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Exam 2: NU664D/ NU 664D (NEW 2025/ 2026 Update) Guide | 100% Correct- Regis
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estradioll labsl indicate Answer: howl welll thel ovariesl arel producingl estrogen lowl whenl therel isl disorderedl eating
Whatl tol orderl ifl alll amenorrheal wul isl negative Answer: progesteronel challengel test pelvicl USl tol measurel endometriall stripe
endometriall stipel thicknessl overl ____l indicatesl adequatel productionl ofl estrogen? Answer: 6mm
Whatl labsl wouldl youl orderl forl - l breastl tenderness,l nausea,l fatigue,
Answer: UPT
Whatl labsl wouldl youl orderl forl - l fatigue,l depression,l dryl skin,l brittlel nailsl coldl intolerance,l constipation,l memoryl problems,l goiter,l weightl gain,l faciall puffiness Answer: TSH,l T3,l T
Whatl labsl wouldl youl orderl forl - l HA,l visuall fieldl defects,l galactorrhea Answer: prolactin
Whatl labsl wouldl youl orderl forl disorderedl eating? Answer: estradiol
Whatl labsl wouldl youl orderl forl shortl stature,l shieldl chest,l lackl ofl secondaryl sexl characteristics,l ovariesl absent Answer: Karyotype,l FHS/LH,l testosterone
Whatl labsl wouldl youl orderl forl irregularl menstruall cyclel withl obesity,l hirtisum,l acne,l male-patternl hairl loss Answer: seruml androgen,l testosterone,l prolactin,l seruml 17 - hyroxyprogesterone,l fastingl glucose
Dysmenorrhea:l subjectivel (primary) Answer: crampy,l achy,l dill,l midlinel pain,l radiationl tol back/legs/abdomen painl beginningl hours-daysl beforel mensesl andl persistl forl 24 - 48 l hours
PMSl symptoms Answer: n/v,l fatigue,l dizziness,l diarrhea,l nervousness,l andl HA
Secondaryl Dysmenorrhea:l definition Answer: changesl tol timingl orl intensityl ofl painl plusl prescencel ofl pelvicl pathology
Secondaryl Dysmenorrhea:l SXS Answer: dyspareunia,l HMB,l IMB,l postcoitall bleeding,l irregularl cycles,l urinaryl complaints,l diarrhea,l vaginall discharge
Secondaryl Dysmenorrhea:l keyl differentiatingl factor Answer: presencel ofl symptomsl ofl painl andl bleedingl thatl persistl beyondl thel normall menstruall cycle
primaryl dysmenorrhea:l examl findings Answer: normal,l mildl tenderl uterus
Secondaryl dysmenorrhea:l examl findings Answer: dependsl onl etiology
Secondaryl dysmenorrhea:l examl findingsl - l endometriosis Answer: normall examl withl nodularity,l thickening,l orl focall tendernessl onl uterosacrall ligament,l cervicall stenosis,l fixedl ovariesl orl uterus,l adnexall fullness
Secondaryl dysmenorrhea:l examl findingsl - l adenmyosis Answer: enlargedl uterus,l softl andl tenderl withl normall mobility
Secondaryl dysmenorrhea:l examl findingsl - l leiomyomas Answer: uterusl enlarged,l firm,l irregularl shape
Secondaryl dysmenorrhea:l examl findingsl - l infection Answer: discharge,l cervicall motionl tenderness,l adnexall tenderness,l fever,l andl uterinel tenderness
COCl - l lowl dose,l takenl inl al continuousl orl extendedl cyclel tol eliminatel menstruationl andl associatedl symptomsl (shouldl allowl forl withdrawall bleedl everyl 3 l months),l 90%l effective depo/nexplanonl - l reducel painl andl morel effectivel forl endometriosisl hormonall IUDl - l mayl reducel byl 50%l andl effectivel forl endometriosis
postmenopausall bleeding:l clinicall manifestations Answer: bleedingl afterl 12 l monthsl cessationl ofl menses
postmenopausall bleeding:l differentiall dx Answer: structurall (polyp),l hyperplasia/carcinoma,l medicationsl (COCs,l anticoagulants,l herbal,l dietl supplements),l inflammationl ofl adjacentl organsl (diverticulitis,l endometriosis)
postmenopausall bleeding:l diagnosticl wu Answer: CBC,l TVUSl tol checkl endometriall liningl (shouldl bel <5mm),l diagnosticl EMBl (tissuel samplesl thel bestl dxl tool)
endometriall stripel normall rangel withl nol c/ol bleeding Answer: 1.1cml (11mm)l orl less
endometriall stripel normall rangel withl c/ol bleeding Answer: <5mm
Lystedal (TXA)l dose Answer: 650mgl 2 l tabsl BIDl xl 5 l daysl duringl menses
Lystedal whenl tol prescribe Answer: whenl otherl optionsl havel beenl unsuccessfull tol txl menorrhagial inl patientsl whol arel notl atl highl riskl forl thrombosis
lystedal mechanisml ofl action Answer: antifibrinolyticl effectl byl blockingl lysinel bindingsl sitesl onl plasminogenl tol preventl fibrinl degradation
menorrhagia:l clinicall manifestations Answer: bleedingl morel thanl 80ml/cycle,l orl cyclel lastingl longerl thanl 7 l days
menorrhagia:l differentiall dx Answer:
endometriall ablationl - l alsol r/ol malignancy
menorrhagia:l TX Answer: lowl dosel COCl - l onel pilll BIDl xl 5 - 7 l daysl - l shouldl slowl orl stopl bleedingl withinl firstl orl secondl dayl ofl tx afterl BIDl regimenl continuel untill packl isl emptyl orl refilll ifl desired
menorrhagia:l txl - l anemia Answer: inpatientl highl dosel estrogenl orl bloodl transfusionl asl needed
Heavyl bleedingl afterl txl withl COCl andl normall intiall labs,l optionl forl furtherl diagnostics Answer: checkl endometrium
metorrhagia Answer: lightl irregularl bleeding
menometrorrhagia Answer: irregularl heavyl bleeding
PCOS:l clinicall manifestations Answer: menstruall irregularitiesl - l oligomenorrheal (<9l cyclesl perl year) hyperandrogenisml - l hirsutism,l acne,l male-patternl hairl loss,l elevatedl seruml androgenl concentrations infertility obesityl - l metabolicl syndrome,l DM2,l CVD,l endometriall carcinoma moodl disordersl - l depression,l anxiety,l eatingl disorders fattyl liver,l sleepl apnea
Rotterdaml criteria Answer: twol outl ofl thel threel mustl bel presentl - l oligo/anovulation,l clinicall orl biochemicall signsl ofl hyperandrogenism,l polycysticl ovariesl onl US
PCOS:l differentiall dx Answer: congenitall adrenall hyperplasial - l r/ol withl 21 l hydroxyprogesteronel (<200l makesl itl unlikley) thyroidl disease hyperprolactinemia adrenall tumorl - l whenl therel isl severel hyperandrogenisml (deepl voice,l clitoromegaly,l seruml testosteronel >l 700)
thiazidel medicaitons Answer: thiazidel inl thel name
HTNl withl angioedema Answer: nol ACE
HTNl withl bronchospasml (asthma) Answer: nol betal blockers
HTNl withl heartl block Answer: NOl BB
mostl prevalentl modifiablel riskl factorl forl prematurel CVl disease Answer: HTN
objectivel findingsl withl hyperlipidema Answer:
obesity,l xanthomas,l lipemial retinalis,l corneall arcus,l hepatosplenomegaly
lipidl medicationsl thatl canl bel usedl inl pregnancy Answer: bilel acidl sequestrants
lipidl medl forl severel hypertriglyceridemia Answer: fibricl acidl derivativel (Gemfibrozil)
medl tol raisel HDLl thel most Answer: nicotinicl acidl (Niacin)
testl ofl choicel forl thrombosisl wu Answer: compressionl USl d-dimerl - l nol specific
Whenl isl thel follicularl phasel ovarianl cyclel begin Answer: beginsl atl thel onsetl ofl mensesl andl endsl onl thel dayl beforel thel LHl surgel (Daysl 1 - 14)
Tannerl stages:l Breastl developmentl - l stagel 2 Answer: breastl budsl withl elevationl ofl breastl andl papilla,l enlargementl ofl areolal (8-9y/o)
Tannerl stages:l Breastl developmentl - l stagel 3 Answer: furtherl enlargementl ofl breastl andl areola,l nol separationl ofl theirl contour
Tannerl stages:l Breastl developmentl - l stagel 4 Answer: areolal andl papillal forml secondaryl moundl abovel levell ofl breast
Tannerl stages:l Breastl developmentl - l stagel 5 Answer: maturel stage,l projectionl ofl papillal only,l recessionl ofl areola
Tannerl stages:l Pubicl hairl - l stagel 1 Answer: prepubertal
Tannerl stages:l Pubicl hairl - l stagel 2 Answer:
sparsel growthl ofl longl slightlyl pigmentl hair
Tannerl stages:l Pubicl hairl - l stagel 3 Answer: darkerl coarserl andl morel curledl hair,l spreadingl sparselyl overl junctionl ofl pubes
Tannerl stages:l Pubicl hairl - l stagel 4 Answer: hairl adultl inl typel byl coveringl smallerl areal thanl inl adult,l nol spreadl tol mediall surfacel ofl thighs
Tannerl stages:l Pubicl hairl - l stagel 5 Answer: adultl inl typel andl quantityl withl horizontall upperl border
Asherman'sl syndromel - l definition Answer: anatomicl variationl associatedl withl traumal tol thel endometriuml froml surgicall procedure,l mostl casesl occurl withinl closel proximityl tol pregnancyl whenl al womenl isl inl al hypo- estrogenizedl state
Asherman'sl syndromel - l clinicall manifestations Answer: intrauterinel adhesions,l scarring,l orl synechiae
Secondaryl amenorrhea:l hyperprolactinemial subjectivel sxs Answer: galactorrhea,l amenorrhea,l oligomenorrhea
Secondaryl amenorrhea:l hyperprolactinemial objectivel sxs Answer: galactorrhea,l visuall fieldl defects
Secondaryl amenorrhea:l functionall hypothalamicl subjectivel sx Answer: menstruall changes,l weightl loss/gain,l exercisel patterns,l stress
Secondaryl amenorrhea:l differnetials Answer: pregnancy/lactation perimenopause/menopause hyperandrogenisml (PCOS) hypo/hyperthyroidism pituitaryl disfunctionl - l hyperprolactinemial (brainl tumorl orl injury) hypothalamicl amenorrhea primaryl ovarianl insufficiencyl (POI)
Otherl - l tumor,l eatingl disorder,l stress,l medications,l chemo,l autoimmunel disorders
Hyperprolactinemial tx Answer: bromocriptinel 1.25mgl OHS
hypothalamicl amenorrheal labl findings Answer: lowl FSH,l LH,l estradiol
hypothalamicl amenorrheal riskl factors Answer: intensel exercise,l eatingl disorder,l weightl lossl morel thanl 10%l belowl BMI
hypothalamicl amenorrheal sxs Answer: menstruall changes,l tooth/guml decay,l bruising,l palel mucousl membranes,l brittlel nails,l stress/anxiety,l normall breastl thyroidl andl pelvicl exam
primaryl ovarianl insufficiencyl labs Answer: increasel inl FSHl andl LHl andl lowl estradiol checkl FSHl onl dayl 3 l ofl cyclel forl morel accuratel results