Harvard-MIT Division of Health Sciences and Technology HST.071: Human Reproductive Biology 1. Prolactin increases ____________________ synthesis and secretion from the hypothalamus. Dopamine and dopamine agonists such as ____________________ subsequently inhibits ____________________ secretion. In females, prolactin inhibits ____________________ synthesis and release, which inhibits ____________________. 2. List the following hormones in order of decreasing potency: estriol, estradiol, estrone. 3. Unopposed estrogen therapy leads to an increased risk of ____________________ cancer. Use of ____________________ with estrogen decreases this risk. 4. Estrogen is important for endometrial __________________ during the follicular phase. Progesterone maintains ___________________ activity of the uterus during the luteal phase. 5. ___________ stimulates theca cells to produce ____________________, which diffuses to nearby __________________ cells. There, it is converted to ____________________ by aromatase. This step is stimulated by ______________. 6. Ovulation occurs _____________ days before menstruation, regardless of cycle length. Ovulation occurs as a result of __________________-induced _____________ surge. 7. During the luteal phase, basal body temperature (increases/decreases) due to the effect of _____________________ on the _____________________ thermoregulatory center. 8. If fertilization occurs, the corpus luteum is rescued from regression by __________________ which is produced by the __________________. 9. The fetal __________________ gland synthesizes dehydroepiandrosterone-sulfate (DHEA-S), which is hydroxylated in the fetal __________________. The intermediates are transferred to the __________________, where enzymes remove sulfate and aromatize to estrogens. 10. Although prolactin levels increase steadily during pregnancy (stimulated by the hormone ________________), lactation does not occur during pregnancy because ________________ and __________________ block the action of prolactin on the breast. 11. Menopause is characterized by the cessation of ________________ production with age-linked decline in the number of ovarian _________________. 12. The most common microbial cause of mastitis is ____________________. 13. Which of these substances decreases the number and density of gap junctions (A) connexin-43(B) oxytocin(C) estrogen(D) progesterone(E) prolactin14. Oxytocin receptors are found in the highest concentrations in the (A) cervix(B) fundusCourse Director: Professor Henry KlapholzHST071: Human Reproductive Biology Homework 2 Female Reproduction(C) lower segment of the uterus(D) vagina(E) fundus and cervix15. Which of the following explains the suppression of lactation during pregnancy? (A) Blood prolactin levels are too low for milk production to occur(B) Human placental lactogen levels are too low for milk production to occur(C) The fetal adrenal gland does not produce sufficient estriol(D) Blood levels of estrogen and progesterone are high(E) The maternal anterior pituitary is suppressed16. The source of estrogen during the second and third trimesters of pregnancy is the (A) corpus luteum(B) maternal ovaries(C) fetal ovaries(D) placenta(E) maternal ovaries and fetal adrenal gland(F) maternal adrenal gland and fetal liver(G) fetal adrenal gland, fetal liver, and placenta17. Secretion of oxytocin is increased by (A) milk ejection(B) dilation of the cervix(C) increased prolactin levels(D) increased serum osmolarity18. Secondary amenorrhea refers to the absence of menses for ________ months in a woman who previously had menses. The most common cause is ____________________, so a serum ________________ assay is always the first step in an evaluation. 19. Secondary amenorrhea can be classified pathophysiologically as follows: • Hypothalamic/pituitary disorders, characterized by (increased/decreased/normal) FSH and LH. These include primary and functional gonadotropism deficiencies. • Ovarian disorders, characterized by (increased/decreased/normal) FSH and LH. • End-organ disease, characterized by (increased/decreased/normal) FSH and LH 20. In addition to gonadotropin levels, a progesterone challenge is an excellent test to perform in the initial evaluation of these patients. Withdrawal bleeding indicates that the endometrial mucosa must have been primed with ________________, so the _______________________ axis and ovaries must be normal. It also rules out an end-organ defect. Match the following clinical descriptions of women with secondary amenorrhea with the most likely laboratory findings. Serum FSH Serum LH Bleeding following Progesterone administration (A) Normal Normal No (B) Increased Increased No (C) Normal Normal Yes (D) Decreased Decreased No (E) Decreased Increased Yes21. _______ A 35-year-old woman with a history of numerous dilation and curettage procedures for menorrhagia. (For extra credit, this woman likely has ___________________ syndrome). 22. _______ A 24-year-old woman with anorexia nervosa. 23. _______ A 42-year-old woman whose ovaries have been surgically removed; hormone replacement has not been