Module 1 Practice Quiz

Question 1

How can you reassure/educate a 13 year-old whose friend has started menstruating but they have not ?

Answer 1

Briefly explain the Tanner stages and let Emily know that the first period usually starts sometime after Tanner Stage 3 or 4 is reached.

Question 2

A 13-year-old patient just started her menstrual cycle and complains of irregular cycles. This is probably because she has:

Answer 2

An immature hypothalamus-pituitary-ovarian (HPO) axis.

Question 3

When should patients expect their period to become regular after starting their period?

Answer 3

12 to 21 months after menarche

Question 4

Tanner stages refer to what events that take place in puberty?

Answer 4

clinical signs of breast and pubic hair growth and development.

Question 5

The menstrual cycle refers to events occurring where?

Answer 5

both uterus and ovaries

Question 6

Follicle stimulating hormone stimulates ovarian follicles to produce:

Answer 6

Estrogen

Question 7

High estrogen levels after a dominant follicle has been established do what to FSH and LH?

Answer 7

Increase follicle-stimulating hormone (FSH) and luteinizing hormone (LH) secretion

Question 8

The dominant ovarian hormone during the second half of the menstrual cycle is:

Answer 8

Progesterone

Note: Progesterone is produced by the corpus luteum at this time of the cycle.

Question 9

Hormonal regulation of the menstrual cycle is controlled by:

Answer 9

Hypothalamus, anterior pituitary, and ovaries

Note: Also referred to as the HPO axis.

Question 10

Estrogen is secreted in the:

Answer 10

Ovaries

Question 11

What primary organ secretes: Progesterone?

Answer 11

Ovaries corpus luteum

Question 12

What primary organ secretes: Estrogen?

Answer 12

Ovarian Follicles

Question 13

What primary organ secretes: Gonadotrophin releasing hormone (GnRH)?

Answer 13

Hypothalamus

Question 14

What primary organ secretes: Lutenizing hormone (LH)

Answer 14

Anterior Pituitary

Question 15

What primary organ secretes: Follicle stimulating hormone (FSH

Answer 15

Anterior Pituitary

Question 16

What primary organ secretes: Prolactin

Answer 16

Anterior pituitary

Question 17

Day 1 of the menstrual cycle corresponds to:

Answer 17

the first day of menstrual bleeding.

Question 18

During the first half of the menstrual cycle estrogen levels…

Answer 18

rise

Question 19

During the last half of the menstrual cycle, what hormone predominates?

Answer 19

Progesterone

Question 20

When estrogen is the dominant hormone, the endometrium….

Answer 20

proliferates (grows and multiplies)

Question 21

When progesterone is the dominant hormone, the endometrium…

Answer 21

thickens in preparation for implantation.

Question 22

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?”

Answer 22

• 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.

Question 23

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:

Answer 23

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.

Question 24

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:

Answer 24

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.

Question 25

Dysmenorrhea is:

Answer 25

pain during menses.

Question 26

Dysmenorrhea is caused by:

Answer 26

excess prostaglandins associated with ovulatory cycles.

Question 27

What is the difference between dysmenorrhea and physical symptoms of PMS?

Answer 27

Dysmenorrhea refers specifically to pain or cramping during menstruation itself. PMS physical symptoms usually start before the first day of bleeding and resolve within a day or two after menses begins. Women with PMS may also have dysmenorrhea as part of their symptom clusters, but many women have dysmenorrhea on its own (without any PMS). We mention this because we find this is commonly confused, based on how your textbook presents these two topics.