Practice quiz 2 Flashcards
Which of the following is NOT a functional cause of abnormal uterine bleeding?
a) Coagulopathy
b) Iatrogenic
c) Leiomyoma
d) Endometrial
c) Leiomyoma
Which of the following has the ability to evaluate the endometrial stripe (thickness) to look for endometrial proliferation?
a) Endometrial biopsy
b) Transvaginal ultrasound
c) Pelvic ultrasound
d) Abdominal ultrasound
b) Transvaginal ultrasound
True or false: History of D&C is a risk factor for Asherman syndrome, which is the most common anatomic cause of abnormal uterine bleeding
True
Imperforate hymen & absence of uterus or vagina may be due to which of the following?
a) Mullerian agenesis
b) Asherman syndrome
c) Secondary amenorrhea
d) Congenital adrenal hyperplasia (CAH)
a) Mullerian agenesis
If a patient has Hypothalamic-pituitary (HP) amenorrhea, what will their hormone levels most likely be?
a) High FSH, LH, and estradiol; low PRL (prolactin)
b) High FSH and PRL; low FSH and estradiol
c) Low FSH, LH, PRL, and estradiol
d) Low FSH, LH, and estradiol; normal PRL
d) Low FSH, LH, and estradiol; normal PRL
What are the 2 most common gynecologic disorders of reproductive-aged women?
a) Primary and secondary amenorrhea
b) Amenorrhea and abnormal uterine bleeding
c) PMS and PMDD
d) Endometriosis and PCOS
b) Amenorrhea and abnormal uterine bleeding
What is the gold standard treatment for PMDD?
SSRIs
Which of the following is NOT a recommended nonpharmacologic Tx for PMS and PMDD?
a) Weightlifting
b) Aerobic exercise
c) Calcium carbonate supplementation
d) Magnesium supplementation
e) Keeping a daily record/ diary
a) Weightlifting
True or false: Anemia & hypothyroidism are common in young menstruating women, and are even more common in patients with PMS or PMDD
False; they are common in young menstruating women, but are not more common in pts with PMS or PMDD
What does diagnosis of PMDD and PMS depend on?
a) Relationship of symptoms to menstrual phase
b) Relationship of symptoms to luteal phase
c) Lab findings (abnormal TSH, FSH, LH, or estrogen)
d) Somatic symptoms only
b) Relationship of symptoms to luteal phase
The most common cause of primary amenorrhea in women with normal breast development is what?
a) Idiopathic imperforate hymen
b) Mullerian agenesis
c) Kallmann syndrome
d) Craniopharyngioma
e) Constitutional (physiologic) delay
f) Low BMI
g) Turner syndrome
b) Mullerian agenesis
The most common cause of delayed puberty with an elevated FSH is what?
a) Idiopathic imperforate hymen
b) Mullerian agenesis
c) Kallmann syndrome
d) Craniopharyngioma
e) Constitutional (physiologic) delay
f) Low BMI
g) Turner syndrome
g) Turner syndrome
Primary ovarian insufficiency results in _______ levels of estradiol, and _______ levels of gonadotropins (LH, FSH).
a) high, high
b) high, low
c) low, high
d) high, low
c) low, high
Which of the following patients should you NOT consider evaluating for primary amenorrhea?
a) 15 year old without menarche
b) 13 year old without thelarche
c) 14 year old without menarche (had thelarche at 12 y/o)
d) 14 year old without menarche (had thelarche at 10 y/o)
c) 14 year old without menarche (had thelarche at 12 y/o)
Which of the following causes of precocious puberty is correctly matched with its treatment?
a) GnRH-dependent (central): GnRH antagonist
b) GnRH-independent (peripheral): GnRH agonist
c) GnRH-dependent (central): suppress gonadal steroidogenesis (based on cause)
d) GnRH-dependent (central): GnRH agonist
d) GnRH-dependent (central): GnRH agonist
Which of the following abnormal hormone levels during precocious puberty may cause short stature in adulthood?
a) Elevated estrogen
b) Elevated progesterone
c) Low estrogen
d) Low growth hormone
a) Elevated estrogen
Which of the following most directly lead to the physical changes of puberty?
a) Higher levels of LH + FSH
b) Higher levels of estrogen + progesterone
c) Higher levels of gonadotropins
d) Lower levels of sex steroids
b) Higher levels of estrogen + progesterone
Self-awareness about sexuality evolves when?
a) Before age 3
b) During childhood
c) During adolescence
d) During early adulthood
b) During childhood
What hormonal change at the end of the luteal phase results in endometrial breakdown & sloughing?
a) Spike in progesterone
b) Spike in estrogen
c) Withdrawal of progesterone
d) Withdrawal of estrogen
c) Withdrawal of progesterone
Which of the following is the most correct regarding the follicular phase?
a) Granulosa cells produce gonadotropins, theca cells produce sex steroids
b) Theca cells produce progesterone, Granulosa cells produce estrogen
c) Theca cells produce estrogens, Granulosa cells produce androgens
d) Granulosa cells produce estrogens, Theca cells produce androgens
Granulosa cells produce estrogens, Theca cells produce androgens
Ovulation occurs within ___________ hrs of the LH surge.
a) 20-24
b) 12-15
c) 30-36
d) 24-30
c) 30-36
Most common cause of ovulatory dysfunction in reproductive-aged women is what?
a) Mullerian agenesis
b) Kallmann syndrome
c) Turner syndrome
d) PCOS
e) PMDD
d) PCOS
What makes up 40% of male fertility causes?
a) Mumps/ prostatitis
b) CCBs
c) Aspermatogenesis
d) Abnormal spermatogenesis
d) Abnormal spermatogenesis
When treating PCOS, what may be added to a combination OCP to treat hirsutism?
a) Peripheral antiandrogen (ex: spironole actone)
b) Central androgen (ex: spironole actone)
c) Central androgen (ex: testosterone)
d) Peripheral androgen (ex: DHEA)
a) Peripheral antiandrogen (ex: spironole actone)
Which of the following is NOT a lab done when evaluating for PCOS to rule out other disorders?
a) Basal serum 17-hydroxyprogesterone level
b) LH:FSH ratio
c) Serum prolactin & TSH levels
d) 24-hour free urinary cortisol or overnight dexamethasone suppression test
b) LH:FSH ratio
PCOS carries an increased risk for which of the following cancers?
a) Ovarian
b) Breast
c) Endometrial
d) Vaginal
c) Endometrial
The most common cause of androgen excess and hirsutism in women is what?
a) Congenital adrenal hyperplasia (CAH)
b) PCOS
c) Turner syndrome
d) Mullerian agenesis
e) HAIR-AN
b) PCOS
What is defined by at least 2 out of 3 of the Rotterdam Criteria?
a) PCOS
b) Hirsutism
c) PMDD
d) PMS
a) PCOS
What is defined by a score >/= 8 on the modified Ferriman-Gallwey scale?
a) PCOS
b) Hirsutism
c) PMDD
d) PMS
b) Hirsutism
Define hirsutism
a) Excess vellus hair (dark, thick, coarse) in a random pattern distribution
b) Excess terminal hair (dark, thick, coarse) in a random pattern of distribution
c) Excess vellus hair (dark, thick, coarse) in a male pattern of distribution
d) Excess terminal hair (dark, thick, coarse) in a male pattern of distribution
d) Excess terminal hair (dark, thick, coarse) in a male pattern of distribution
Medroxyprogesterone acetate (Depo-Provera) is the most commonly used medication for what?
a) PCOS treatment
b) Primary amenorrhea treatment
c) Progesterone challenge test
d) Secondary amenorrhea treatment
c) Progesterone challenge test
Which of the following is NOT an acceptable surgical treatment for acute and chronic abnormal uterine bleeding (AUB)?
a) Hysteroscopy with D&C
b) Selective embolization of uterine vessels
c) Balloon tamponade
d) Endometrial ablation
e) Hysterectomy
f) All are acceptable treatments (under different circumstances)
g) None are acceptable treatments for AUB
f) All are acceptable treatments (under different circumstances)
Which of the following are the initial labs for AUB? Select all that apply
a) HCG
b) CBC
c) Thyroid
d) Coagulation tests (PT, PTT, INR)
e) Iron + ferritin
f) Creatinine
g) T&S
h) BUN
i) Liver
a) HCG
b) CBC
d) Coagulation tests (PT, PTT, INR)
e) Iron + ferritin
g) T&S
Which of the following are structural causes of abnormal uterine bleeding? Select all that apply
a) Polyp
b) Coagulopathy
c) Iatrogenic
d) Endometrial
e) Adenomyosis
f) Leiomyoma
g) Malignancy
h) Hyperplasia
a) Polyp
e) Adenomyosis
f) Leiomyoma
g) Malignancy
h) Hyperplasia
Which of the following is NOT recommended in treating PCOS related hirsutism?
a) Shaving
b) Depilatory creams
c) Plucking
d) Electrolysis
e) Laser therapy
f) Intense pulsed light
c) Plucking
Puberty is a ___________ process
a) Endocrine
b) Exocrine
c) Merocrine
d) Hormonal
a) Endocrine
Which of the following puts steps of puberty in the correct order?
a) Growth acceleration, pubarche, thelarche, maximum growth, menarche
b) Growth acceleration, pubarche, thelarche, menarche, maximum growth
c) Growth acceleration, thelarche, pubarche, maximum growth, menarche
d) Growth acceleration, thelarche, pubarche, menarche, maximum growth
c) Growth acceleration, thelarche, pubarche, maximum growth, menarche
Which form of precocious puberty is more common and more likely to be idiopathic?
a) GnRH-dependent sex hormone production: true/ central
b) GnRH-independent sex hormone production false/ peripheral
a) GnRH-dependent sex hormone production: true/ central
Anosmia & no breast development (no GnRH) are common symptoms of which of the following?
a) Idiopathic imperforate hymen
b) Kallmann syndrome
c) Mullerian agenesis
d) Craniopharyngioma
e) Constitutional (physiologic) delay
f) Low BMI
g) Turner syndrome
b) Kallmann syndrome
What is the most common tumor/ calcified cyst associated with delayed puberty?
a) Ovarian cyst
b) Hypothalamic tumor
c) Brain stem tumor
d) Craniopharyngioma
d) Craniopharyngioma
What is the typical order you should give hormones to a patient with Tanner syndrome?
a) Estrogen, GH, progestin
b) GH, progestin, estrogen
c) GH, estrogen, progestin
d) Estrogen, progestin, GH
c) GH, estrogen, progestin
What hormone(s) are elevated with hypergonadatropic hypogonadism? Select all that apply
a) LH
b) FSH
c) Estradiol
d) PRL
a) LH
b) FSH
Incomplete genital plate canalization will cause what?
a) Vaginal agenesis
b) Imperforate hymen
c) Mullerian syndrome
d) Kallmann syndrome
b) Imperforate hymen
How common is PMS?
a) Affects 90-95% of women
b) Affects 80-85% of women
c) Affects 75-85% of women
d) Affects 50-55% of women
c) Affects 75-85% of women
How many symptoms are necessary to diagnose PMS?
a) At least 1
b) At least 2
c) At least 3
d) At least 4
a) At least 1
Describe molimina and PMS
a) Molimina is a diagnosable condition, PMS is normal
b) PMS is a diagnosable condition, molimina is normal
c) Both molimina and PMS are diagnosable conditions
d) Both molimina and PMS are normal
b) PMS is a diagnosable condition, molimina is normal
Which of the following regarding PMS and PMDD is most correct?
a) PMDD must include physical symptoms
b) PMDD must include mood-related symptoms
c) PMS must include physical and mood related symptoms
d) PMS must include physical symptoms
b) PMDD must include mood-related symptoms
What 2 supplements may help PMS and PMDD? Select 2
a) Calcium carbonate
b) Magnesium
c) Vitamin C
d) Zinc
a) Calcium carbonate
b) Magnesium
Which of the following SSRIs are FDA approved for PMDD treatment? Select all that apply
a) Fluoxetine
b) Sertraline
c) Buspirone
d) Paroxetine
e) Escitalopram
a) Fluoxetine
b) Sertraline
d) Paroxetine
Which of the following conditions should you use Drospirenone/ethinyl estradiol for?
a) Endometriosis
b) Amenorrhea
c) PMS
d) PMDD
d) PMDD
Define Hypomenorrhea
a) Bleeding occurring less frequently than every 35 days (>35days)
b) Lack of for 3 months in individuals with hx of regular cycles or for 6 months in those with irregular cycles.
c) Reduction in number of days or amount of menstrual flow
d) No menarche by age 16
c) Reduction in number of days or amount of menstrual flow
Which of the following are potential causes of Hypothalamic-pituitary (HP) dysfunction? Select all that apply
a) Altered catecholamine (dop, epi, norepi) secretion & sex steroid hormone feedback
b) Alteration of blood flow through the hepatic portal system
c) Alteration of blood flow through HP portal plexus (i.e., tumor)
d) Alteration of blood flow to the uterus
a) Altered catecholamine (dop, epi, norepi) secretion & sex steroid hormone feedback
c) Alteration of blood flow through HP portal plexus (i.e., tumor)
True or false: Asherman syndrome is the most frequent anatomic cause of primary amenorrhea
False; secondary amenorrhea, not primary
If withdrawal bleeding does not occur with a progesterone challenge test, which if the following conditions is NOT a potential cause of the pts amenorrhea?
a) Asherman syndrome
b) PCOS
c) Premature ovarian failure
d) Outflow tract obstruction
b) PCOS
Which of the following locations of tubal occlusion is most common?
a) Mid-section
b) Isthmus-cornual
c) Fimbrial end
d) Ampulla
c) Fimbrial end
Which of the following parts of the tube is most likely to be affected by TB?
a) Mid-section
b) Isthmus-cornual
c) Fimbrial end
d) Salpingitis
a) Mid-section
