LE1 - GYNE Flashcards
Which of the following produces symptoms of premenstrual syndrome?
A. Progesterone
B. Estrogen
C. LH
D. FSH
A. Progesterone
High-yield rationale: Progesterone fluctuations are responsible for PMS symptoms like mood swings, bloating, and breast tenderness.
When during the menstrual cycle will you experience the LH surge?
A. Days 11-13
B. Days 14-16
C. Days 17-19
D. Days 20-22
A. Days 11–13
High-yield rationale: LH surge occurs ~24–36 hours before ovulation, typically around days 11–13 of a 28-day cycle.
Which phase of the menstrual cycle corresponds to the follicular/proliferative phase?
A. Days 1-4
B. Days 5-14
C. Days 15-28
D. Entire cycle
B. Days 5–14
High-yield rationale: The follicular/proliferative phase spans from the end of menstruation to ovulation, driven by estrogen.
Which stage of the uterine cycle corresponds to the secretory phase?
A. Days 1-4
B. Days 5-14
C. Days 14-28
D. Entire cycle
C. Days 14–28
High-yield rationale: The secretory phase follows ovulation, dominated by progesterone secretion from the corpus luteum.
During which phase of the menstrual cycle is progesterone highest?
A. Follicular phase
B. Ovulatory phase
C. Luteal phase
D. Menstrual phase
C. Luteal phase
High-yield rationale: Progesterone peaks in the luteal phase to support potential implantation and pregnancy.
This hormone acts primarily on the theca cells:
A. LH
B. FSH
C. Estrogen
D. Progesterone
A. LH
High-yield rationale: LH acts on theca cells to produce androgens, which granulosa cells convert to estrogens.
Which of the following hormones share the same alpha subunit, except?
A. LH
B. FSH
C. TSH
D. Progesterone
D. Progesterone
High-yield rationale: LH, FSH, and TSH share the same alpha subunit; progesterone is a steroid hormone, not glycoprotein.
A 36-year-old nulligravid woman consults for a fertility workup. Which of the following should be included in her evaluation?
A. Request for FSH
B. Antral follicle count
C. Both A and B
D. None of the above
C. Both A and B
High-yield rationale: FSH level and antral follicle count assess ovarian reserve and reproductive potential.
Which event in folliculogenesis is typically completed by day 5 of the menstrual cycle?
A. Selection of a dominant follicle
B. Antral formation
C. Primordial follicle activation
D. Ovulation
A. Selection of a dominant follicle
High-yield rationale: By day 5, one follicle becomes dominant and continues developing toward ovulation.
A 35-year-old nulligravid woman consults for a fertility workup. What should be included in her evaluation?
A. Request for FSH
B. Anti-Müllerian hormone and Antral follicle count
C. Both A and B
D. None of the above
C. Both A and B
High-yield rationale: FSH gives insight into ovarian function; AMH and AFC reflect ovarian reserve and fertility potential.
The presence of some nuclear vacuoles that appear at the base of the cell linings is indicative of which hormone?
A. Progesterone
B. Estrogen
C. LH
D. FSH
A. Progesterone
High-yield rationale: Subnuclear vacuolization in endometrial cells indicates early secretory changes due to progesterone.
A 35-year-old woman with a history of infertility for 2 years has been undergoing follicular monitoring. The follicle was measured at 1.8 cm. What does this signify?
A. The patient is on her ovulation phase, and this is the best time for them to have sexual contact.
B. The follicle is not yet mature, and further monitoring is needed.
C. The patient is in the luteal phase, and ovulation has already occurred.
D. The follicle is cystic and may require intervention.
A. The patient is on her ovulation phase, and this is the best time for them to have sexual contact.
High-yield rationale: A dominant follicle measuring 1.8 cm (18 mm) indicates imminent ovulation—ideal for conception.
Which of the following statements is true about the hypothalamic-pituitary-ovarian (HPO) axis in utero?
A. GnRH is present in the hypothalamus as early as 10 weeks AOG.
B. FSH and LH are produced as early as 8 weeks AOG.
C. The HPO axis becomes functional at birth.
D. The HPO axis is fully mature by the second trimester.
A. GnRH is present in the hypothalamus as early as 10 weeks AOG.
High-yield rationale: GnRH appears by 10 weeks gestation; FSH/LH production and full HPO function follow postnatally.
An 11-year-old female comes in for a consult with her mother. The child had her menarche a year ago, and subsequent menses have been occurring every 2-3 months. What is the most likely explanation?
A. Immature HPO axis
B. Polycystic ovary syndrome (PCOS)
C. Hypothyroidism
D. Normal variation in cycle length
A. Immature HPO axis
High-yield rationale: Irregular menses in the first few years after menarche is normal due to immature HPO axis.
You are examining a 13-year-old girl, and during the examination, you notice a change in contour and the presence of coarse, crinkly hair along the labia majora. What is the Tanner stage?
A. B3H2
B. B2H3
C. B4H3
D. B3H4
A. B3H2
High-yield rationale: Tanner B3 = breast enlargement without separation of contours; H2 = sparse, pigmented, crinkly hair.
Transection of the pituitary stalk will adversely affect the synthesis of which hormone(s) in circulation?
A. FSH and LH
B. Prolactin and Oxytocin
C. ACTH and TSH
D. GH and ADH
A. FSH and LH
The mother of a 9-year-old enrolled her child in gymnastics, where she practices 3 times per week. What is expected regarding the timing of the child’s menses?
A. Be delayed with each year of training
B. Occur earlier than average
C. Have no effect on menarche
D. Irregular cycles post-menarche
A. Be delayed with each year of training
High-yield rationale: High physical activity delays menarche due to energy deficit and hypothalamic suppression.
Twin sisters separated at birth, one weighing 55 kg and the other 45 kg. What principle explains the timing of their menarche?
A. BMI
B. Genetic factors
C. Environmental factors
D. Nutrition
A. BMI
High-yield rationale: Menarche timing strongly correlates with body fat/BMI—higher BMI leads to earlier menarche.
According to the two-cell gonadotropin theory, how does luteinizing hormone contribute to estrogen production?
A. By producing androgens
B. By converting androgens to estrogens
C. By stimulating the release of estrogen from granulosa cells
D. By triggering ovulation
A. By producing androgens
High-yield rationale: LH stimulates theca cells to produce androgens, which granulosa cells convert to estrogen via FSH.
In a reproductive-age woman who has missed her menses for more than 20 days with a negative pregnancy test, which of the following conditions should be excluded first?
A. Hyperprolactinemia
B. Polycystic Ovary Syndrome (PCOS)
C. Hypothyroidism
D. Pregnancy
D. Pregnancy
High-yield rationale: Always rule out pregnancy first in any amenorrheic reproductive-age woman, even if initial test is negative.
What is the first diagnostic test to request for a 24-year-old woman with a history of regular menses who presents with sudden amenorrhea?
A. Pelvic Ultrasound
B. Serum Prolactin
C. Thyroid Function Test
D. Pregnancy Test
D. Pregnancy Test
High-yield rationale: Always rule out pregnancy first in any reproductive-age woman with amenorrhea.
What is the most cost-effective diagnostic modality to evaluate the female reproductive tract?
A. Hysterosalpingography
B. MRI
C. Transvaginal Ultrasound
D. Laparoscopy
C. Transvaginal Ultrasound
High-yield rationale: Cost-effective, non-invasive, and provides detailed imaging of the uterus and ovaries.
A 25-year-old single woman, previously with normal menstrual cycles, presents with milky white breast discharge. Which test should you request?
A. Thyroid Function Test
B. Serum Prolactin
C. Pregnancy Test
D. Mammogram
B. Serum Prolactin
High-yield rationale: Galactorrhea with amenorrhea suggests hyperprolactinemia—prolactin is the first test to order.
In evaluating a woman with irregular menses and unilateral milky breast discharge, which imaging modality would be most appropriate?
A. Mammogram
B. Pelvic Ultrasound
C. Brain MRI
D. Breast Ultrasound
C. Brain MRI
High-yield rationale: Unilateral galactorrhea and amenorrhea raise suspicion for a prolactinoma—evaluate the pituitary.