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