109 Questions
Which hormones are naturally involved in the development of primary and secondary sexual characteristics at puberty?
Estrogens and Androgens
What is the therapeutic use of Estrogens and Androgens?
Contraception and management of menopausal symptoms
From which compound are Estrogens and Androgens synthesized?
Cholesterol
Estrogens and Androgens are naturally involved in the development of primary and secondary sexual characteristics at puberty?
True
Estrogens and Androgens are only produced by the adrenal glands?
False
Antagonists of Estrogens and Androgens are used for the treatment or prevention of hormone responsive cancers?
True
Which natural estrogen is primarily found in the ovaries of premenopausal women?
Estradiol
From which compound are most estrone and estriol formed in the liver?
Estradiol
During which period is estriol primarily present?
Pregnancy
Estriol is primarily present during pregnancy?
True
Most estrone and estriol are formed in the liver from estradiol?
True
Estradiol is primarily found in the ovaries of premenopausal women?
True
What is the primary mechanism of action for synthetic estrogens?
Binding to specific nuclear proteins interacting with RNA synthesis
What is the therapeutic use of postmenopausal hormone therapy (HT) involving estrogens?
Management of menopausal symptoms
What is the additional requirement for women with intact uterus undergoing postmenopausal hormone therapy (HT) involving estrogens?
Addition of a progestogen
Synthetic estrogens bind with high affinity to specific nuclear proteins interacting with DNA RNA synthesis proteins needed for physiologic functions. (True/False)
True
Postmenopausal hormone therapy involving estrogens is used for menopausal symptoms such as vasomotor instability and urogenital tract atrophy. (True/False)
True
Vaginal estrogens are used for women with urogenital symptoms as part of postmenopausal hormone therapy. (True/False)
True
What is the primary use of a combination of estrogen and progestogen for contraception?
Effective contraception in women
Which type of estrogen is stored in adipose tissue and released slowly due to its fat solubility?
Synthetic estrogens
What is the primary route of metabolism for natural estrogens when taken orally?
Rapid metabolism in the liver
Natural estrogens are rapidly metabolized and partially inactivated when taken orally. (True/False)
True
Vaginal estrogens are used for women with urogenital symptoms as part of postmenopausal hormone therapy. (True/False)
True
Synthetic estrogens are stored in adipose tissue and released slowly due to their fat solubility. (True/False)
True
What is the primary route of metabolism for natural estrogens when taken orally?
All of the above
Which type of estrogen is stored in adipose tissue and released slowly due to its fat solubility?
Synthetic estrogens
Orally administered estradiol is primarily metabolized to estrone and estriol?
True
Estrogens are primarily bound to plasma albumin or sex hormone binding globulin?
True
Estrone and estriol are primarily metabolized by hepatic CYP 450 enzymes?
True
Which adverse effect is commonly associated with estrogens?
Breast tenderness
Estrogens can lead to fluid retention. (True/False)
True
Estrogens can cause myocardial infarction. (True/False)
True
Breast and endometrial cancer are adverse effects of estrogens. (True/False)
True
Which selective estrogen receptor modulator (SERM) competes with estrogen on the estrogen receptor in breast tissue and breast tumors?
Raloxifene
Which SERM has estrogen agonist activity in bone and lowers serum total cholesterol and LDL?
Raloxifene
Which SERM interferes with the negative feedback of estrogens on the hypothalamus, leading to ovulation?
Clomiphene
Tamoxifen and raloxifene compete with estrogen on estrogen receptor in breast tissue.
True
Raloxifene has estrogen agonist activity in bone.
True
Clomiphene is a partial estrogen antagonist interfering with the negative feedback of estrogens on the hypothalamus ovulation.
True
Which selective estrogen receptor modulator (SERM) is used for the prevention and treatment of osteoporosis?
Raloxifene
What is the therapeutic use of tamoxifen?
Metastatic breast cancer
Which selective estrogen receptor modulator (SERM) is used for symptoms of menopausal women with an intact uterus?
Bazedoxifene
Raloxifene is primarily used for the prevention and treatment of osteoporosis. (True/False)
True
Clomiphene is used for infertility. (True/False)
True
Estrogen can cause myocardial infarction. (True/False)
True
Which selective estrogen receptor modulator (SERM) is primarily used for the prevention and treatment of osteoporosis?
Raloxifene
What is the primary adverse effect associated with tamoxifen use?
Endometrial hyperplasia and malignancies
Which enzyme metabolizes selective estrogen receptor modulators (SERMs) into active metabolites?
CYP 2D6
What is the primary adverse effect associated with raloxifene use?
DVT and PE and Leg Cramps
Tamoxifen is primarily metabolized by CYP 450 enzymes.
True
Raloxifene is primarily used for the prevention and treatment of osteoporosis.
True
Clomiphene is used for the treatment of infertility.
True
Synthetic estrogens are stored in adipose tissue and released slowly due to their fat solubility.
True
Which enzyme metabolizes selective estrogen receptor modulators (SERMs) into active metabolites?
CYP 450 enzymes
What is the primary adverse effect associated with tamoxifen use?
Endometrial hyperplasia and malignancies
Which SERM has estrogen agonist activity in bone and lowers serum total cholesterol and LDL?
Raloxifene
Which compound is primarily produced in response to LH by males and females?
Progesterone
Which hormone binds with high affinity to specific nuclear proteins interacting with DNA RNA synthesis proteins needed for physiologic functions?
Estradiol
What hormones are naturally involved in the development of primary and secondary sexual characteristics at puberty?
Estrogens and androgens
What is the primary therapeutic use of progestogens?
Contraception
What is the primary route of metabolism for natural estrogens when taken orally?
Liver
What is the primary route of metabolism for micronized preparation of progesterone when taken orally?
Liver metabolism to pregnanediol + glucuronide/sulfate conjugates
What is the primary therapeutic use of progestogens?
Management of endometriosis and infertility
What is the main difference in metabolism between synthetic progestins and micronized preparation of progesterone?
Synthetic progestins are less rapidly metabolized compared to natural progesterone
Micronized preparation of progesterone is rapidly absorbed orally. (True/False)
True
Synthetic progestins are less rapidly metabolized. (True/False)
True
Estriol is primarily present during pregnancy. (True/False)
True
Raloxifene has estrogen agonist activity in bone. (True/False)
True
Which progestogen has the longest half-life?
IM medroxyprogesterone acetate
Which adverse effect is specifically associated with 19-nortestosterone derivatives?
Hirsutism and acne
Which progestogen carries the risk of hyperkalemia when used with drugs that increase potassium levels?
Drospirenone
Which progestogen is an antiprogestin used for the termination of pregnancy when combined with misoprostol?
Mifepristone
Progestogens have a longer half-life when administered intramuscularly compared to orally. (True/False)
True
Hirsutism and acne are adverse effects associated with 19-nortestosterone derivatives. (True/False)
True
Drospirenone may raise serum potassium levels and pose a risk of hyperkalemia when combined with drugs that increase potassium. (True/False)
True
Mifepristone is an antiprogestin used for the termination of pregnancy when combined with misoprostol. (True/False)
True
What is the primary mechanism of action for progestins in contraception?
Thickening the cervical mucus
What is a contraindication for the use of oral contraceptives?
Liver disease
Which adverse effect is specifically associated with estrogens and smoking in women over the age of 35?
Thromboembolism
Estrogens negatively affect FSH release. (True/False)
True
Progestins thicken the cervical mucus. (True/False)
True
Oral contraceptives are contraindicated in the presence of liver disease. (True/False)
True
Which of thr following is correct type of contraceptive contains both estrogen and progestin?
All of the above
Which hormone is the most common estrogen in combination oral contraceptives?
Ethinyl estradiol
Which enzyme metabolizes selective estrogen receptor modulators (SERMs) into active metabolites?
CYP 2D6
Which type of hormonal contraceptive is specifically recommended for breastfeeding women or those who have intolerance to estrogen containing products?
Progestin only pills
Which contraceptive method has the potential adverse effect of weight gain and osteoporosis/fractures if used for more than 2 years?
Injectable progestin
What is the primary hormone involved in the postcoital or emergency contraception method using a single high dose of levonorgestrel within 72 hours?
Progesterone
Progestin only pills are suitable for women who are breastfeeding or have intolerance to estrogen containing products. (True/False)
True
Injectable progestin can lead to weight gain and osteoporosis after prolonged use. (True/False)
True
Long acting reversible contraceptives include progestin implants and progestin intrauterine device. (True/False)
True
Emergency contraception with a single high dose of levonorgestrel can be used within 5 days of unprotected intercourse. (True/False)
False
What is the most important androgen synthesized in the testis, ovaries, and adrenal glands in males and females?
Testosterone
Which function is NOT required for androgens like testosterone, 5 α dihydrotestosterone, and dehydroepiandrosterone?
Promotion of estrogen production
Which androgen is primarily involved in the normal maturation of male and sperm production?
Testosterone
Testosterone is the most important androgen synthesized in the testis, ovaries, and adrenal glands in males and females. (True/False)
True
Clomiphene is used for infertility. (True/False)
True
Hirsutism and acne are adverse effects associated with 19-nortestosterone derivatives. (True/False)
True
Danazol has weak androgenic activity but has antiestrogenic activity as well.
True
Testosterone only (or its derivative) is used in females with menopausal symptoms unresponsive to estrogen alone.
False
Anabolic steroids are treatment of chronic wasting due to HIV or cancer.
True
Which route of administration for testosterone results in more lipid solubility and prolonged duration of action?
Intramuscular injection
Testosterone derivatives with 17α alkylation undergo less hepatic metabolism and can be administered orally.
True
Oxandrolone and oxymetholone are testosterone derivatives with 17 α alkylation,DHT enabling oral administration.
True
Testosterone derivatives like methyltestosterone and fluoxymesterone are primarily administered via transdermal patches or topical gels.
False
Androgens can cause abnormal sexual maturation and growth disturbances in children. (True/False)
True
Estrogens can cause myocardial infarction. (True/False)
True
What is a potential adverse effect of androgens in females?
Deepening of the voice
Which hormone binds with high affinity to specific nuclear proteins, interacting with DNA RNA synthesis proteins needed for physiologic functions?
Estrogens
Study Notes
Hormones Involved in Puberty
- Estrogens and Androgens are naturally involved in the development of primary and secondary sexual characteristics at puberty
- Estrogens are primarily found in the ovaries of premenopausal women
- Androgens are primarily found in the testes of males and adrenal glands in both males and females
Estrogens
- Estrogens can be synthesized from cholesterol
- Estradiol is the most common estrogen in combination oral contraceptives
- Estrone and estriol are formed in the liver from estradiol
- Estriol is primarily present during pregnancy
- Vaginal estrogens are used for women with urogenital symptoms as part of postmenopausal hormone therapy
- Synthetic estrogens bind with high affinity to specific nuclear proteins interacting with DNA RNA synthesis proteins needed for physiologic functions
- Estrogens can cause fluid retention, breast and endometrial cancer, and cardiovascular disease
Selective Estrogen Receptor Modulators (SERMs)
- Tamoxifen competes with estrogen on the estrogen receptor in breast tissue and breast tumors
- Raloxifene has estrogen agonist activity in bone and lowers serum total cholesterol and LDL
- Clomiphene interferes with the negative feedback of estrogens on the hypothalamus, leading to ovulation
- Raloxifene is used for the prevention and treatment of osteoporosis
- Tamoxifen is used for the treatment of breast cancer
- Clomiphene is used for the treatment of infertility
Progestogens
- Progestogens are involved in the development of primary and secondary sexual characteristics at puberty
- Progestogens have a longer half-life when administered intramuscularly compared to orally
- Drospirenone may raise serum potassium levels and pose a risk of hyperkalemia when combined with drugs that increase potassium
- Mifepristone is an antiprogestin used for the termination of pregnancy when combined with misoprostol
- Progestins thicken the cervical mucus
Contraceptives
- Combination oral contraceptives contain both estrogen and progestin
- Progestin-only pills are suitable for women who are breastfeeding or have intolerance to estrogen-containing products
- Injectable progestin can lead to weight gain and osteoporosis after prolonged use
- Long-acting reversible contraceptives include progestin implants and progestin intrauterine devices
- Emergency contraception with a single high dose of levonorgestrel can be used within 5 days of unprotected intercourse
Androgens
- Testosterone is the most important androgen synthesized in the testis, ovaries, and adrenal glands in males and females
- Testosterone is primarily involved in the normal maturation of male and sperm production
- Danazol has weak androgenic activity but has antiestrogenic activity as well
- Testosterone is used in females with menopausal symptoms unresponsive to estrogen alone
Test your knowledge about estrogens and androgens, the sex hormones produced by gonads, their role in conception, embryonic maturation, development of primary and secondary sexual characteristics at puberty, and their therapeutic uses such as contraception, management of menopausal symptoms, and hormone replacement therapy.
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