Primary Care II- Module 3- Gynecology
Exam Questions with Answers
16, thelarche, 13 - Correct Answer Primary amenorrhea is no menarche by age ___.
Consider the dx for any girl who has not had menarche by age 15, 3 years after ___, or
lack of breast development by ___.
3-6, 3 - Correct Answer Secondary amenorrhea is the lack of menstruation for __-__
months or for the duration of __ typical menstrual cycles for a patient with
oligomenorrhea
pregnancy - Correct Answer The most common cause of amenorrhea
weight loss, exercise, anxiety - Correct Answer Hypothalamic-pituitary dysfunction that
leads to amenorrhea can be due to __ __, excessive ___, obesity, marijuana,
psychoactive drugs, tumors, chronic ___, anorexia nervosa, or head injury
behaviors, gonadotropin secretion - Correct Answer Amenorrhea from hypothalamic-
pituitary dysfunction can usually be corrected by modifying __, stimulating ___ ___, or
giving exogenous human menopausal gonadotropins
prolactin, low - Correct Answer If ·hypothalamic-pituitary dysfunction is suspected
measure FSH, LH, and __ levels. The FSH and LH will be ___.
estrogen deficiency - Correct Answer Amenorrhea due to ovarian dysfunction will
cause s/s of __ __ and may be due to Turner syndrome, X chromosome long-arm
deletion, gonadotropin-resistant ovary syndrome, premature natural menopause, or
autoimmune ovarian failure
menstruation, galactorrhea - Correct Answer Symptoms of amenorrhea include the
absence of ___ and if d/t a pituitary tumor- _____.
eating disorders, hirsutism, BMI - Correct Answer In those with amenorrhea assess
their LMP, exercise and diet, __ ___, psychiatric hx, hx of ___/acne/galactorrhea,
Tanner staging, evaluation of genital tract anatomy, and __
progesterone, week, low estrogen - Correct Answer In those with amenorrhea a ___
challenge test can be given which consists of a 10-14 day course that should induce
withdrawal bleeding within a ___ of finishing it. If bleeding does not occur the patient
may have __ __ or an anatomic condition
,ovulatory cycles, anovulatory - Correct Answer Dysfunctional uterine bleeding can be
abnormal bleeding with ___ __ which have organic causes or from ___ causes (PCOS,
exogenous obesity, adrenal hyperplasia)
frequency, duration, amount - Correct Answer Dysfunctional uterine bleeding results in
a difference in the ___, ___, and __ of menstrual bleeding.
shortened, earlier - Correct Answer Dysfunctional uterine bleeding d/t a luteal phase
defect is when ovulation occurs but the corpus luteum is not fully developed so the cycle
is ___ and menstruation occurs ___ than expected.
polyps, malignancy, and coagulopathy, endometrial - Correct Answer Causes of
dysfunctional uterine bleeding (PALM COEIN): ___, adenomyosis, leiomyoma, ___,
___, ovulatory disorders, ___, iatrogenic, not classified
regular, predictable, premenstrual - Correct Answer Dysfunctional uterine bleeding is
diagnosed when vaginal bleeding is not ___, not ___, and not associated with ___ s/s.
cervical, uterine cancer - Correct Answer Women 35+ with dysfunctional uterine
bleeding should be evaluated for __ and __ ___.
endometrial cancer - Correct Answer Dysfunctional uterine bleeding results from
chronic, unopposed estrogenic stimulation of the endometrium which increases the risk
of __ __
medroxyprogesterone, OCPs - Correct Answer Dysfunctional uterine bleeding can be
treated with ___ x10 days with withdrawal bleeding in 7-10 days or ____ to suppress
the endometrium and establish regular/predictable cycles.
prostaglandins, lower abdomen, suprapubic, fetal, heating pads - Correct Answer
Primary dysmenorrhea is due to excess ___ and occurs in late teens to early 20s. It
results in diffuse "coming and going" pain in the __ __ and __ area with radiation to the
__. The __ position and ___ ___ provide relief.
recurrent, normal activities - Correct Answer Dysmenorrhea is ___ and spasmodic that
occurs on day 1-3 of menses. It is painful and prevents participation in __ __. Patients
may have N/V/D, headache, or dizziness.
dyspareunia, menstrual period - Correct Answer Secondary dysmenorrhea can cause
___ and pain that lasts longer than the __ __.
normal, pale, diaphoretic - Correct Answer Physical findings of primary dysmenorrhea
should be ___. The patient may appear __ and __ during the exam if experiencing
symptoms at the time.
, Leiomyoma - Correct Answer In the pelvic exam for this cause of secondary
amenorrhea the patient may have asymmetry or irregular enlargement of the uterus and
have a rubbery solid consistency
adenomyosis - Correct Answer In the pelvic exam for this cause of secondary
amenorrhea the patient may have a tender and symmetrically enlarged boggy uterus
endometriosis - Correct Answer In the pelvic exam for this cause of secondary
amenorrhea there will be painful nodules in the posterior cul-de-sac an restricted uterine
motion
NSAIDs, heat, COCs, reassurance - Correct Answer Management of primary
dysmenorrhea is ___, __ therapy, exercise, ___, psychotherapy and ___. If the first
does not provide relief, reevaluate primary as the cause
2 months - Correct Answer If starting a patient on COCs for dysmenorrhea f/u in __
___ and again after 6 months.
sexual trauma, candidiasis, menopause - Correct Answer Risk factors for dyspareunia
include __ __, hx STIs, recurrent ___ infection, poor hygiene, ___, and difficulties with
intimate relationships
painful, initiation, deep, pregnancy, childbirth - Correct Answer Dyspareunia is __ sex
with __ of penetration or __ penetration. Patients may have vaginal discharge, irritation,
pelvic pain, recent __ or ___, pelvic or abdominal trauma, chemotherapy, radiation, or
surgery.
tampons, pelvic exam, CMT - Correct Answer Patients with dyspareunia may report
difficulty using ___ or tolerating __ __. They may have · hymnal remnants, Bartholdi’s
cyst or abscess, vestibulitis, veganism’s, ___.
vaginal estrogen, lubricant - Correct Answer If dyspareunia is due to atrophy advise
the patient to use __ __ and water-soluble ___.
progressive dilation, muscle awareness - Correct Answer If dyspareunia is d/t
veganism’s, hymnal strands, anatomically narrow introits or scar tissue treat with __ __
and muscle awareness exercises (___).
reproductive, GU, GI, sleep disturbances - Correct Answer Pelvic pain can be due to
__, ___, or ___ disease. Assess the description and timing, menstrual and sexual hx,
home/work status, social hx, family hx, __ ___, s/s of depression, and physical/sexual
abuse.
noncyclic, 6 months, functional disability - Correct Answer Pelvic pain is ___ pain
lasting > __ ___ localized to the anatomic pelvis, anterior abdominal wall or below the
Exam Questions with Answers
16, thelarche, 13 - Correct Answer Primary amenorrhea is no menarche by age ___.
Consider the dx for any girl who has not had menarche by age 15, 3 years after ___, or
lack of breast development by ___.
3-6, 3 - Correct Answer Secondary amenorrhea is the lack of menstruation for __-__
months or for the duration of __ typical menstrual cycles for a patient with
oligomenorrhea
pregnancy - Correct Answer The most common cause of amenorrhea
weight loss, exercise, anxiety - Correct Answer Hypothalamic-pituitary dysfunction that
leads to amenorrhea can be due to __ __, excessive ___, obesity, marijuana,
psychoactive drugs, tumors, chronic ___, anorexia nervosa, or head injury
behaviors, gonadotropin secretion - Correct Answer Amenorrhea from hypothalamic-
pituitary dysfunction can usually be corrected by modifying __, stimulating ___ ___, or
giving exogenous human menopausal gonadotropins
prolactin, low - Correct Answer If ·hypothalamic-pituitary dysfunction is suspected
measure FSH, LH, and __ levels. The FSH and LH will be ___.
estrogen deficiency - Correct Answer Amenorrhea due to ovarian dysfunction will
cause s/s of __ __ and may be due to Turner syndrome, X chromosome long-arm
deletion, gonadotropin-resistant ovary syndrome, premature natural menopause, or
autoimmune ovarian failure
menstruation, galactorrhea - Correct Answer Symptoms of amenorrhea include the
absence of ___ and if d/t a pituitary tumor- _____.
eating disorders, hirsutism, BMI - Correct Answer In those with amenorrhea assess
their LMP, exercise and diet, __ ___, psychiatric hx, hx of ___/acne/galactorrhea,
Tanner staging, evaluation of genital tract anatomy, and __
progesterone, week, low estrogen - Correct Answer In those with amenorrhea a ___
challenge test can be given which consists of a 10-14 day course that should induce
withdrawal bleeding within a ___ of finishing it. If bleeding does not occur the patient
may have __ __ or an anatomic condition
,ovulatory cycles, anovulatory - Correct Answer Dysfunctional uterine bleeding can be
abnormal bleeding with ___ __ which have organic causes or from ___ causes (PCOS,
exogenous obesity, adrenal hyperplasia)
frequency, duration, amount - Correct Answer Dysfunctional uterine bleeding results in
a difference in the ___, ___, and __ of menstrual bleeding.
shortened, earlier - Correct Answer Dysfunctional uterine bleeding d/t a luteal phase
defect is when ovulation occurs but the corpus luteum is not fully developed so the cycle
is ___ and menstruation occurs ___ than expected.
polyps, malignancy, and coagulopathy, endometrial - Correct Answer Causes of
dysfunctional uterine bleeding (PALM COEIN): ___, adenomyosis, leiomyoma, ___,
___, ovulatory disorders, ___, iatrogenic, not classified
regular, predictable, premenstrual - Correct Answer Dysfunctional uterine bleeding is
diagnosed when vaginal bleeding is not ___, not ___, and not associated with ___ s/s.
cervical, uterine cancer - Correct Answer Women 35+ with dysfunctional uterine
bleeding should be evaluated for __ and __ ___.
endometrial cancer - Correct Answer Dysfunctional uterine bleeding results from
chronic, unopposed estrogenic stimulation of the endometrium which increases the risk
of __ __
medroxyprogesterone, OCPs - Correct Answer Dysfunctional uterine bleeding can be
treated with ___ x10 days with withdrawal bleeding in 7-10 days or ____ to suppress
the endometrium and establish regular/predictable cycles.
prostaglandins, lower abdomen, suprapubic, fetal, heating pads - Correct Answer
Primary dysmenorrhea is due to excess ___ and occurs in late teens to early 20s. It
results in diffuse "coming and going" pain in the __ __ and __ area with radiation to the
__. The __ position and ___ ___ provide relief.
recurrent, normal activities - Correct Answer Dysmenorrhea is ___ and spasmodic that
occurs on day 1-3 of menses. It is painful and prevents participation in __ __. Patients
may have N/V/D, headache, or dizziness.
dyspareunia, menstrual period - Correct Answer Secondary dysmenorrhea can cause
___ and pain that lasts longer than the __ __.
normal, pale, diaphoretic - Correct Answer Physical findings of primary dysmenorrhea
should be ___. The patient may appear __ and __ during the exam if experiencing
symptoms at the time.
, Leiomyoma - Correct Answer In the pelvic exam for this cause of secondary
amenorrhea the patient may have asymmetry or irregular enlargement of the uterus and
have a rubbery solid consistency
adenomyosis - Correct Answer In the pelvic exam for this cause of secondary
amenorrhea the patient may have a tender and symmetrically enlarged boggy uterus
endometriosis - Correct Answer In the pelvic exam for this cause of secondary
amenorrhea there will be painful nodules in the posterior cul-de-sac an restricted uterine
motion
NSAIDs, heat, COCs, reassurance - Correct Answer Management of primary
dysmenorrhea is ___, __ therapy, exercise, ___, psychotherapy and ___. If the first
does not provide relief, reevaluate primary as the cause
2 months - Correct Answer If starting a patient on COCs for dysmenorrhea f/u in __
___ and again after 6 months.
sexual trauma, candidiasis, menopause - Correct Answer Risk factors for dyspareunia
include __ __, hx STIs, recurrent ___ infection, poor hygiene, ___, and difficulties with
intimate relationships
painful, initiation, deep, pregnancy, childbirth - Correct Answer Dyspareunia is __ sex
with __ of penetration or __ penetration. Patients may have vaginal discharge, irritation,
pelvic pain, recent __ or ___, pelvic or abdominal trauma, chemotherapy, radiation, or
surgery.
tampons, pelvic exam, CMT - Correct Answer Patients with dyspareunia may report
difficulty using ___ or tolerating __ __. They may have · hymnal remnants, Bartholdi’s
cyst or abscess, vestibulitis, veganism’s, ___.
vaginal estrogen, lubricant - Correct Answer If dyspareunia is due to atrophy advise
the patient to use __ __ and water-soluble ___.
progressive dilation, muscle awareness - Correct Answer If dyspareunia is d/t
veganism’s, hymnal strands, anatomically narrow introits or scar tissue treat with __ __
and muscle awareness exercises (___).
reproductive, GU, GI, sleep disturbances - Correct Answer Pelvic pain can be due to
__, ___, or ___ disease. Assess the description and timing, menstrual and sexual hx,
home/work status, social hx, family hx, __ ___, s/s of depression, and physical/sexual
abuse.
noncyclic, 6 months, functional disability - Correct Answer Pelvic pain is ___ pain
lasting > __ ___ localized to the anatomic pelvis, anterior abdominal wall or below the
