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GYN endocrinology
R-GU
30
Medical
Graduate
10/14/2010

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Term
why are mitochondria necessary for sexual reproduction?
Definition
only mitochondria contain the enzyme which converts cholesterol to pregnenolone - the precursor to all of the sex hormones.
Term
why do you always inherit your mitochondria from your mother?
Definition
b/c sperm have no mitochondria
Term
do mitochondria have their own DNA?
Definition
yes
Term
how is the adrenal gland like a donut?
Definition
90% of adrenal is cortex and in center 10% is medulla
Term
what is the medulla of the adrenal gland composed of?
Definition
chromaffin cells - which produce catecholamines. (a tumor here is called a pheochromocytoma - produces catecholamines in excess)
Term
what is the adrenal cortex composed of?
Definition
zona glomerulosa (aldosterone), zona fasciculata (glucocorticoids), zona and reticularis (androgens)
Term
why is androgen (male hormone) production so necessary?
Definition
b/c you need that to make estrogen (this is the ONLY way)
Term
where are androgens produced?
Definition
the adrenal cortex and gonads
Term
how many androgens are there? what are they? (*possible exam question*)
Definition
5: DHEA (dehydroepiandrosterone), DHEA sulfate (only made in adrenal gland), androstenedione, testosterone and dihydrotestosterone
Term
which 2 of the 5 androgens are the only ones w/receptors? what is the theory as to why this is?
Definition
testosterone and dihydrotestosterone - so that the other androgens as they go through the pathways do not have uncontrolled effects.
Term
regardless of the pathway, what is the form that all steroids have to go through along their synthetic pathway?
Definition
*androstenedione - which can become testosterone or estrogen.
Term
what can testosterone convert to?
Definition
testosterone can go into a cell and convert to dihydrotestosterone (100% more potent than testosterone) or convert to estradiol (the major female estrogen)
Term
why do most OCPs have ethanol estradiol?
Definition
ethanol increases estradiol's strength 100x
Term
is pregnenolone a hormone?
Definition
no, b/c it has no function beyond being converted - automatically converts to progesterone or 17-hydroxypregnenolone, has no staying capacity.
Term
what are uses for progesterone and 17-hydroxypregnenolone (products of pregnenolone conversion)?
Definition
*17-hydroxypregnenolone: intermediate. *progesterone: not an androgen, but a precursor for aldosterone, cortisol and adrenal
Term
what will a cortisol-producing tumor cause?
Definition
cushing's syndrome
Term
what precursor does cortisol come from?
Definition
17-hydroxyprogesterone
Term
how can high levels of cortisol lead to hypothyroidism?
Definition
cortisol inhibits conversion of T4 to T3. T3 is the main integrator which controls release of substances.
Term
what is "reverse T3"? when is it formed?
Definition
reverse T3 attaches at T3's receptor, but has no function (makes the thyroid inert). reverse T3 is formed under stress.
Term
what characterizes the onset of menopause?
Definition
ovarian function progressively declines through the 40s and the resultant estrogen deficiency can cause: hot flashes, sweating, trouble sleeping (insomnia), and irritability. the build up of male hormone (as a result of no longer being converted to estrogen) also causes hair thinning, male pattern baldness and abnormal hair growth.
Term
since women did not originally live to menopause, what is the biologic compensation for the build-up of testosterone?
Definition
increased fat (slow down metabolism), which can convert testosterone to estradiol since the ovaries are no longer able to perform this function, and some of the symptoms of menopause are negated. modern HRT can also perform this more efficiently.
Term
what is the relationship between estrogen and breast CA?
Definition
estrogen can stimulate undetected breast CA (*does not cause it)
Term
how does estrogen HRT affect the liver in a positive and negative way?
Definition
estrogen triggers production of beta-globulins. some of these globulins bind to male hormone and inhibit its activity (positive) but others are involved in clotting and can cause DVTs (negative)
Term
if a menopausal woman decides against HRT, what does she risk?
Definition
becoming generally heavy, hairy, hypertensive and depressed
Term
what are the key cells to the menstrual cycle? why? what stimulates this?
Definition
the *granulosa cells are key to the menstrual cycle b/c they *convert male hormone to estrogen upon stimulation by FSH (works on granulosa cells to produce aromatase, the hormone converting enzyme).
Term
where does male hormone come from in the ovary? what stimulates this?
Definition
the theca cells, which surround the granulosa are stimulated to produce male hormone by LH.
Term
what is the function of inhibins in the menstrual cycle?
Definition
inhibins decrease FSH levels (FSH initially used to recruit, then support eggs) which kills off all the recruited eggs, except one - which becomes "egg of the month".
Term
what is the effect of FSH and estrogen combined?
Definition
*FSH and estrogen combined* produce *receptors for progesterone, which is necessary to produce before ovulation (2nd half of cycle) can begin (reason for slight spike in progesterone before ovulation, and deluge after).
Term
how do different levels affect the function of estrogen?
Definition
low level: inhibitory. high level: stimulatory for LH surge, which kicks off ovulation (first gen estrogen: stopped estrogen peak from occurring).
Term
what function does progesterone perform in the 2nd half of the cycle?
Definition
stimulation of a lush lining for the fertilized egg
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