Week 4 Practice Questions from the Book Flashcards
Debilitating menstrual pain that disrupts a woman's lifestyle is termed: A. a menstrual irregularity. B. dysmenorrhea. C. menstrual pathology. D. menstrual dysphoria.
B. dysmenorrhea.
T/F Menstrual symptoms that cause significant discomfort and affect a woman’s quality of life are usually indicative of pathology.
False
Dysmenorrhea is more likely in a woman who: A. is over 30 years old. B. exercises regularly. C. has a body mass index over 22. D. smokes.
C. has a body mass index over 22.
T/F Primary dysmenorrhea differs from secondary dysmenorrhea in that it is caused by pelvic pathology.
True
The effectiveness of SSRIs in treating PMDD points to \_\_\_\_\_ as a possible causative factor. A. estrogen B. aldosterone C. serotonin D. progesterone
C. serotonin
T/F PMS and PMDD share many of the same symptoms: the differentiation being the severity of these symptoms.
True
Which of the following conditions is caused by the attachment of the uterus lining to organs outside of the uterus which are affected by hormones during menstruation that cause bleeding and pain and eventually result in scar tissue that can develop into chronic pelvis pain? A. Primary dysmenorrhea B. Secondary dysmenorrhea C. Endometriosis D. Uterine fibroids
C. Endometriosis
T/F By monitoring symptoms through record keeping, women and their clinicians can help rule out differential diagnoses and determine cyclical patterns to provide a better understanding of what possible care and treatment options will be successful.
True
The use of _____ by itself or along with NSAIDs can help reduce the amount of discomfort associated with pelvic pain.
heat
Taking supplemental doses of continuous vitamin B and _____ has been shown to alleviate symptoms of PMS.
calcium
The increase in endometrial _____, which is prompted by uterine contractions during menstruation, causes further contractions and results in ischemia and pain.
prostaglandins
T/F Studies about the menstrual experience have traditionally used medical jargon and been from the male perspective, making it difficult for clinicians to see the experience from a female perspective.
True
Which of the following pharmacologic therapies has been approved by the FDA for use in treating psychological, physical, and functional symptoms associated with PMS/PMDD? A. SSRIs B. Antianxiety meds C. High doses of estrogen D. Diuretics
A. SSRIs
T/F When a woman’s cycle causes severe symptoms that significantly and negatively affect her health, relationships, and her ability to function, she is diagnosed with PMDD.
True
T/F The use of COCs by some clinicians to treat dysmenorrhea is not effective for a wide array of women.
False. Contraceptives are often used in the treatment of dysmenorrhea, particularly for women who also desire both cycle control and contraception. Combined oral contraceptives (COCs) include both estrogen and progestin and act to suppress ovulation, which in turn reduces prostaglandin production and relieves dysmenorrhea in as many as 70% to 80% of women.
Sarah is taking a contraceptive to treat her dysmenorrhea and heavy menstrual bleeding. She chose this treatment to deal with her endometriosis but has seen some irregular spotting and weight gain since she started this course of treatment. Which of the following contraceptive methods is Sarah taking? A. Progestin implants B. Levo IUD C. Depo D. Oral contraceptives
B. Levo IUD
The symptoms collectively known as molimina are a result of higher levels of \_\_\_\_\_ in the body. A. progesterone B. estrogen C. cortisol D. serotonin
A. progesterone
T/F Infrequent cycles are characterized as those that occur at an interval of over 38 days.
True
Nearly \_\_\_\_\_ of women diagnosed with HMB have higher than average annual healthcare costs. A. 65% B. 80% C. 25% D. 50%
B. 80%
T/F Over half of all annual GYN visits are attricuted to abnormal uterine bleeding.
False. It accounts for as many as 1/3.
The category of \_\_\_\_\_ is unrelated to structural abnormalities. A. leiomyoma B. malignancy C. coagulopathy D. hyperplasia
C. coagulopathy
T/F In the PALM-COEIN system, PALM is defined by structural criteria, while COEIN categories are unrelated to structural abnormalities.
True
Women who are \_\_\_\_\_ have an increased rate of endometrial cancer. A. of reproductive age B. premenopausal C. obese D. African American
C. obese
T/F Physiologic causes of anovulation include not only obesity but also a BMI under 18.
True
The most accurate method of diagnosing endometrial pathologies is: A. TSH B. SIS C. TVS D. MRI
B. SIS
T/F In order to rule out structural abnormalities as a cause of AUB, an MRI and CT scan should be ordered in addition to general labs.
False
\_\_\_\_\_ should not be considered for long-term treatment. A. Progestogens B. GnRHas C. IUDs D. Progestin therapy
B. GnRHas
T/F The quickest way to stop acute bleeding is endometrial ablation.
False. High dose estrogen.
The treatment of choice for AUB is: A. surgery. B. CHM. C. combined contraceptives. D. estrogen therapy.
C. combined contraceptives.
T/F The mechanism and efficacy of using CEE therapy in anovulatory bleeding is well documented, which is why it is a treatment of choice for many healthcare providers.
False
\_\_\_\_\_ may indicate hypothyroidism, which can cause amenorrhea. A. Positive progestogen challenge B. Elevated FSH C. Low TSH D. Elevated TSH
D. Elevated TSH
T/F The most common cause of amenorrhea is ovarian function abnormalities.
True
A primary method of treating abnormal bleeding in adolescents should be: A. estrogen therapy. B. combined contraceptives. C. weight-bearing exercises. D. nutrition counseling.
D. nutrition counseling.
T/F In postmenopausal women, all uterine bleeding should be considered cancer until ruled out.
True
T/F The uterus, ovary, and pituitary are the anatomical structures that are responsible for a normal menses.
False. It requires 4: uterus, ovary, pituitary, and hypothalamus.
_____ has a large impact on adolescent gynecologic health, and eating such as bulimia and anorexia can negatively affect normal menstruation in adolescent females.
Nutrition
T/F While the interval, amount, and duration of menses is different for each individual, a normal menses for an individual woman will follow the same pattern once she has ovulated unless there is a significant change in her health status.
True. Menses resulting from ovulatory cycles tend to demonstrate the same interval, amount, and duration from cycle to cycle unless significant health changes occur that negatively affect the HPOA.
Risk factors such as obesity and polycystic ovarian syndrome increase the chance that a woman with AUB might have _____ cancer.
Endometrial
T/F When deciding on a course of treatment for AUB, the age of the woman is the most important factor to consider.
False. The woman’s choice of treatment should always be considered.
Which of the following surgical procedures would be justified if a woman desires a less invasive procedure and does not consider fertility to be a priority? A. Endometrial ablation B. Uterine artery embolization C. D and C D. Hysterectomy
A. Endometrial ablation
How should a clinician proceed if an adolescent who has already started to menstruate presents with AUB?
A. Evaluate for endocervical polyps.
B. Order diagnostic tests such as an ultrasound or MRI.
C. Rule out possible pregnancy or a complication due to pregnancy.
D. Draw blood to determine evidence of a blood clotting disorder.
C. Rule out possible pregnancy or a complication due to pregnancy.
Which of the following times are common for women to experience bleeding outside of their recognized patterns of menstruation? A. Postmenarche B. Perimenopause C. Pregnancy D. Postmenarche and perimenopasue
B. Perimenopause
A clinician who observes a patient who complains of AUB and has pale skin tone and delayed cap refill has a probably diagnosis of which of the following conditions? A. Hypothyroidism B. Anemia C. Galactorrhea D. Pituitary disease
B. Anemia
AUB caused by the use of hormonal contraceptives would be categorized as _____ in the PALM-COEIN classification system.
Iatrogenic (AUB-I)
In reprodutive-aged women, hyperandrogenism is most frequently associated with: A. PCOS. B. early-onset menopause. C. androgen-producing tumors. D. nonclassical adrenal hyperplasia.
A. PCOS.
T/F The most common source of increased testosterone and androstenedione is the adrenal glands.
False. The ovaries are the most common source.
Most women who present with \_\_\_\_\_ will be found to have polycystic ovary syndrome. A. acne B. hirsutism C. alopecia D. obesity
B. hirsutism
T/F Women with PCOS have higher rates of depressive and anxiety disorders, often relating to physical effects such as hirsutism, alopecia, acne, and obesity.
True
All women who have hyperandrogenism should have a \_\_\_\_\_ test to exclude hyperprolactinermia and thyroid disorders. A. insulin resistance B. serum prolactin C. fasting lipid profile D. 2-hour oral glucose tolerance
B. serum prolactin
T/F An endometrial biopsy is recommended for women over age 40 who have longstanding anovulation.
False
The diagnosis of PCOS is primarily based on:
A. hirsutism.
B. menstrual dysfunction.
C. ruling out all other possible causes of hyperandrogenism.
D. anovulation.
C. ruling out all other possible causes of hyperandrogenism.
T/F Four specific and biologically different phenotypes of PCOS have been identified.
True
Approximately 4% of women with androgen excess have \_\_\_\_\_, which is also marked by acanthosis nigricans and severe hyperinsulinemia. A. HAIR-AN syndrome B. an androgen-producing tumor C. Cushing syndrome D. idiopathic hirsutism
A. HAIR-AN syndrome
T/F While Cushing syndrome is a common referral diagnosis of androgen excess, it is rarely the final diagnosis.
True
\_\_\_\_\_ may be recommended for women with impaired glucose tolerance of normal weight such that weight loss is not appropriate. A. Spironolactone B. Flutamide C. Metformin D. Finasterid
C. Metformin
T/F Antiandrogens alone are generally safe for sexually active women of productive age.
False. Antiandrogens are effective in the treatment of hirsutism, but they should always be used in combination with effective contraception in a woman who is sexually active because of their potential for teratogenicity.
In adolescents, premature adrenarche may be a consequence of: A. a theca-lutein cyst. B. hyperinsulinemia. C. hyperreactio luteinalis. D. luteoma.
B. hyperinsulinemia.
T/F Women with PCOS usually experience a deterioration of menstrual function as they age.
False
Which of the following pharmacologic treatments is used to address hirsutism in women who do not want or need to take COCs? A. Drospirenone B. Metformin C. Antiandrogens D. Progestogens
D. Progestogens
Markers for _____ disease have been found in women with PCOS along with increased risk factors for metabolic syndrome.
Cardiovascular
T/F With the development of new ultrasound technology, guidelines concerning the morphology of the polycystic ovary has changed from 25 follicles to 12 ovarian follicles measuring 2-9 mm in the whole ovary.
False. It changed from 12 to 25.
T/F Development in the education of the public has resulted in increased awareness of PCOS and the affect it has on the lives of women.
False. It is not well understood by the public.
Michelle has noticed a decrease in the density of her hair on her scalp and has begun to notice some patches toward the back of her head where she can see her scalp through her thinning hair. Which of the following initial diagnoses might help Michelle without any additional screening or tests. A. Alopecia B. Hyperandrogenemia C. PCOS D. Virilization
A. Alopecia
T/F There are no preventive measures that can be taken to keep from developing PCOS, but early detection and management can help deal with risk factors.
True
A woman who has experienced increased muscle bulk, voice deepening, and a rapid development of symptoms of hirsutism should be evaluated for which of the following rare conditions? A. Glucose intolerance B. Hyperprolactinemia C. Pituitary tumor D. Androgen-producing tumor
D. Androgen-producing tumor
Changes in hair growth in areas that are androgen sensitive that modify hair texture and increase its density are called _____.
Hirsutism
Determining _____ levels at specific times during a woman’s menstrual cycle can help diagnose ovulatory dysfunction in women who exhibit clinical signs of hyperandrogensism with regular menstrual cycles.
Progesterone.Women who have clinical signs of hyperandrogenism with regular menstrual cycles should be evaluated for ovulatory dysfunction by obtaining a serum progesterone level between days 20 and 24 of the menstrual cycle. If this luteal-phase progesterone level is less than 3 ng/mL, the cycle is considered oligo-anovulatory. Repeating the progesterone level during a second cycle can confirm the diagnosis of chronic oligo-anovulation and PCOS.
T/F The ovaries and the adrenal glands along with secondary conversions by the adipose tissue, skin, and the liver are responsible for androgen production.
True
\_\_\_\_\_ pain serves as a defense mechanism that alerts the sufferer to tissue injury or disease, which is why it is known as "pain with purpose." A. Visceral B. Somatic C. Neuropathic D. Nociceptive
D. Nociceptive
T/F Almost half of women who report to the emergency room are experiencing chronic pelvic pain.
False. Almost half of all visits to the emergency department by women of reproductive age are for complaints of ACUTE pelvic pain, pelvic inflammatory disease, and lower genital tract infections (e.g., cervicitis, candidiasis, Bartholin’s abscess)
About 1/4 of women who experience CPP have: A. cancer. B. syphilis. C. PID. D. endometriosis.
D. endometriosis.
T/F The Carnett test can be used to differentiate abdominal wall pain from visceral sources of pain.
True
The most common source of acute pelvic pain in women is: A. abdominal wall hernia. B. ectopic pregnancy. C. diverticulitis. D. appendicitis.
D. appendicitis.
T/F Ovarian hyperstimulation syndrome is a potentially life-threatening complication of ovulation induction resulting from fertility treatment.
True
The most common functional gastrointestinal disorder is: A. lactose allergy. B. IBS. C. Crohn's disease. D. diverticulitis.
B. IBS.
T/F Diagnosis of IBS can be made if a woman is positive for 3/5 Rome criteria.
False. The Rome III Diagnostic Criteria for IBS include the following findings: recurrent abdominal pain or discomfort that has occurred for at least 3 days each month for the past 3 months and has been accompanied by at least two of the following: (1) improvement with defecation, (2) onset associated with a change in frequency of stool, and (3) onset associated with a change in form (appearance) of stool.
\_\_\_\_\_ is a commonly used surgical treatment for endometriosis. A. Reconstructive pelvic surgery B. Laser ablation C. Presacra neurectomy D. Hysterectomy
B. Laser ablation
T/F Pharmacologic treatment for CPP usually begins with a mild opioid such as codeine or hydrocodone.
False.
Recetn studies have shown that women:
A. tend to experience more psychosomatic pain than men.
B. tend to rate pain intensity lower on a pain scale than men.
C. tend to rate pain intensity higher on a pain scale than men.
D. tend to experience pain the same as men.
C. tend to rate pain intensity higher on a pain scale than men.
T/F In adolescents, pelvic pain is more likely to be of gynecologic origin than of GI origin.
True
T/F Chronic pelvic pain is most often classified as gynecologic.
False
Which of the following risks doubles in those suffering from chronic pain? A. Suicide B. Depression C. Substance abuse D. Divorce
C. Substance abuse
Attitude, culture, and _____ all provide a different context to understanding pain and can affect a clinician’s ability to provide competent health care.
Gender
While it can take time, once a definitive diagnosis and treatment are instituted for a patient with chronic pelvic pain, the chance for recurrence is low.
False. It is very important the clinicians understand that even a distinct diagnosis does not ensure that treatment will be curative; indeed, recurrence of CPP is common.
Dr. Ross has a patient who presents with acute pelvic pain that is crampy, continuous, and unilateral. She has an elevated temp and vaginal bleeding. Which of the following gynecological conditions is her patient suffering from? A. Ectopic pregnancy B. Ovarian cysts C. Adnexal torsion D. Uterine fibroids
A. Ectopic pregnancy
Recent studies and evidence in chronic pain have determined that pain differences exist between which of the following?
A. Gynecological and nongynecological
B. Men and women
C. Premenopausal and postmenopausal women
D. Pharmacologic and nonpharmacologic treatment
B. Men and women
PID or ectopic pregnancy is categorized as _____ pelvic pain, which comes upon an individual suddenly and can be sharp, intense, and short in duration.
Acute
T/F Treating chronic pelvic pain in adolescents must include an awareness of the state and local statutes regarding health care for minors and parental consent laws that form legal restrictions regarding care.
True
Which of the following pharmacologic treatments for CPP is useful for patients with localized areas of pain and involves the use of electrical impulses to control pain? A. Hormonal treatment B. Laser ablation C. Adnexal torsion D. TENS
D. TENS
A patient with acute abdominal pain accompanied by symptoms of bloating, urgency of defecation, diarrhea, and blood in their stool would be diagnosed with _____.
IBS
