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NU664D/ NU 664D Exam 2 Study Guide (Latest 2025/ 2026
Update) Primary Care Adult Woman I Review| Questions &
Answers | Grade A (100% Correct Solutions)- Regis
Question:
When is the follicular phase ovarian cycle begin
Answer:
begins at the onset of menses and ends on the day before the LH surge (Days 1-14)
Question:
What happens during the follicular phase
Answer:
Increase in FSH stimulates the ovary to develop follicles that contain and egg
Question:
The follicles produce
Answer:
estrogen
Question:
estrogen causes the uterine lining to
Answer:
thicken
Question:
LH is released from
Answer:
the pituitary gland
Question:
LH surge
Answer:
pituitary releases a large amount of LH
Question:
Luteal phase of the ovarian cycles begins
Answer:
on the day of the LH surge - 24 hours before ovulation - days 15-28 of cycle
Question:
Luteal phases causes
Answer:
rupture of the mature follicle and release of egg
Question:
Uterine cycle: proliferative phase
Answer:
depends on estrogen - corresponds with follicular phase - causes endometrial lining to grow
Question:
uterine cycle: secretory phase
Answer:
corresponds to luteal phase of ovarian cycle - corpus luteum produces progesterone - endometrium is receptive to implantation of blastocyst
Question:
Excessive estrogen
Answer:
menorrhagia, dysmenorrhea, fibrocystic breast changes, mucorrhea, edema/leg cramps, bloating, cyclic weight gain, increased fibroid growth, withdrawal headache
Question:
Insufficient estrogen
Answer:
amenorrhea, hypomenorrhea, break through bleeding before day 10, irritability, atrophy of vagina, hot flases, night sweats, decreased pelvic tone
Question:
excessive progesterone
Answer:
loss of libido, increased yeast infections, oligomenorrhea, increased appetite, depressed mood/anxiety, skin changes, non-cyclic weight gain, HTN
Question:
insufficient progesterone
Answer:
dysmenorrhea, menorrhagia, break through bleeding after day 10 of cycle
Question:
primary amenorrhea definition
Answer:
- absence of menarche by age 15 w/ secondary sex charact.
- OR age 13 if no menses and no secondary sex characteristics
Question:
primary amenorrhea: causes
Answer:
imperforate hymen, gonadal dysgenesis, mullerian agenesis (MRKH syndrome) physiologic delay
Question:
primary amenorrhea: gonadal dysgenesis (turner syndrome) SXS
Answer:
short stature, normal external female characteristics OR ambiguous genitalia, intra-abdominal tests, blind vaginal pouch, lack of secondary sex characteristics widely space nipples (shield chest), short webbed neck, absent pubic/axillary hair, lack of breast development, vagina and uterus present ovaries usually absent - replaced by scar tissue estrogen production is minimal
Question:
primary amenorrhea: mullerian agenesis dx
Answer:
probable when FSH is normal and US shows absence of uterus
Question:
Tanner stages: Breast development - stage 1
Answer:
prepubertal
Question:
Tanner stages: Breast development - stage 2
Answer:
breast buds with elevation of breast and papilla, enlargement of areola (8-9y/o)
Question:
Tanner stages: Breast development - stage 3
Answer:
further enlargement of breast and areola, no separation of their contour
Question:
Tanner stages: Breast development - stage 4
Answer:
areola and papilla form secondary mound above level of breast
Question:
Tanner stages: Breast development - stage 5
Answer:
mature stage, projection of papilla only, recession of areola
Question:
Tanner stages: Pubic hair - stage 1
Question:
Asherman's syndrome - definition
Answer:
anatomic variation associated with trauma to the endometrium from surgical procedure, most cases occur within close proximity to pregnancy when a women is in a hypo-estrogenized state
Question:
Asherman's syndrome - clinical manifestations
Answer:
intrauterine adhesions, scarring, or synechiae amenorrhea or disturbance of normal menses infertility
Question:
androgen insensitivity syndrome - definition
Answer:
46XY genotypically male but has male and female characteristics
Question:
androgen insensitivity syndrome - clinical manifestations
Answer:
uterus and ovaries absent, blind vaginal pouch, labia underdeveloped,, partially descended tests or they may be intra-abdominal
Question:
androgen insensitivity syndrome - dx
Answer:
sonohysterogram, HSG, MRI
Question:
androgen insensitivity syndrome - tx surgery, IUD
Answer:
Question:
Secondary amenorrhea: definition
Answer:
absence of menses for more than 3 months in a girl who previously had regular menstrual cycles or 6 month absence in a girl who previously had irregular menses
Question:
Secondary amenorrhea: hyperprolactinemia subjective sxs
Answer:
galactorrhea, amenorrhea, oligomenorrhea
primary ovarian insufficiency (POI) Other - tumor, eating disorder, stress, medications, chemo, autoimmune disorders
Question:
Hyperprolactinemia tx
Answer:
bromocriptine 1.25mg OHS
Question:
hypothalamic amenorrhea lab findings
Answer:
low FSH, LH, estradiol
Question:
hypothalamic amenorrhea risk factors
Answer:
intense exercise, eating disorder, weight loss more than 10% below BMI
Question:
hypothalamic amenorrhea sxs
Answer:
menstrual changes, tooth/gum decay, bruising, pale mucous membranes, brittle nails, stress/anxiety, normal breast thyroid and pelvic exam
Question:
primary ovarian insufficiency labs
Answer:
increase in FSH and LH and low estradiol check FSH on day 3 of cycle for more accurate results
Question:
primary ovarian insufficiency symptoms
Answer:
physiologic menopause in women < 40 irregular menses FSH levels equal to those in postmenopausal range
Question:
amenorrhea diagnostic work up
Answer:
UPT, thyroid, prolactin - fasting, FSH/LH, estradiol, pelvic US
Question:
Question:
estradiol labs indicate
Answer:
how well the ovaries are producing estrogen low when there is disordered eating
Question:
What to order if all amenorrhea wu is negative
Answer:
progesterone challenge test pelvic US to measure endometrial stripe
Question:
endometrial stipe thickness over ____ indicates adequate production of estrogen?
Answer:
6mm
Question:
What labs would you order for - breast tenderness, nausea, fatigue,
Answer:
UPT
Question:
What labs would you order for - fatigue, depression, dry skin, brittle nails cold intolerance, constipation, memory problems, goiter, weight gain, facial puffiness
Answer:
TSH, T3, T
Question:
What labs would you order for - HA, visual field defects, galactorrhea
Answer:
prolactin
Question:
What labs would you order for disordered eating?
Answer:
estradiol
Question:
What labs would you order for short stature, shield chest, lack of secondary sex characteristics, ovaries absent
Answer:
Karyotype, FHS/LH, testosterone
Provera challenge: continued failure
Answer:
endometrial scarring is likely - hysterosalpingogram can confirm
Question:
Provera challenge: why is it used
Answer:
to confirm presence of estrogen and intactness of the outflow tract (uterus, vagina) ordered prior to additional hormone testing
Question:
Dysmenorrhea: subjective (primary)
Answer:
crampy, achy, dill, midline pain, radiation to back/legs/abdomen pain beginning hours-days before menses and persist for 24-48 hours
Question:
PMS symptoms
Answer:
n/v, fatigue, dizziness, diarrhea, nervousness, and HA
Question:
Secondary Dysmenorrhea: definition
Answer:
changes to timing or intensity of pain plus prescence of pelvic pathology
Question:
Secondary Dysmenorrhea: SXS
Answer:
dyspareunia, HMB, IMB, postcoital bleeding, irregular cycles, urinary complaints, diarrhea, vaginal discharge
Question:
Secondary Dysmenorrhea: key differentiating factor presence of symptoms of pain and bleeding that persist beyond the normal menstrual cycle
Answer:
Question:
primary dysmenorrhea: exam findings
Answer:
normal, mild tender uterus
Question:
Secondary dysmenorrhea: exam findings
