| Question |
Answer |
| FSH is secreted in a __ manner |
Pulsatile |
| Estrogen has a __ feedback on FSH |
Negative |
| How do the ovaries respond to FSH |
Produce estradiol |
| LH stimulates __ |
Ovulation |
| Levels of FSH are __ in primary gonadal failure (castration, alcoholism) |
Elevated |
| Levels of FSH are __ with secondary gonadal failure (stress, malnutrition/anorexia, severe illness, hyperprolactemia, pregnancy) |
Low |
| How is FSH measured in the urine |
24 hour collection |
| LH is secreted in a __ manner |
Pulsatile |
| LH stimulates __ |
Follicular production of estrogen, ovulation and formation of corpus luteum |
| LH levels are __ with gonadal failure, precocious puberty, pituitary adenoma, menopause, PCOS |
Elevated |
| LH levels are __ with pituitary failure, hypothalamic failure, severe stress, anorexia, malnutrition, severe illness, pregnancy, hemochromatosis, sickle cell anemia, hyperprolactemia |
Low |
| Estrogen has a __ feedback on LH release |
Negative |
| LH surge indicates __ |
Ovulation |
| What is required to stimulate ovulation |
LH |
| What is the best time to obtain single specimen to determine LH level |
11am-3pm |
| Physiologically most important type of estrogen |
Estradiol |
| What is the major estrogen present in pregnancy |
Estriol |
| Corpus luteum produces __ after ovulation |
Progesterone |
| What produces progesterone in pregnancy |
Progesterone |
| What effect does progesterone have on the endometrium |
Induces glandular secretion |
| When are progesterone levels decreased |
Preeclampsia, threatened abortion, placental failure, fetal demise, ovarian neoplasm, amenorrhea, ovarian hypofunction |
| Levels of progesterone rise rapidly after __ |
Ovulation |
| Levels of progesterone continue to rise for __ after ovulation then decrease after menses occurs |
6-10 days |
| Estrogen causes __ of endometrial glands |
Proliferation |
| What are the three major estrogens |
Estradiol, estrone, estriol |
| Levels of estrogen are elevated with what |
Precocious puberty, ovarian tumor, adrenal tumor, gonadal tumor, normal pregnancy, cirrhosis, liver necrosis, hyperthyroidism |
| Levels of estrogen are low with what |
Failing pregnancy, turner’s syndrome, hypopituitarism, hypogonadism, stein-leventhal syndrome, menopause, anorexia |
| Estrogen has a negative feedback on __ |
LH and FSH |
| How is day one of the menstrual cycle determined |
First day of menses |
| Estrogens are catabolized by the __ |
Liver |
| What is the major estrogen circulating during menopause |
Estrone |
| What is the estrogen produced in the placenta, and is an index of fetal well-being |
Estriol |
| How can estrogen be measured in the lab |
Serum, urine, salivary |
| Which estrogen is measured to determine menstrual and fertility problems, menopause status, and sexual maturity |
Estradiol |
| Which estrogen is measured in serial studies in pregnancy beginning 28-30 weeks gestation |
Estriol |
| When a woman stops having periods what is the first thing to check |
Pregnancy |
| Why would you perform a testosterone assay |
Evaluate ambiguous sex characteristics, precocious puberty, female virilization syndromes, tumor markers, hirsutism, male infertility/hypogonadism, monitor antiandrogen treatment |
| What role does FSH play in the menstrual cycle |
Promotes maturation of germinal follicle, causing estrogen secretion and allowing ovum to mature (follicular phase) |
| Increase in FSH begins approximately __ days before onset of menstruation and is necessary for follicle/ovum formation |
2 |
| In a state of estrogen deficiency, __ FSH is secreted |
More |
| Plasma LH surge proceeds ovulation by __ |
24-36 hours |
| LH surges by day__ of normal 28 day cycle |
11-13 |
| What happens to FSH and LH during luteal phase |
They are suppressed to low levels |
| Progesterone initiates the __ phase in the endometrium |
Secretory |
| What happens to progesterone if fertilization and implantation do not occur |
Production diminishes rapidly |
| Corpus luteum has a lifespan of __ days unless pregnancy occurs |
13-14 |
| Stimulation test done to evaluate the hypothalamic pituitary gonadal axis |
Progesterone withdrawal test |
| What situations cause a surge in prolactin |
Breast stimulation, pregnancy, nursing, stress, exercise, sleep |
| Levels of prolactin are elevated in what pathologic disorders |
Pituitary adenomas, secondary amenorrhea, galactorrhea, hypothyroidism, PCOS, anorexia, paraneoplastic syndromes, disease of hypothalamus and pituitary stalk, renal failure |
| Levels of prolactin should be measured __ hours after waking |
3-4 |
| __ have a higher baseline level of prolactin |
Pregnant women |
| When do prolactin levels naturally rise |
Late in pregnancy, initiation of lactation, every time the infant suckles |
| Concentration of hCG are typically lower in __ |
Ectopic pregnancies |
| __ is unique to the developing placenta and some tumors |
hCG |
| Monoclonal antibodies can detect very small levels of hCG __ after conception |
3-7 days |
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