APEA Patho-Women’s Health Study
Guide aligned with a
hypothetical 2026/2027 updated
syllabus
Menstrual Cycle & Hormonal Regulation
1. A patient has an anovulatory cycle with irregular bleeding. Lack of which hormone is the
primary cause?
ANSWER ✓ Progesterone
2. During the follicular phase, which hormone stimulates follicle growth?
ANSWER ✓ Follicle-stimulating hormone (FSH)
3. Ovulation is triggered by a surge in which hormone?
ANSWER ✓ Luteinizing hormone (LH)
4. The corpus luteum primarily secretes which hormone to maintain the endometrial
lining?
ANSWER ✓ Progesterone
5. A patient with a short luteal phase is at risk for infertility due to inadequate secretion of
what?
ANSWER ✓ Progesterone
6. Which condition is characterized by the presence of endometrial tissue outside the
uterine cavity?
ANSWER ✓ Endometriosis
7. In polycystic ovary syndrome (PCOS), high LH levels relative to FSH lead to excess
production of which hormone from theca cells?
ANSWER ✓ Androstenedione
8. A patient with PCOS has acanthosis nigricans. This is a sign of:
ANSWER ✓ Insulin resistance
9. Which menstrual disorder involves painful menstruation with no identifiable pelvic
pathology?
ANSWER ✓ Primary dysmenorrhea
10. Elevated prostaglandin F2α is most associated with which condition?
ANSWER ✓ Primary dysmenorrhea
, 11. Abnormal uterine bleeding (AUB) in a non-pregnant patient with regular cycles but
heavy flow is classified as:
ANSWER ✓ AUB (heavy menstrual bleeding)
12. The PALM-COEIN classification system for AUB includes ―POLYP‖ under which category?
ANSWER ✓ Structural causes
13. A patient with AUB and a thickened endometrium on ultrasound should be evaluated
for:
ANSWER ✓ Endometrial hyperplasia
14. Which hormonal contraceptive works primarily by thickening cervical mucus and
suppressing ovulation?
ANSWER ✓ Progestin-only pill
15. Breakthrough bleeding on combined oral contraceptives is most common due to:
ANSWER ✓ Low estrogen dose
Pregnancy & Placental Pathophysiology
16. Human chorionic gonadotropin (hCG) is produced by which cells?
ANSWER ✓ Syncytiotrophoblasts
17. A positive pregnancy test detects the beta subunit of which hormone?
ANSWER ✓ hCG
18. In ectopic pregnancy, the most common implantation site is:
ANSWER ✓ Fallopian tube (ampulla)
19. Rupture of an ectopic pregnancy typically presents with:
ANSWER ✓ Sudden unilateral pain and hemorrhagic shock
20. Which condition is defined as hypertension with proteinuria after 20 weeks of gestation?
ANSWER ✓ Preeclampsia
21. The pathophysiology of preeclampsia is thought to involve failure of:
ANSWER ✓ Trophoblast invasion of spiral arteries
22. HELLP syndrome includes hemolysis, elevated liver enzymes, and:
ANSWER ✓ Low platelets
23. Which form of gestational trophoblastic disease shows hydropic villi without fetal tissue?
ANSWER ✓ Complete hydatidiform mole
24. A patient with a complete mole has markedly elevated hCG and a fetus:
ANSWER ✓ False — no fetus is present
25. Persistent trophoblastic disease after molar evacuation is associated with:
ANSWER ✓ Persistent elevated hCG
Guide aligned with a
hypothetical 2026/2027 updated
syllabus
Menstrual Cycle & Hormonal Regulation
1. A patient has an anovulatory cycle with irregular bleeding. Lack of which hormone is the
primary cause?
ANSWER ✓ Progesterone
2. During the follicular phase, which hormone stimulates follicle growth?
ANSWER ✓ Follicle-stimulating hormone (FSH)
3. Ovulation is triggered by a surge in which hormone?
ANSWER ✓ Luteinizing hormone (LH)
4. The corpus luteum primarily secretes which hormone to maintain the endometrial
lining?
ANSWER ✓ Progesterone
5. A patient with a short luteal phase is at risk for infertility due to inadequate secretion of
what?
ANSWER ✓ Progesterone
6. Which condition is characterized by the presence of endometrial tissue outside the
uterine cavity?
ANSWER ✓ Endometriosis
7. In polycystic ovary syndrome (PCOS), high LH levels relative to FSH lead to excess
production of which hormone from theca cells?
ANSWER ✓ Androstenedione
8. A patient with PCOS has acanthosis nigricans. This is a sign of:
ANSWER ✓ Insulin resistance
9. Which menstrual disorder involves painful menstruation with no identifiable pelvic
pathology?
ANSWER ✓ Primary dysmenorrhea
10. Elevated prostaglandin F2α is most associated with which condition?
ANSWER ✓ Primary dysmenorrhea
, 11. Abnormal uterine bleeding (AUB) in a non-pregnant patient with regular cycles but
heavy flow is classified as:
ANSWER ✓ AUB (heavy menstrual bleeding)
12. The PALM-COEIN classification system for AUB includes ―POLYP‖ under which category?
ANSWER ✓ Structural causes
13. A patient with AUB and a thickened endometrium on ultrasound should be evaluated
for:
ANSWER ✓ Endometrial hyperplasia
14. Which hormonal contraceptive works primarily by thickening cervical mucus and
suppressing ovulation?
ANSWER ✓ Progestin-only pill
15. Breakthrough bleeding on combined oral contraceptives is most common due to:
ANSWER ✓ Low estrogen dose
Pregnancy & Placental Pathophysiology
16. Human chorionic gonadotropin (hCG) is produced by which cells?
ANSWER ✓ Syncytiotrophoblasts
17. A positive pregnancy test detects the beta subunit of which hormone?
ANSWER ✓ hCG
18. In ectopic pregnancy, the most common implantation site is:
ANSWER ✓ Fallopian tube (ampulla)
19. Rupture of an ectopic pregnancy typically presents with:
ANSWER ✓ Sudden unilateral pain and hemorrhagic shock
20. Which condition is defined as hypertension with proteinuria after 20 weeks of gestation?
ANSWER ✓ Preeclampsia
21. The pathophysiology of preeclampsia is thought to involve failure of:
ANSWER ✓ Trophoblast invasion of spiral arteries
22. HELLP syndrome includes hemolysis, elevated liver enzymes, and:
ANSWER ✓ Low platelets
23. Which form of gestational trophoblastic disease shows hydropic villi without fetal tissue?
ANSWER ✓ Complete hydatidiform mole
24. A patient with a complete mole has markedly elevated hCG and a fetus:
ANSWER ✓ False — no fetus is present
25. Persistent trophoblastic disease after molar evacuation is associated with:
ANSWER ✓ Persistent elevated hCG
