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Reproductive

FA complete review part 2 Physiology

QuestionAnswer
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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