SOUTH UNIVERSITY NSG 6330 WOMENS HEALTH FINAL
EXAM NEWEST ACTUAL EXAM COMPLETE 180
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS)
What 3 hormonal axes are attributed to most physical changes in adolescents? -
ANSWER: 1) Hypothalamic-pituitary-gonadal (HPG) axis
2) Hypothalamic-pituitary-adrenal axis (HPA)
3) Growth hormone (GH) axis
What hormones are attributed to Hypothalamic-pituitary-GONADAL (HPG) axis? -
ANSWER: 1. Gonadotropin-releasing hormone (GnRH), also called luteinizing
hormone-releasing hormone (LHRH)
2. Luteinizing hormone (LH)
3. Follicle stimulating hormone (FSH)
4. Estrogen
5. Testosterone
What hormones are attributed to Hypothalamic-pituitary-ADRENAL axis (HPA)? -
ANSWER: 1. Adrenocorticotropic hormone
2. Dehydroepiandrosterone (ACTH)
3. DHEA sulfate (DHEA-S)
What hormones are attributed to Growth hormone (GH)?axis - ANSWER: 1. Growth
hormone-releasing hormone (GHRH)
2. Growth hormone (GH)
3. Insulin-like growth factors (IGFs)
What is thought to be three distinct changes in the hypothalamic-pituitary unit that
may trigger puberty? - ANSWER: three distinct changes in the hypothalamic-pituitary
unit:
(1) a nocturnal sleep-related augmentation of pulsatile LH secretion;
(2) a decrease in the sensitivity of the hypothalamus and the pituitary to estradiol
and testosterone, so that the gonadotropins LH and FSH begin to increase; and
(3) in the female, development of a positive feedback system, whereby critical levels
of estrogen trigger a large release of GnRH, stimulating LH to initiate ovulation.
What scale allows for the accurate classification of physical pubertal maturation -
ANSWER: Sexual Maturity Rating (SMR) scale (also called the Tanner scale)
Girls major events of puberty - ANSWER: 1. Thelarche
2. Growth Spurt
3. Menarche
,Thelarche - ANSWER: Often the earliest physical sign of puberty in girls, although a
minority develop pubic hair as the first sign. On average, breast development starts
at age 10.0 for Caucasian girls and 8.9 years for African-American girls
Growth Spurt - ANSWER: Thelarche and pubarche (pubic hair) may both be preceded
by about 1 year by the growth spurt; thus the growth curve is an essential tool in the
evaluation of precocious puberty.
Menarche - ANSWER: This event usually occurs during SMR B3 or B4 and about 3.3
years after the growth spurt, or roughly 2 years after breast budding.
What is the average length of time for completion of puberty ? - ANSWER: 4 years,
but it can range from 1.5 to 8 years
What is the first physical sign of puberty in the majority of boys ? - ANSWER:
Testicular Growth: The first physical sign of puberty in the majority of boys is
increased testicular volume, although the most noticeable first event of male
puberty is the growth of pubic hair
What are other signs of male puberty? - ANSWER: 2. Growth Spurt: Midpuberty, or
the time of rising testosterone concentrations, is associated with the period of most
rapid linear growth in boys, in contrast to the early growth spurt in girls. It is also at
this time that the voice changes axillary hair appears, and possibly also acne. Facial
hair growth typically starts about 3 years after pubic hair growth. The hair on the
face, chest, back, and abdomen may continue to appear throughout and beyond
puberty into adulthood, its amount and distribution being quite variable and
dependent on ethnicity and family patterns.
3. Attainment of Fertility: Ejaculation usually occurs at SMR G3, as does the first
evidence of spermarche, but fertility is not usually attained until SMR G4.
What is the average length of time for completion of puberty for boys? - ANSWER:
average length of time for the completion of puberty is 3 years, but it can range from
2 to 5 years.
Genital development is initiated at about 10.1 years for white boys, 9.5 years for
African-American boys, and 10.4 years for Mexican-American boys, with completion
of puberty at 15.9 years in white boys, 15.7 years in African-American boys, and 14.9
years in Mexican-American boys.
Gonadal Steroids - ANSWER: The target tissues of LH and FSH are the ovaries and
testes, which produce estradiol and testosterone, respectively. Testicular Leydig cells
also produce androstenedione, dihydrotestosterone, and estradiol, but to a much
lesser extent.
Estrogen. - ANSWER: Estradiol from the ovary accounts for the majority of the
circulating estrogens, although there is a small amount of extraovarian conversion
from androstenedione and testosterone. In addition to stimulating breast growth
and maturation of the vaginal mucosa, estrogen has been found to have a major
, impact on the skeleton, being the primary hormone responsible for epiphyseal
closure.
Testosterone. - ANSWER: The testes produce most of the circulating testosterone,
but a small amount comes from extratesticular conversion of the adrenal hormone
androstenedione in both males and females. Testosterone is responsible for the
voice change in males and the attainment of male body habitus, while
dihydrotestosterone, the product of conversion of testosterone by 5a-reductase,
causes growth of the phallus and prostate.
GnRH Pulse Generator - ANSWER: At the time of puberty, GnRH is secreted from the
GnRH pulse generator in the hypothalamus, leading to pituitary secretion of LH and
FSH and subsequent secretion of estradiol from the ovaries or testosterone from the
testes. The exact triggers are still incompletely understood, although new research
has elucidated new potential regulators and key players in the awakening of this
system. These include leptin, the genes GPR54/KiSS-1, as well as several
neuropeptides and neurotransmitters.
ADRENARCHE - ANSWER: The increased secretion of androgens from the adrenal
gland, called adrenarche, in the prepubertal and pubertal periods is independent of
HPG changes.
What is the Local conversion of DHEA-S to testosterone and then to
dihydrotestosterone is responsible for? - ANSWER: -hair growth in the androgen-
dependent areas (face, chest, pubic area, axillae). Axillary and pubic areas are the
most sensitive to the effects of androgens, which is why these areas are the first to
develop sexual hair.
-local conversion of DHEA-S within the apocrine glands of the axillae causes body
odor,
-conversion within sebaceous glands is responsible for the development of acne.
What is the height spurt during puberty attributed to? - ANSWER: primarily upon
growth hormone and the insulin-like growth factors, but many other hormones may
influence growth as well, especially the sex steroids. Without prompt recognition
and treatment, premature or delayed puberty may have marked effects on height.
What is most linear growth contributed to? - ANSWER: Growth hormone and its
feedback loop
GH during Puberty - ANSWER: GH secretion is increased by growth hormone-
releasing hormone (GHRH) and decreased by somatostatin from the hypothalamic
arm of the loop. Growth hormone has been shown to double during the pubertal
growth spurt. Like many hormones, GH is secreted in pulsatile fashion, with
maximum rates at the onset of slow-wave sleep. It is this pulsatile secretion that
renders random testing of GH unhelpful. GH exerts its effects through IGFs, mainly
IGF-I (formerly somatomedin-C) and IGF-II.
EXAM NEWEST ACTUAL EXAM COMPLETE 180
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS)
What 3 hormonal axes are attributed to most physical changes in adolescents? -
ANSWER: 1) Hypothalamic-pituitary-gonadal (HPG) axis
2) Hypothalamic-pituitary-adrenal axis (HPA)
3) Growth hormone (GH) axis
What hormones are attributed to Hypothalamic-pituitary-GONADAL (HPG) axis? -
ANSWER: 1. Gonadotropin-releasing hormone (GnRH), also called luteinizing
hormone-releasing hormone (LHRH)
2. Luteinizing hormone (LH)
3. Follicle stimulating hormone (FSH)
4. Estrogen
5. Testosterone
What hormones are attributed to Hypothalamic-pituitary-ADRENAL axis (HPA)? -
ANSWER: 1. Adrenocorticotropic hormone
2. Dehydroepiandrosterone (ACTH)
3. DHEA sulfate (DHEA-S)
What hormones are attributed to Growth hormone (GH)?axis - ANSWER: 1. Growth
hormone-releasing hormone (GHRH)
2. Growth hormone (GH)
3. Insulin-like growth factors (IGFs)
What is thought to be three distinct changes in the hypothalamic-pituitary unit that
may trigger puberty? - ANSWER: three distinct changes in the hypothalamic-pituitary
unit:
(1) a nocturnal sleep-related augmentation of pulsatile LH secretion;
(2) a decrease in the sensitivity of the hypothalamus and the pituitary to estradiol
and testosterone, so that the gonadotropins LH and FSH begin to increase; and
(3) in the female, development of a positive feedback system, whereby critical levels
of estrogen trigger a large release of GnRH, stimulating LH to initiate ovulation.
What scale allows for the accurate classification of physical pubertal maturation -
ANSWER: Sexual Maturity Rating (SMR) scale (also called the Tanner scale)
Girls major events of puberty - ANSWER: 1. Thelarche
2. Growth Spurt
3. Menarche
,Thelarche - ANSWER: Often the earliest physical sign of puberty in girls, although a
minority develop pubic hair as the first sign. On average, breast development starts
at age 10.0 for Caucasian girls and 8.9 years for African-American girls
Growth Spurt - ANSWER: Thelarche and pubarche (pubic hair) may both be preceded
by about 1 year by the growth spurt; thus the growth curve is an essential tool in the
evaluation of precocious puberty.
Menarche - ANSWER: This event usually occurs during SMR B3 or B4 and about 3.3
years after the growth spurt, or roughly 2 years after breast budding.
What is the average length of time for completion of puberty ? - ANSWER: 4 years,
but it can range from 1.5 to 8 years
What is the first physical sign of puberty in the majority of boys ? - ANSWER:
Testicular Growth: The first physical sign of puberty in the majority of boys is
increased testicular volume, although the most noticeable first event of male
puberty is the growth of pubic hair
What are other signs of male puberty? - ANSWER: 2. Growth Spurt: Midpuberty, or
the time of rising testosterone concentrations, is associated with the period of most
rapid linear growth in boys, in contrast to the early growth spurt in girls. It is also at
this time that the voice changes axillary hair appears, and possibly also acne. Facial
hair growth typically starts about 3 years after pubic hair growth. The hair on the
face, chest, back, and abdomen may continue to appear throughout and beyond
puberty into adulthood, its amount and distribution being quite variable and
dependent on ethnicity and family patterns.
3. Attainment of Fertility: Ejaculation usually occurs at SMR G3, as does the first
evidence of spermarche, but fertility is not usually attained until SMR G4.
What is the average length of time for completion of puberty for boys? - ANSWER:
average length of time for the completion of puberty is 3 years, but it can range from
2 to 5 years.
Genital development is initiated at about 10.1 years for white boys, 9.5 years for
African-American boys, and 10.4 years for Mexican-American boys, with completion
of puberty at 15.9 years in white boys, 15.7 years in African-American boys, and 14.9
years in Mexican-American boys.
Gonadal Steroids - ANSWER: The target tissues of LH and FSH are the ovaries and
testes, which produce estradiol and testosterone, respectively. Testicular Leydig cells
also produce androstenedione, dihydrotestosterone, and estradiol, but to a much
lesser extent.
Estrogen. - ANSWER: Estradiol from the ovary accounts for the majority of the
circulating estrogens, although there is a small amount of extraovarian conversion
from androstenedione and testosterone. In addition to stimulating breast growth
and maturation of the vaginal mucosa, estrogen has been found to have a major
, impact on the skeleton, being the primary hormone responsible for epiphyseal
closure.
Testosterone. - ANSWER: The testes produce most of the circulating testosterone,
but a small amount comes from extratesticular conversion of the adrenal hormone
androstenedione in both males and females. Testosterone is responsible for the
voice change in males and the attainment of male body habitus, while
dihydrotestosterone, the product of conversion of testosterone by 5a-reductase,
causes growth of the phallus and prostate.
GnRH Pulse Generator - ANSWER: At the time of puberty, GnRH is secreted from the
GnRH pulse generator in the hypothalamus, leading to pituitary secretion of LH and
FSH and subsequent secretion of estradiol from the ovaries or testosterone from the
testes. The exact triggers are still incompletely understood, although new research
has elucidated new potential regulators and key players in the awakening of this
system. These include leptin, the genes GPR54/KiSS-1, as well as several
neuropeptides and neurotransmitters.
ADRENARCHE - ANSWER: The increased secretion of androgens from the adrenal
gland, called adrenarche, in the prepubertal and pubertal periods is independent of
HPG changes.
What is the Local conversion of DHEA-S to testosterone and then to
dihydrotestosterone is responsible for? - ANSWER: -hair growth in the androgen-
dependent areas (face, chest, pubic area, axillae). Axillary and pubic areas are the
most sensitive to the effects of androgens, which is why these areas are the first to
develop sexual hair.
-local conversion of DHEA-S within the apocrine glands of the axillae causes body
odor,
-conversion within sebaceous glands is responsible for the development of acne.
What is the height spurt during puberty attributed to? - ANSWER: primarily upon
growth hormone and the insulin-like growth factors, but many other hormones may
influence growth as well, especially the sex steroids. Without prompt recognition
and treatment, premature or delayed puberty may have marked effects on height.
What is most linear growth contributed to? - ANSWER: Growth hormone and its
feedback loop
GH during Puberty - ANSWER: GH secretion is increased by growth hormone-
releasing hormone (GHRH) and decreased by somatostatin from the hypothalamic
arm of the loop. Growth hormone has been shown to double during the pubertal
growth spurt. Like many hormones, GH is secreted in pulsatile fashion, with
maximum rates at the onset of slow-wave sleep. It is this pulsatile secretion that
renders random testing of GH unhelpful. GH exerts its effects through IGFs, mainly
IGF-I (formerly somatomedin-C) and IGF-II.
