NM 701 MODULE 6 EXAM QUESTIONS AND ANSWERS
WITH COMPLETE SOLUTIONS
Anovulation
not ovulating, unpredictable sloughing and irregular bleeding, seen at either end of the
reproductive phase: teen (immature APO axis) and perimenopause, at risk for
endometrial CA and hyperplasia
amenorrhea
no period for 6 months or for 3 of her normal cycles; r/o pregnancy by either
Primary amenorrhea
never had a period; concern if sex characteristics have developed but no menses by
16yo or no sex characteristics by age 12; possible causes: preg, anatomic
abnormalities, outflow tract abnormality, genetic abnormality
metr
uterus
progestogen challenge test (PCT)
give progestogen for 7-10days (+ if bleeding occurs it means there is adequate
estrogen to build up the endometrium (PCOS, obesity, ovarian insufficiency)/ - means
there is not enough estrogen (galactorrhea, breastfeeding, prolactinoma))
secondary amenorrhea
has had menses in the past but not right now; check TSH and prolactin (pituitary tumor
if elevated- consult/refer), Estrogen can be low or high
, rrhagia
bleeding
meno
menstrual
poly
many
oligo
not much
abnormal uterine bleeding (AUB)
PALM: polyps, adenomyosis, leiomylomata (fibroids), malignancy and hyperplasia
COIEN: coagulopathy, ovulatiory dysfunction, iatrogenic, endometrial, not yet classified
Labs for AUB
general labs, prolactin, FSH, LH, TSH, T3 and T4, gonorrhea and chlamydia + wet
mount
polycystic ovary disease (PCOS)
must have 2 of the 3 following characteristics: 1)ovaries with multiple large (2-9mm in
diameter) follicles (string of pearls) 2)irregular or no ovulation 3)high levels of
androgens; s/sx irregular, unpredictable menses, infertility, hirsutism, acne, alopecia,
insulin resistance, obesity
ovarian cyst
s: often unilateral, adnexal pain, can be gradual or sudden, mild or severe; consultation
needed for novices; often expectant management and spontaneous resolution; pain
WITH COMPLETE SOLUTIONS
Anovulation
not ovulating, unpredictable sloughing and irregular bleeding, seen at either end of the
reproductive phase: teen (immature APO axis) and perimenopause, at risk for
endometrial CA and hyperplasia
amenorrhea
no period for 6 months or for 3 of her normal cycles; r/o pregnancy by either
Primary amenorrhea
never had a period; concern if sex characteristics have developed but no menses by
16yo or no sex characteristics by age 12; possible causes: preg, anatomic
abnormalities, outflow tract abnormality, genetic abnormality
metr
uterus
progestogen challenge test (PCT)
give progestogen for 7-10days (+ if bleeding occurs it means there is adequate
estrogen to build up the endometrium (PCOS, obesity, ovarian insufficiency)/ - means
there is not enough estrogen (galactorrhea, breastfeeding, prolactinoma))
secondary amenorrhea
has had menses in the past but not right now; check TSH and prolactin (pituitary tumor
if elevated- consult/refer), Estrogen can be low or high
, rrhagia
bleeding
meno
menstrual
poly
many
oligo
not much
abnormal uterine bleeding (AUB)
PALM: polyps, adenomyosis, leiomylomata (fibroids), malignancy and hyperplasia
COIEN: coagulopathy, ovulatiory dysfunction, iatrogenic, endometrial, not yet classified
Labs for AUB
general labs, prolactin, FSH, LH, TSH, T3 and T4, gonorrhea and chlamydia + wet
mount
polycystic ovary disease (PCOS)
must have 2 of the 3 following characteristics: 1)ovaries with multiple large (2-9mm in
diameter) follicles (string of pearls) 2)irregular or no ovulation 3)high levels of
androgens; s/sx irregular, unpredictable menses, infertility, hirsutism, acne, alopecia,
insulin resistance, obesity
ovarian cyst
s: often unilateral, adnexal pain, can be gradual or sudden, mild or severe; consultation
needed for novices; often expectant management and spontaneous resolution; pain
