast enlargement + formation of mound? | Tanner stage III |
| Coarse hair across pubis, sparing the thigh in male and female. This a characteristic of which Tanner stage? | Tanner stage IV |
| What are the approximate age (range) of a person in Tanner stage IV of sexual development? | ~13-15 years old |
| What are the male features of Tanner stage IV? | 1. Coarse hair across pubis, sparing the thigh 2. Penis width/glans increases |
| What is the breast (female) description of Tanner stage IV? | Breast enlarges, raised areola, and mound on mound |
| What Tanner stage covers people ~ > 15 years of age? | Tanner stage V |
| Features of pubic hair seen in Tanner stage V? | Coarse hair across pubis and medial thigh |
| Breast development of normal female in Tanner stage V? | Adult breast contour, areola flattens |
| By which Tanner stage of sexual development does the areola tends to flatten again? | Tanner stage V |
| Coarse hair across pubis, and including the medial thigh. Which Tanner stage is this part of? | Tanner stage V |
| What are the 3 criteria described by Tanner stage sexual development system? | 1. Genitalia 2. Pubic hair 3. Breast |
| Is it possible for a single person to have different Tanner stages? | Yes; Tanner stages are assigned independently to genitalia, pubic hair, and breast (female). |
Created by:
rakomi
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