Repro wk 1

Question 1

withdrawl bleeding following the admin of a progestin imples the patients has what levels of pituitary gonadottopins?

Answer 1

normal levels, because what happens is that withdrawa bleed means the progestin was being adminstered and then the progestin was stopped and the woman started bleeding = correct, usually progesterone maintains your progestation uterus

Question 2

the layer of the endometrium that remains to regenerate after menstuation is

Answer 2

the basal zone

Question 3

what is the most common pattern of hormonal change for amenorrhea caused by PCOS?

Answer 3

normal estrogen, decreased progesterone, high androgen

Question 4

PCOS is associate with what elevated hormone?

Answer 4

elevated plasma lutenizing hormone ( LH)

Question 5

the hormone produced by the crpus luteum which inhibitos ovulation is

Answer 5

progesterone

Question 6

the follicular phase of the ovarian cycle is characterized by the synthesis of high levels of

Answer 6

high estrogen levels in the ovary

Question 7

what is the role of FSH in menstuation?

Answer 7

FSH induced the granulosa cell’s LH receptors within the dominant follicle. this relates to the “ two cell theory” of estrogen synthesis, where the developing follicle requires both granulosa cells and the theca.

Question 8

what are the products of the second meiosis released from teh graffian follicle during ovulation?

Answer 8

secondary oocyte and first polar body.

Question 9

the progressive sequence ( with some steps omitted) in the metabolism of steroid hormones is:

Answer 9

cholesterol pregnenolone to androstenedione estradiol

Question 10

what is the ejaculatory duct?

Answer 10

when the vas deferens and the duct of the seminal vesicle meet, to go into the prostate together.

Question 11

trace the path of sperm during ejaculation

Answer 11

seminiferous tubules. epididymis, vas deferens, urethra

Question 12

which cell from the list is haploid:
spermatogonium
primary spermatocyte
spermatid
sertoli cell

Answer 12

spermatid

Question 13

physiologically mature spermatozoa could be obtain from wihch region(s) of the male reproductive tract?

Answer 13

cause epididymis ( distal part of the epi)

Question 14

in the azoospermic male, the diagnosis of testiculare failure can be made by the finding of elevated levels of:

Answer 14

FSH. the sertoili cells of the tests produce inhibitn, which maintains the FSH in normal range. Injury to the sertoli cells reduce inhibin production, thus permitting FSH levels to rise. Finding elevated FSH in men with azoospermia is evidence that the lesion lies within the testes

Question 15

the simplest and most accurate way to test and confirm ovulation is to do a:

Answer 15

mid luteal progesterone assay.

Question 16

the fertilized human ovum implants in the uterus at what day after ovulation?

Answer 16

approximately 6 days after ovulation

Question 17

which contraception method has the highest failure rate?

Answer 17

natural family planning methods ( basal temperature etc)

Question 18

a couple has unprotected intercourse for a year and have not conceived, what would you advise the couple do regarding the most productive approach to pregnancy?

Answer 18

donor oocyte IVF

Question 19

in PCOS, the rist of what is NOT shown to be increasd .

Answer 19

osteoporosis, the risk has not been shown to increase in PCOS.

Question 20

what are indications for cyclic progestin therapy in PCOS?

Answer 20

protection of the endometrium from changes associted with chronic anovulation ( eg against hyperplastic and neoplastic changes) . treating hirsuitism and insulin resistance are not indications

Question 21

what is the general probabiltiy of conceiving during a monthly cycle?

Answer 21

20%

Question 22

a 30 yr old G2 P2 presents with 18 months history of inability to conceive following an emergency surgery for a ruptured apprendix. She developed an acute appendicitis after the borth of her seocnd child 2 years ago and decided to try 6 months after the srugery to become pregnant again her most likely diagnosis is:

Answer 22

tubal disease

Question 23

a 28 yr olf female athelete prevent with inability to conceive despite unprotected intercourse for 18 months. per periods are erratic and stopped 18 months ago. her lower genital tract appears hypoestrogenic. the most likely diagnosis is:

Answer 23

hypothalamic amenorrhea ( hypohypo)

Question 24

clomiphene citrate is the most likely to be effective in restoring fertility in a patient with what disorder?

Answer 24

oligomenorrhea

Question 25

testicular varicoceles should be repaired when:

Answer 25

when present if there is no other explanation for the male factor infertility in association with abnormal bulk semen parameters