Term
| Describe the positive feedback of estradiol during FOLLICULAR phase both locally (follicle) and distant (HPG axis). |
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Definition
| Local - LH/FSH stim production of estrodiol which stims FSH receptors leading to more estradiol and granulose cell proliferation; Distant - graafian follicle is increasingly sensitive to FSH leading to more estradiol secretion and in the late follicular phase causes an LH surge inducing enzymes in follicle to rupture stigma. |
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Term
| Describe the feedback of estradiol and progesterone during the LUTEAL phase. |
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Definition
| E + P induce negative feedback on GnRH pulse frequency and thus LH/FSH frequency which is enough to keep corpus luteum alive and producing E + P. |
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Term
| What role does Kisspeptin and GPR54 play in regulating estradiol feedback on the hypothalamus? |
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Definition
| Estrdiol stims Kiss-1 neurons in AVPV and inhibs Kiss-1 neurons in the ARC, these nerves express kisspeptin peptides that bind to GPR54 receptors on the hypothalamus, which regulates GnRH activity. |
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Term
| Mutations in the GPR54 receptor gene can induce which of the following - absence of puberty, low GnRH, low sex steroids, impaired menstrual cyclicity? |
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Definition
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Term
| True or False: high frequency/amplitude pulses of LH stimulate estradiol and low frequency/amplitude pulses of LH and do not stimulate estradiol production. |
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Definition
| False, amplitude is not a factor except in ovulation. |
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Term
| Why is it that excessive GnRH secretion inhibits LH/FSH secretion? |
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Definition
| It causes down-regulartion of GnRH receptors on pituitary gonadotropes via internalization of receptors, inhib of 2nd messengers, inhib of receptor transcription; can utilize this fact to treat precocious puberty. |
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Term
| Does a woman’s ornamentation and a man’s relationship status related to their hormone secretion? |
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Definition
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Term
| Which of the following are outcomes associated with estradiol during the follicular phase - facilitates sperm penetration to the uterus, oocyte transport along oviduct, or sets up environment for implantation of blastocyst? |
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Definition
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Term
| Which of the following are outcomes associated with sex steroids during the luteal phase - reduced sperm penetration due to hardened cervix (reduced secretions) and decreased uterine contractions, or endometrial lining becomes secretory to facilitate blastocyst implantation. |
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Definition
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Term
| What is the primary determinant in sperm transport to follicle? |
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Definition
| Uterine and ovarian peristaltic contractions |
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Term
| Since there are only 5 days for the blastocyst to implant in the uterus which two hormones coincide with elevated plateaus to create an ideal environment? |
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Definition
| Progesterone and estradiol |
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Term
| There is a growing body of evidence that which placental hormone activates parturition? |
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Definition
| Free serum CRH and/or low levels of CRH binding protein |
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Term
| During which week of pregnancy is the role of the corpus luteum diminished and is replaced by the placenta? |
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Definition
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Term
| Which of the following hormones produced during pregnancy constantly elevate until parturition - hCG, Progesterone, Estrogens, hCS? |
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Definition
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Term
| Which of the following are increased both locally and systemically to induce contractions and eventually parturition - CRH, Prostaglandins (due to CRH), Oxytocin, estrogen/progesterone receptor ratio? |
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Definition
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Term
| Review metten’s placenta lecture file. |
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Definition
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Term
| The gonads of a developing embryo do not acquire male or female characteristics until the ______ week of development despite genetically determined sex. |
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Definition
| 7th; With the SRY gene and its SOX9 resultant being important for male differentiation. |
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Term
| Since the paramesonephric ducts are the fundamental tubes in female development list what structures they become when they fuse. |
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Definition
| The endometrium of the corpus and cervix of the uterus as well as the upper vaginal canal; the myometrium comes from mesenchyme. |
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Term
| What is the leading cause of infant mortality in the US? |
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Definition
| Congenital abnormalities/malformations |
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Term
| Which type of dysmorphic features cause both a functional and cosmetic problem for the patient? |
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Definition
| Major malformations which account for 3% of births, the majority of which stem from single anomalies; minor malformations only result in cosmetic problems |
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Term
| A multiple congenital anomaly which features such as vertebral, anal, tracheal, esophageal, and renal abnormalities are known as what type of association? |
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Definition
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Term
| Define the following terms that describe single anomaly birth defects - malformation, deformation, disruption. |
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Definition
| Malformation: a primary defect in the cells or tissue forming an organ or organ system; Deformation: abnormality which is often imposed by external forces (e.g., asymmetric skull shape secondary to in-utero positioning); Disruption: interruption of normal development caused by a secondary destructive event or process, limb amputation by amniotic bands or failure of vascular flow to portions of the cerebrum in porencephaly) |
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Term
| Define the following terms that describe multiple anomaly birth defects - association, sequence, syndrome. |
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Definition
| Association: an exclusion diagnosis in which two or more malformations have been found to occur together, but not necessarily due to a specific causal entity; Sequence: a pattern of related malformations such that one initial physical abnormality leads to the occurrence of additional abnormalities:Pierre Robin Sequence; Syndrome: recurring pattern of multiple anomalies in one or more tissues allowing secure recognition of a distinct phenotype |
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Term
| During which weeks of development is organogenesis most sensitive to genetic defects and teratogens like alcohol, smoking, thalidomide, and retinoids? |
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Definition
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Term
| What is affliction called hyper/hypotelorism referring to? |
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Definition
| Eyes that are too far/close together |
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Term
| Of the 50% of causes known for congenital malformations what type of defect is the vast majority of those? |
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Definition
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Term
| What is the most common chromosomal disorder? |
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Definition
| Down syndrome, trisomy 21 |
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Term
| True or False: The small proportion of women who do not use contraceptives (7%) account for roughly half of all unplanned pregnancies. |
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Definition
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Term
| Which of the following are health risks of hormonal contraception - small breast cancer risk in users <35, CVD in normotensive non-smokers, or small increase in venous thromboembolism? |
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Definition
| Everything except the CVD |
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Term
| Which of the following are health benfits of hormonal contraception - improvement of menstrual symptoms, preserved bone density, improvement in arthritis, improves acne/fibroids/cyst/endometrioses, reduces risk of reproductive tract cancers? |
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Definition
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Term
| What is the mechanism of action of estrogen/progestin combinations for contraception versus progestin only for emergency contraception? |
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Definition
| E/P provides negative feedback to hypothalamus inhibiting LH/FSH which prevents follicular growth/ovulation; Progestin only blocks or delays the LH surge, attenuates pre-ovulatory rise in estradiol, and thickens cervical mucus thereby preventing or delaying ovulation and fertilization |
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Term
| Rank the following in decreasing level of estrogen exposure - OCP, patch, vaginal ring. |
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Definition
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Term
| In regards to a confidence interval a result is considered significant if the CI does NOT cross what value? |
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Definition
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Term
| True or False: in regards to menopause, ovarian follicular loss proceeds at a steady rate for the first 30 years of life, then rapidly drops off. |
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Definition
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Term
| What is the mechanism behind hot flashes in a menopausal woman? |
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Definition
| Decerased amounts of estrogen and inhibin with follicular exhaustion limit feedback on GnRH and thermoregulatory center in the hypothalamus, ultimately LH/FSH levels rise, peripheral dilatation results in a hot flash. |
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Term
| Menopause has associated vasomotor symptoms (hot flashes, insomnia, irritability, myalgia) attributed to hypothamlic instability and symptoms associated with urogenital atrophy (UTI, pain with intercourse), which of the two groups improve with time? |
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Definition
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Term
| Although andropause is controversial in men because there is no drop off of testosterone levels, what causes true andropause? |
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Definition
| It is usually due to an abrupt end of testicular function like cancer, then it creates the same vasomotor symptoms as women. |
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Term
| Why is both estrogen and progesterone given in HRT, and not just estrogen? |
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Definition
| If only estrogen is given it will cause uterine hyperplasia and possible cancer. |
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Term
| What was the ultimate conclusion of experts in regards to HRT and its usage amongst post-menopausal women? |
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Definition
| To take the HRT for the shortest time possible and in the small dosage; it increases incidence of dementia, breast cancer, and MI risk |
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Term
| True or False: Progesterone stimulates uterine epithelial proliferaton. |
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Definition
| False, Estrogen/estradiol stimulates uterine epithelial proliferaton |
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Term
| True or False: Elevated progesterone during the luteal phase of the menstrual cycle or during pregnancy inhibits the stimulatory effects of estrogen on uterine myometrial contractions, leading to a decrease in the magnitude and frequency of uterine contractions. |
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Definition
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Term
| ______________ is a progestin-only contraceptive that is thought to prevent pregnancy by blocking ovulation and increasing viscosity of cervical fluid that blocks sperm penetration, is injected into muscle (buttocks) every 3 months; It decreases bone mineral density; A common side-effect is amenorrhea and break-through bleeding. |
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Definition
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Term
| True or False: A minor (age 12 or older) may consent for abortion, birth control, STD and HIV testing, outpatient mental health treatment, and alcohol and drug abuse treatment. An emancipated minor (married, in the active military or who has received a declaration of emancipation) may also consent for all medical treatment. Parents must be consented for all children under 18 who do not fall into the categories above. |
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Definition
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Term
| True or False: Without a normally functioning CL, there is no significant elevation in progesterone secretion |
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Definition
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Term
| Proliferation of sex chords in both sexes stems from what tissue layer? |
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Definition
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Term
| True or False: 30% of all congenital heart diseases are due to extra-cardiogenic malformations. |
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Definition
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Term
| In regards to contraceptives, what is time requirement for administration for OCP, the patch, the ring, IM injections, or subcu implants? |
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Definition
| weekly, monthly, 4 times a year, once every 3 years |
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