Chapter 16-32 Flashcards
A national study with 31,581 respondents found that ________ of women reported
having some type of sexual problem, such as orgasm difficulties.
a. 67%
b. 44%
c. 22.3%
d. 10%
b. 44%
A woman’s sexual complaint may be attributed to
a. physical or mental health factors.
b. sociocultural influences.
c. normal variations of sexuality.
d. any of the above.
d. any of the above.
Which one of the following statements about androgen supplementation is false?
a. Adverse effects of its use include acne, liver damage, and decreased levels of
HDL cholesterol.
b. There are no androgen therapies approved by the U.S. Food and Drug
Administration (FDA) for use in women.
c. Correlations between testosterone levels and sexual dysfunction have been
found to be consistent across numerous studies.
d. Transdermal preparations are frequently used in women, though dosing is
difficult because they are packaged in doses appropriate for men.
c. Correlations between testosterone levels and sexual dysfunction have been
found to be consistent across numerous studies.
The absence or markedly diminished feelings of sexual excitement and sexual pleasure
from any type of sexual stimulation is called _______ sexual arousal disorder.
a. genital
b. subjective
c. combined genital and subjective
d. persistent
b. subjective
All of the following medications may cause sexual arousal problems except
a. SSRIs and MAOIs.
b. tricyclic antidepressants.
c. sildenafil, alprostadil, and tibolone.
d. antihistamines and antihypertensives.
c. sildenafil, alprostadil, and tibolone.
Management of sexual arousal disorders in women may include any one of the
following except
a. treatments that decrease blood flow to the genital tissues.
b. the use of vaginal lubricants to increase stimulation.
c. use of the Eros-CTD, a clitoral therapy device.
d. localized estrogen therapy.
a. treatments that decrease blood flow to the genital tissues.
. In a randomized controlled trial, women who used _______ had significantly greater
mean improvement in the desire and arousal domains of the FSFI compared to women
who used a placebo.
a. Yohimbine, an extract from the bark of an African tree
b. L-Arginine, one of the ingredients in a nutritional supplement
c. Zestra, a topical formulation that contains botanical oils and extracts
d. None of the above
c. Zestra, a topical formulation that contains botanical oils and extracts
For the woman who has never experienced orgasm, the clinician should
a. diagram and describe female genital anatomy to her.
b. recommend Kegel exercises to help inhibit the orgasmic response.
c. suggest psychotherapy before suggesting any self-help measures.
d. explain that most women achieve orgasm only through penetration of the
vagina
a. diagram and describe female genital anatomy to her.
Which one of the following is the best definition of vaginismus?
a. Persistent difficulty to allow vaginal entry of a penis, finger, or any object
b. Semen hypersensitivity that causes pain, diffuse urticaria, and malaise
c. A form of vaginal spasm that results from fearful anticipation of pain
d. Recurrent pain upon vaginal entry and/or penile vaginal intercourse
a. Persistent difficulty to allow vaginal entry of a penis, finger, or any object
Management of dyspareunia
a. depends on the etiology of the pain.
b. requires nonpharmacologic treatment modalities.
c. is 100% effective with vestibulectomy and advancement plasty.
d. is only a matter of teaching the patient to change the angle of the uterus during
intercourse.
a. depends on the etiology of the pain.
About half of all pregnancies in the United States are unintended and occur most frequently in women who a. are married or divorced. b. have finished high school. c. are between the ages of 18 and 24. d. are members of the majority group.
c. are between the ages of 18 and 24.
Estimates from the 2002 National Survey of Family Growth indicate that _______ of
infants born to never-married women younger than 45 years of age were relinquished for
adoption between 1996 and 2002.
a. 1%
b. 11%
c. 24%
d. 49%
a. 1%
Unintended pregnancy is associated with
a. tobacco and alcohol use during pregnancy.
b. less risk of physical abuse and depression.
c. higher number of total prenatal care visits.
d. higher infant birth weights.
a. tobacco and alcohol use during pregnancy.
One study of more than 10,000 women who had abortions found that _______ had
been using a contraceptive method in the month they conceived.
a. 14%
b. 34%
c. 54%
d. 74%
c. 54%
When a patient’s decision about an unintended pregnancy causes an irreconcilable
conflict between a clinician’s personal beliefs and professional responsibilities, the
clinician should
a. make sure the patient understands what those personal beliefs are.
b. continue to work in settings where such conflicts occur frequently.
c. deny comprehensive pregnancy options counseling to the patient.
d. refer the patient to a colleague or to a different setting entirely.
d. refer the patient to a colleague or to a different setting entirely.
All of the alternatives that follow are included in pregnancy options counseling except
a. discontinue the pregnancy.
b. carry the pregnancy and parent the child.
c. assess the need for additional attention after abortion.
d. carry the pregnancy and place the infant for adoption
c. assess the need for additional attention after abortion.
Women who present for pregnancy options counseling
a. understand the time-sensitive nature of the decision-making process.
b. should be made aware of the gestational age of the pregnancy.
c. have made their decision and do not need to discuss it.
d. need no further resources to establish a plan of action.
b. should be made aware of the gestational age of the pregnancy.
The most recent data on the timing of abortions indicate that \_\_\_\_\_\_\_\_\_\_ are performed prior to 13 weeks gestation. a. 99% b. 88% c. 77% d. 66%
b. 88%
The methods of abortion used in the United States—in order, with the most common
method listed first—are
a. aspiration, medication, induction, surgical.
b. medication, induction, aspiration, surgical.
c. surgical, induction, medication, aspiration.
d. induction, aspiration, surgical, medication.
a. aspiration, medication, induction, surgical.
The World Health Organization (2007) estimates that _______ unsafe abortions took
place annually between 1993 and 2003, resulting in enough deaths to render unsafe
abortion one of the leading causes of maternal mortality.
a. 19 to 20 million
b. 19 to 20 thousand
c. 1 to 2 million
d. 1 to 2 thousand
a. 19 to 20 million
For women younger than 35, infertility is defined as failure to achieve a successful
pregnancy after _______ of regular unprotected intercourse.
a. 6 weeks
b. 6 months
c. 12 weeks
d. 12 months
d. 12 months
For a woman older than 35, the clinician will consider infertility treatment after six
months of attempting a pregnancy because
a. fecundity begins to increase gradually at age 28.
b. there is a higher risk of pregnancy loss in the older woman.
c. the older woman is not as frivolous as a younger woman might be.
d. conditions that impair fertility decline after age 35.
b. there is a higher risk of pregnancy loss in the older woman.
Approximately 72 _______ are required for spermatogenesis, after which sperm
mature in the epididymis and then travel out of the vas deferens during ejaculation.
a. days
b. hours
c. minutes
d. seconds
a. days
Among the causes of infertility in women are all of the following except
a. endometriosis.
b. a luteal-phase deficiency.
c. a bicornuate or septate uterus.
d. tubal scarring as a result of an STI.
c. a bicornuate or septate uterus.
The fertility test that involves radiologic imaging of an injection of a water- or oilsoluble contrast traveling through a women’s reproductive system is called
a. transvaginal ultrasound and hysteroscopy.
b. hysterosalpingogram.
c. semen analysis.
d. laparoscopy.
b. hysterosalpingogram.
All of the following diagnostic testing and procedures are now infrequently performed in clinical practice except a. hysterosalpingogram. b. sperm penetration assay. c. the postcoital test (PCT). d. endometrial biopsy (EMB)
a. hysterosalpingogram.
The infertility evaluation is an opportune time to suggest health promotion behaviors
that may specifically improve fertility, including
a. achieving a BMI in the range of 30 to 35, if the woman is under- or overweight.
b. reducing alcohol consumption to about 4 drinks per week.
c. reducing caffeine consumption to no more than 350 per day.
d. none of the above.
b. reducing alcohol consumption to about 4 drinks per week.
The form of assisted reproductive technology that requires fertilization to occur within
a patent fallopian tube, instead of a laboratory dish, is called
a. intracytoplasmic sperm injection (ICSI).
b. gamete intrafallopian transfer (GIFT).
c. zygote intrafallopian transfer (ZIFT).
d. in vitro fertilization (IVF).
b. gamete intrafallopian transfer (GIFT).
For women and men with infertility an option that involves a sperm or egg donor is
called
a. assisted reproductive technology (ART).
b. collaborative reproduction.
c. child-free living.
d. adoption.
b. collaborative reproduction.
An ethical question that is specifically about pre-implantation testing with ART has to
do with
a. ownership of frozen embryos after the couple has divorced.
b. a surrogate deciding she does not want to relinquish the infant.
c. genetic engineering and the ability to reject embryos affected by inherited
disorders.
d. the implantation of multiple embryos, which can create high risk for the
embryos and the woman.
c. genetic engineering and the ability to reject embryos affected by inherited
disorders.
What is the major source of normal vaginal secretions?
a. Bartholin’s glands
b. Apocrine glands
c. Sebaceous glands
d. Cervical mucosa
d. Cervical mucosa
What is the term for the inflammation of the vagina characterized by an increased
vaginal discharge containing numerous white blood cells?
a. Vaginitis
b. Vaginosis
c. Cystitis
d. Vaginal mucosa
a. Vaginitis
How does vaginosis differ from vaginitis?
a. It must be treated with metronidazole.
b. The discharge does not contain white blood cells.
c. The discharge does not have an odor.
d. It causes itching and/or burning.
b. The discharge does not contain white blood cells.
What is the most important step in preventing vaginal infections?
a. Good personal hygiene
b. Healthy diet
c. Scented sanitary products
d. Douching
a. Good personal hygiene
What can bacterial vaginosis lead to?
a. Vulvovaginal candidiasis
b. Pelvic inflammatory disease
c. Toxic shock syndrome
d. Trichomoniasis
b. Pelvic inflammatory disease
Approximately what percentage of women with bacterial vaginosis are asymptomatic?
a. 25%
b. 40%
c. 75%
d. 50%
d. 50%
What is the most common symptom of bacterial vaginosis?
a. Vaginal itching and/or burning
b. Cottage cheese-like discharge
c. Fishy odor
d. Yeasty odor
c. Fishy odor
Vulvovaginal candidiasis accounts for what percentage of all vaginal infections?
a. 10-15%
b. 20-25%
c. 50-55%
d. 60-65%
b. 20-25%
Which organism causes 90% of vulvovaginal candidiasis episodes in women?
a. Candida tropicalis
b. Candida albicans
c. Candida glabrata
d. Candida krusei
b. Candida albicans
What is the most common symptom of vulvovaginal candidiasis?
a. Fishy odor
b. Fever
c. Thin, grayish-white discharge
d. Vulvar pruritis
d. Vulvar pruritis
What percentage of Toxic Shock Syndrome cases are related to menses?
a. 50%
b. 25%
c. 75%
d. 90%
a. 50%
Women who have had Toxic Shock Syndrome should be instructed not to use tampons or a. barrier contraception methods. b. hormonal contraception methods. c. intravaginal antibiotic cream. d. oral antibiotics.
a. barrier contraception methods.
What is generally the cause of Bartholin’s cyst?
a. Complications from gonorrhea
b. Cystic fluid in Bartholin’s gland becomes infected
c. A fungal infection in Bartholin’s gland
d. Obstruction of a duct in Bartholin’s gland
d. Obstruction of a duct in Bartholin’s gland
Approximately how many Americans will contract one or more sexually transmitted infections during their lifetime? a. 50% b. 25% c. 40% d. 60%
a. 50%
Why is it often more difficult to detect STIs in women than in men?
a. Men are two times more likely to transmit STIs to women than the reverse.
b. The risk of a woman contracting an STI is much higher than a man’s risk.
c. The anatomy of women’s genital tracts makes examination more difficult.
d. Women tend to have fewer sexual partners than men do.
c. The anatomy of women’s genital tracts makes examination more difficult.
Who should be screened regularly for STIs?
a. Women who have more than one sexual partner
b. Women over the age of 21
c. Women who are sexually active
d. Women over the age of 15
c. Women who are sexually active
Of the more than 100 known serotypes of human papillomavirus (HPV),
approximately how many can infect the genital tract?
a. 80
b. 60
c. 20
d. 40
d. 40
Routine HPV vaccination is recommended for girls of what age?
a. 8-9
b. 13-14
c. 6-7
d. 11-12
d. 11-12
An initial or primary genital herpes infection characteristically lasts about
a. one week.
b. three weeks.
c. one month.
d. six weeks.
b. three weeks.
How do systemic antivirul drugs treat genital herpes?
a. They can control the symptoms.
b. They can reduce the frequency of recurrences after discontinuation.
c. They can prevent transmission to sexual partners.
d. They can prevent secondary infection.
a. They can control the symptoms.
Which of the following is caused by an anaerobic one-celled protozoan that commonly lives in the vagina? a. Trichomoniasis b. Chlamydia c. Gonorrhea d. Syphilis
a. Trichomoniasis
The prevalence of chlamydia is how many times higher in black women than in white women? a. Two times b. Three times c. Five times d. Four times
c. five times higher
The second most commonly reported STI after chlamydia is
a. gonorrhea.
b. pelvic inflammatory disease.
c. syphilis.
d. hepatitis B.
a. gonorrhea
Why do adolescents have the highest risk of developing pelvic inflammatory disease
(PID)?
a. They have the highest risk for bacterial vaginosis.
b. They are the least at risk for developing other STIs.
c. They are the most sexually active.
d. They have decreased immunity to infectious organisms.
d. They have decreased immunity to infectious organisms.
What is different about syphilis as compared to other bacterial STIs?
a. The incidence in women is much higher than in men.
b. The rates are higher for white women than for black women.
c. It cannot be spread by kissing.
d. It persists past age 25, into the 30s and 40s.
d. It persists past age 25, into the 30s and 40s.
What has contributed to the decreased incidence of Hepatitis B over the past 20 years? a. The decrease in PID b. The HBV vaccination c. The increase in condom use d. More precise screening methods
b. The HBV vaccination
Patients presenting for STI treatment should be screened for HIV
a. at each visit.
b. at the end of treatment.
c. at the beginning of treatment.
d. each year.
a. at each visit.
Half of all women have experienced a urinary tract infection (UTI) by age
a. 18.
b. 24.
c. 40.
d. 32.
d. 32.
How does women’s anatomy make them more susceptible to UTIs?
a. Asymptomatic UTIs do not resolve themselves without treatment.
b. Women tend to get UTIs when they are pregnant.
c. There is a longer distance between the urethra and anus.
d. Their urethras are shorter.
d. Their urethras are shorter.
What is the most common type of UTI that affects women?
a. Acute bacterial cystitis
b. Pyelonephritis
c. Asymptomatic bacteruria
d. Pyelitis
a. Acute bacterial cystitis
Uncomplicated acute bacterial cystitis occurs in women who
a. are pregnant.
b. have no signs of upper tract infection.
c. have a high fever.
d. have had recent antibiotics.
b. have no signs of upper tract infection.
What distinguishes pyelonephritis from cystitis?
a. The infection has descended to the bladder.
b. The infection has ascended to the kidneys.
c. The infection is caused by E. coli bacteria.
d. The infection occurs only in pregnant women.
b. The infection has ascended to the kidneys.
An inexpensive screening tool that can be used to confirm a UTI diagnosis if the history is ambiguous is the a. urine culture. b. sensitivity test. c. urine dipstick. d. empiric culture.
c. urine dipstick.
Any woman with a complicated cystitis or symptoms of upper tract disease needs a urine culture and a. sensitivity test. b. blood culture. c. urine dipstick. d. parenteral culture.
a. sensitivity test.
Fever associated with pyelonephritis will usually resolve within how many hours of treatment with antibiotics? a. 24 hours b. 12 hours c. 72 hours d. 48 hours
d. 48 hours
What has changed in terms of recommended antibiotic treatment for uncomplicated
lower UTIs?
a. Seven-day regimens are now recommended.
b. Three times a day of oral antibiotics are now recommended.
c. Three-day regimens are now recommended.
d. A single dose is now recommended.
c. Three-day regimens are now recommended.
What do current theories suggest as to how cranberry products can reduce UTIs?
a. The hippuric acid in cranberries inhibits the growth of E. coli bacteria.
b. The fructose keeps E. coli bacteria from adhering to bladder cell walls.
c. Ingestion of cranberry products changes the flora of the vagina.
d. The quinic acid in cranberries thins out the lining of the urethra.
b. The fructose keeps E. coli bacteria from adhering to bladder cell walls.
What is the reason that urinary incontinence (UI) is probably underreported?
a. Its symptoms are difficult to isolate.
b. The majority of sufferers are men.
c. People may be too embarrassed to report it to a clinician.
d. It generally occurs in women over the age of 70.
c. People may be too embarrassed to report it to a clinician.
In order to maintain continence bladder pressure must be
a. higher than urethral pressure.
b. equal to the pressure of the urethral sphincter.
c. higher than the pressure of the levator ani.
d. lower than urethral pressure.
d. lower than urethral pressure.
In women, the urethra rests on the anterior vaginal wall, which is supported by a
muscle that is known as the pelvic floor muscle or
a. Kegel muscle.
b. urethral sphincter.
c. striated muscle.
d. intra-abdominal sphincter.
a. Kegel muscle.
What is the name of the triangular fibrous complex that supports the pelvic muscles
during urination, defecation, and birth, when the levator ani muscle must relax?
a. Perineal membrane
b. Urethral sphincter
c. Bladder neck
d. Detrusor muscle
a. Perineal membrane
What is the recommended interval target between urinations?
a. 30-45 minutes
b. 3-4 hours
c. 1-2 hours
d. 4-5 hours
b. 3-4 hours
What is an age-related anatomic change that can lead to UI?
a. The shortening of the urethra
b. The reduction in bladder capacity
c. The increase in habitual preventative emptying of the bladder
d. The decline in number of urethral striated muscle fibers
d. The decline in number of urethral striated muscle fibers
Women with BMIs higher than what number were found to be more than twice as
likely to experience UI compared to women with lower BMIs?
a. 35
b. 40
c. 20
d. 25
a.35
What test measures intra-abdominal pressure and determines how large the pressure
increase must be to produce leakage in an individual woman?
a. The leak point pressure test
b. The urinary stress test
c. The extra-urethral pressure test
d. The urethral threshold test
a. The leak point pressure test
The urethra typically holds back how much fluid in the bladder several times a day?
a. 100-200mL
b. 500-600mL
c. 300-400mL
d. 700-800mL
c. 300-400mL
What is the name for a pelvic muscle contraction that is strategically timed to increase
intraurethral pressure just before and after the event that causes UI?
a. Kegel contraction
b. Detrusor maneuver
c. Reverse bladder contraction
d. Knack maneuver
d. Knack maneuver
What is the recommended amount of Kegel contractions per day for women whose pelvic muscles are weak? a. 10 b. 50 c. 30 d. 70
c. 30
What type of behavioral intervention is recommended for women with urge UI who
have no urge sensation until the bladder is excessively full and signals a strong and
uncomfortable urge?
a. Electrical stimulation
b. The Knack maneuver
c. Reverse bladder retraining
d. Kegel exercises
b. The Knack maneuver
What can be used as a space-filling device, replacing normal pressure on the vaginal
walls when levator ani support is unreliable?
a. Diaphragms
b. Tampons
c. Kegels
d. Sacral nerve stimulators
b. Tampons
What is the general goal of surgical treatment for stress UI?
a. To increase the capacity of the bladder
b. To increase pressure on the vaginal walls
c. To support and strengthen the levator ani
d. To support and stabilize the urethra
d. To support and stabilize the urethra
What term refers to the period from about 7 to 10 days before menstrual flow begins
until the first or second day of menstrual flow?
a. Amenorrhea
b. Premenstrual
c. Dysmenorrhea
d. Perimenstrual
d. Perimenstrual
Approximately what percentage of women experience severe recurring symptoms associated with their menstrual cycle? a. 10% b. 20% c. 5% d. 25%
a. 10%
Why shouldn’t symptoms such as bloating and breast tenderness be considered
disordered perimenstrual symptoms?
a. Because only a small minority of women have these symptoms
b. Because these symptoms affect the majority of women
c. Because these symptoms do not affect women’s moods
d. Because it is not possible to quantify these symptoms
b. Because these symptoms affect the majority of women
Of the four symptom clusters of perimenstrual symptoms identified by Woods,
Mitchell & Lentz (1999), which was the dominant one in terms of explaining variance in
premenstrual symptoms?
a. Fluid retention
b. Arousal
c. Turmoil
d. Somatic symptoms
c. Turmoil
How is secondary dysmenorrhea defined?
a. Absence of menstruation due to an underlying pathology
b. Painful menstruation in the absence of pathology
c. An underlying pathology causing pain symptoms during menstrual flow
d. Painful menstruation that occurs in women after the age of 35
c. An underlying pathology causing pain symptoms during menstrual flow
What is the term for the exacerbation of somatic or mood symptoms in the late luteal or menstrual phase of the cycle? a. Premenstrual magnification b. Perimenstrual dysmenorrhea c. Premenstrual syndrome d. Premenstrual dysphoric disorder
a. Premenstrual magnification
Which of the following is a diagnostic label that is listed in the Diagnostic and Statistical Manual IV-TR? a. Premenstrual dysphoric disorder b. Premenstrual magnification c. Dysmenorrhea d. Premenstrual syndrome
a. Premenstrual dysphoric disorder
Women who report experiencing the most severe symptoms of PMS tend to be
a. in their late 40s.
b. in their early 20s.
c. in their late teens.
d. in their late 30s.
d. in their late 30s.
Which of the following is one of the key criteria for a diagnosis of PMS?
a. The symptoms markedly interfere with occupational functioning
b. One of the symptoms is depressed mood, anxiety, or irritability
c. Exclusion of other diagnoses that may better explain the symptoms
d. The symptoms are confirmed by prospective daily ratings over at least two
menstrual cycles
c. Exclusion of other diagnoses that may better explain the symptoms
All menstruating women report that which type of symptoms is highest during menses? a. Muscular b. Gastrointestinal c. Incontinent d. Skeletal
b. Gastrointestinal
What hormone has been shown to help with relieving the mood discomfort cluster of symptoms of PMS? a. Diuretics b. NSAID c. Progesterone d. Fluoxetine
c. Progesterone
Which dietary supplement has been shown to help treat PMS?
a. Calcium
b. Magnesium
c. Vitamin B12
d. Iron
a. Calcium
The only botanical treatment with Level I evidence to support its use in PMS is
a. echinacea.
b. chaste tree berry
c. linolenic acid.
d. cramp bark.
b. chaste tree berry.
Research suggests a link between PMS and
a. seasonal affective disorder.
b. celiac disease.
c. high blood pressure.
d. hypoglycemia.
a. seasonal affective disorder.
What is the best definition of abnormal uterine bleeding (AUB)?
a. Uterine bleeding for which no pelvic pathology is found
b. Uterine bleeding that is irregular during a woman’s menstrual cycle
c. Uterine bleeding that is irregular in amount or frequency
d. Uterine bleeding that is related to systemic conditions
c. Uterine bleeding that is irregular in amount or frequency
What is a good first question to ask women who present with a concern about
abnormal bleeding?
a. What is a normal pattern for you?
b. How long has this persisted?
c. What was your last menstrual cycle like?
d. How many times has this occurred?
a. What is a normal pattern for you?
In women of reproductive age, the most common cause of a bleeding pattern that is
suddenly different is
a. an increase in estrogen.
b. a reaction to a change in eating or exercise habits.
c. adrenal hyperplasia.
d. a complication of pregnancy
d. a complication of pregnancy.
Progesterone breakthrough bleeding is sometimes seen in women who
a. have polycystic ovary syndrome.
b. are obese.
c. use progesterone-only contraception.
d. have ceased progesterone therapy.
c. use progesterone-only contraception.
The least variation in menses occurs during the ages of
a. 30-50.
b. 40-50.
c. 12-20.
d. 20-40
d. 20-40