Module 1 Practice Quiz Flashcards
How can you reassure/educate a 13 year-old whose friend has started menstruating but they have not ?
Briefly explain the Tanner stages and let Emily know that the first period usually starts sometime after Tanner Stage 3 or 4 is reached.
A 13-year-old patient just started her menstrual cycle and complains of irregular cycles. This is probably because she has:
An immature hypothalamus-pituitary-ovarian (HPO) axis.
When should patients expect their period to become regular after starting their period?
12 to 21 months after menarche
Tanner stages refer to what events that take place in puberty?
clinical signs of breast and pubic hair growth and development.
The menstrual cycle refers to events occurring where?
both uterus and ovaries
Follicle stimulating hormone stimulates ovarian follicles to produce:
Estrogen
High estrogen levels after a dominant follicle has been established do what to FSH and LH?
Increase follicle-stimulating hormone (FSH) and luteinizing hormone (LH) secretion
The dominant ovarian hormone during the second half of the menstrual cycle is:
Progesterone
Note: Progesterone is produced by the corpus luteum at this time of the cycle.
Hormonal regulation of the menstrual cycle is controlled by:
Hypothalamus, anterior pituitary, and ovaries
Note: Also referred to as the HPO axis.
Estrogen is secreted in the:
Ovaries
What primary organ secretes: Progesterone?
Ovaries corpus luteum
What primary organ secretes: Estrogen?
Ovarian Follicles
What primary organ secretes: Gonadotrophin releasing hormone (GnRH)?
Hypothalamus
What primary organ secretes: Lutenizing hormone (LH)
Anterior Pituitary
What primary organ secretes: Follicle stimulating hormone (FSH
Anterior Pituitary
What primary organ secretes: Prolactin
Anterior pituitary
Day 1 of the menstrual cycle corresponds to:
the first day of menstrual bleeding.
During the first half of the menstrual cycle estrogen levels…
rise
During the last half of the menstrual cycle, what hormone predominates?
Progesterone
When estrogen is the dominant hormone, the endometrium….
proliferates (grows and multiplies)
When progesterone is the dominant hormone, the endometrium…
thickens in preparation for implantation.
A patient presents with periods every 34 days. She reports the following: I feel awful! “I have terrible cramps for two days, heavy bleeding, and I often get nauseated. I’ve even thrown up! What can I do?”
- ibuprofen 800 mg PO TID starting a couple of days before her period is expected and continuing for 48 hours
- menstrual suppression using a low-dose combined oral contraceptive pill
- heating pads applied to her abdomen, reassurance, and rest when she has symptoms.
B, aged 33, presents to the office saying “I just can’t stand myself anymore.” She reports sadness, irritability, crying, and states that she yells at her children too much. To best determine how to help B, the clinician should FIRST inquire about:
how long B has been feeling this way.
Note: Yes! It’s very important to determine whether or not B has major depression. If she has had these symptoms for 2 weeks, combined with a lack of enjoyment or pleasure and feeling hopeless, B may be depressed.
Z is a 36-year-old woman whom the clinician has determined has PMS. Z would like to know what her options are to treat her condition. Her symptoms include bloating and fluid retention, moodiness beginning about 5 days before her period begins, feelings of anxiety, breast pain, and craving carbohydrates like chocolate and potato chips. The clinician responds, considering that:
Z should be heavily involved in establishing treatment goals and priorities for herself.
Note: Yes! Z should establish her own treatment goals, with a little facilitation and help from the clinician. The clinician can help Z identify which symptoms are the most bothersome, and help Z determine how much better those symptoms will need to become in order for Z to feel comfortable and satisfied with her quality of life premenstrually.
