NURS 3537 Female Reproductive System

What is dysfunctional uterine bleeding (DUB)?

A) Abnormal bleeding due to infection of the uterus

B) Abnormal bleeding due to disturbance of the menstrual cycle

C) Heavy bleeding due to fibroids

D) Bleeding that occurs after menopause

B) Abnormal bleeding due to disturbance of the menstrual cycle

Which of the following are symptoms of dysfunctional uterine bleeding (DUB)? Select all that apply.

A) Heavy blood loss

B) Depletion of iron stores

C) Regular menstruation

D) Passage of large clots

E) Fatigue

A, B, D, E

What is a common treatment for dysfunctional uterine bleeding (DUB)?

A) Hormone therapy

B) Surgery

C) Antidepressants

D) Antibiotics

A) Hormone therapy

What factor can contribute to menstrual irregularity?

A) Increase or decrease in weight

B) High levels of estrogen only

C) Decreased physical activity

D) High progesterone levels

A) Increase or decrease in weight

In which group of women is dysfunctional uterine bleeding most commonly found, and what is the primary cause?

A) Postmenopausal women, due to age-related changes

B) Premenopausal women, due to estrogen/progesterone disparity

C) Adolescent girls, due to underdeveloped reproductive organs

D) Women using hormonal birth control, due to contraceptive use

B) Premenopausal women, due to estrogen/progesterone disparity

What is primary dysmenorrhea?

A) Painful menstruation associated with pelvic disease

B) Painful menstruation due to endometriosis

C) Painful menstruation associated with ovulation but not pelvic disease

D) Painful menstruation caused by uterine fibroids

C) Painful menstruation associated with ovulation but not pelvic disease

Which of the following symptoms are commonly associated with primary dysmenorrhea? Select all that apply.

A) Pelvic pain

B) Vomiting

C) Diarrhea

D) Excessive bleeding

E) Headache

A, B, C, E

Also backache and anorexia

What is the primary cause of primary dysmenorrhea?

A) Excess prostaglandin F2α leading to increased myometrial contraction

B) Pelvic disease and infections

C) Hormonal imbalance due to ovulation

D) Uterine fibroids causing excessive pain

A) Excess prostaglandin F2α leading to increased myometrial contraction

What effect does excess prostaglandin F2α have during menstruation?

A) Causes muscle relaxation in the uterus

B) Causes uterine muscle contraction leading to ischemia and pain

C) Prevents the shedding of the uterine lining

D) Increases blood flow to the uterus

B) Causes uterine muscle contraction leading to ischemia and pain

Which of the following is NOT true about primary amenorrhea?

A) Failure of menarche

B) Absence of menstruation, development of secondary sex characteristics by age 14

C) Excessive menstruation due to stress and lifestyle factors

D) Absence of menstruation by age 16

C) Excessive menstruation due to stress and lifestyle factors

Which of the following are causes of primary amenorrhea? (Select all that apply)

A) Congenital defects of the CNS or HPG

B) Acquired CNS lesions

C) Stress, over-exercising, or eating disorders

D) Genetic disorders

E) Obesity

F) High caffeine intake

G) Thyroid or pituitary disorders

H) Smoking

A, B, C, D, G

Primary amenorrhea has no impact on ability to ovulate.

A) True

B) False

B) False

Unable to ovulate

Which of the following is a common treatment for primary amenorrhea?

A) Oral contraceptives

B) Laparoscopic surgery

C) Antidepressants

D) Iron supplements

A) Oral contraceptives

What is defined as secondary amenorrhea? (Select all that apply)

A) Absence of menstruation for 3 months in women with previous menstrual irregularities

B) Absence of menstruation for 6 months in women with no previous menstrual irregularities

C) Absence of menstruation for 3 months in women with no previous menstrual irregularities

D) Absence of menstruation for 6 months in women with previous menstrual irregularities

C, D

Which of the following is considered a normal occurrence related to secondary amenorrhea?

A) Early adolescence

B) Pregnancy

C) Lactation

D) Peri-menopausal period

E) All of the above

E) All of the above

Which tests should be conducted when evaluating a patient with secondary amenorrhea? (Select all that apply)

A) Pregnancy test

B) FSH, LH, prolactin, TSH

C) Growth hormone

D) CT scan for pituitary adenomas

E) Blood pressure test

F) Aldosterone

A, B, D

Match each case of secondary amenorrhea with the appropriate treatment.

1. Due to pituitary adenoma

2. Not due to pituitary adenoma

A) Hormone replacement therapy

B) Surgery

1. B

2. A

In Polycystic Ovary, which of the following is true?

A) The HPG axis is dysfunctional, leading to ovulation inhibition.

B) Ovulation is inhibited due to intrinsic defects in the ovaries.

C) Ovulation is inhibited by excessive androgens, but the HPG axis remains intact.

D) The HPG axis is intact, and ovulation is not affected.

C) Ovulation is inhibited by excessive androgens, but the HPG axis remains intact.

Which of the following conditions may be associated with Polycystic Ovary?

A) Adrenal dysfunction

B) Thyroid dysfunction

C) Ovarian cyst rupture

D) Androgen-producing ovarian tumors

E) Hyperprolactinemia

F) Hyperhidrosis

A, B, D, E

Which of the following are clinical manifestations of Polycystic Ovary? (Select all that apply)

A) Dysfunctional bleeding

B) Amenorrhea

C) Hirsutism

D) Ectopic pregnancy

E) Increased libido

F) Infertility

A, B, C, F

Polycystic ovary is the leading cause of infertility.

A) True

B) False

A) True

What is vulvitis?

A) Inflammation of the cervix due to bacterial infection

B) Inflammation of the skin of the vulva due to irritation from hygiene products or vaginal infections

C) A type of vaginal yeast infection

D) Painful urination due to urinary tract infection

B) Inflammation of the skin of the vulva due to irritation from hygiene products or vaginal infections

Which of the following is a common trigger for vulvitis?

A) Hair removal

B) Excessive water intake

C) Prolonged bed rest

D) High fiber diet

A) Hair removal

Also STIs and certain undergarments

What should be done to help manage vulvitis symptoms?

A) Keep the vulva clean and dry

B) Use tight-fitting clothing to prevent friction

C) Use scented soaps for cleansing

D) Avoid all types of underwear

A) Keep the vulva clean and dry

Which of the following is NOT a recommended intervention for vulvitis?

A) Hydrocortisone cream for inflammation

B) Soothing baths for itching

C) Use of harsh chemical irritants

D) Removing the irritant

C) Use of harsh chemical irritants

What is Bartholinitis?

A) Inflammation of the cervix due to bacterial infection

B) Inflammation of one or both of the ducts that connect the Bartholin glands to the vaginal surface

C) Inflammation of the uterus

D) Infection of the urinary tract

B) Inflammation of one or both of the ducts that connect the Bartholin glands to the vaginal surface

What is a common consequence of the obstruction of the duct in Bartholinitis?A) Formation of Bartholin cyst

B) Vaginal bleeding

C) Urinary incontinence

D) Pelvic inflammatory disease

A) Formation of Bartholin cyst

Which of the following is usually NOT a symptom of Bartholinitis?

A) Asymptomatic

B) Fever

C) Abnormal vaginal discharge

D) Malaise

C) Abnormal vaginal discharge

What bacteria are commonly associated with Bartholinitis?

A) Strep and staph

B) Escherichia coli

C) Mycoplasma pneumoniae

D) Clostridium difficile

A) Strep and staph

What is a recommended diagnostic procedure to rule out cancer in Bartholinitis?

A) Blood test for infections

B) Biopsy

C) Pelvic ultrasound

D) Pap smear

B) Biopsy

To rule out cancer

What is the typical treatment approach for a recurring Bartholin cyst?

A) Oral antibiotics

B) Surgical drainage and leaving a pipe in place if it recurs

C) Applying topical creams

D) Vaginal suppositories

B) Surgical drainage and leaving a pipe in place if it recurs

If Bartholinitis is related to an STI, what is the recommended treatment?

A) Supportive care

B) Surgery to remove the gland

C) Anti-inflammatories

D) Antibiotics

D) Antibiotics

What is vaginitis?

A) Inflammation of the cervix caused by bacterial infection

B) Inflammation of the vagina, often due to sexually transmitted pathogens

C) Infection of the uterus caused by viral pathogens

D) Inflammation of the ovaries due to hormonal imbalance

B) Inflammation of the vagina, often due to sexually transmitted pathogens

What factor contributes to the development of vaginitis?

A) High vaginal pH

B) Low vaginal pH

C) Poor diet

D) Excessive exercise

A) High vaginal pH

What is the normal vaginal pH range that helps prevent microorganisms?

A) 4.5 to 5.0

B) 3.8 to 4.5

C) 3.0 to 3.5

D) 5.0 to 6.0

B) 3.8 to 4.5

Which of the following causes an increase in vaginal pH above 4.5?

A) Neisseria gonorrhoeae infection

B) Trichomoniasis

C) Atrophic vaginitis

D) Both B and C

D) Both B and C

Which of the following factors can contribute to the development of vaginitis? (Select all that apply)

A) Presence of antibodies against the body

B) Use of vaginal products

C) Excessive physical activity

D) Diabetes

E) Use of sanitary products

F) Pregnancy

A, B, D, E, F

What is a common indication of infection in vaginitis?

A) Vaginal discharge that is irritating or changes in colour or odour

B) Abdominal pain and bloating

C) Burning during urination

D) Pelvic pain with menstruation

A) Vaginal discharge that is irritating or changes in colour or odour

Which of the following is not a way of diagnosing vaginitis?

A) Health history

B) Physical exam

C) Pelvic MRI

D) Lab examination of discharge

C) Pelvic MRI

Which of the following are part of the treatment for vaginitis? (Select all that apply)

A) Use of antibiotics for STIs

B) Applying antifungal creams for bacterial infections

C) Restoring acid pH and relieving pruritus

D) Avoiding intercourse until resolution

E) Bed rest and better personal care

F) Using douches to cleanse the vaginal area

A, C, D, E

Avoid intercourse until resolved

What is cervicitis?

A) Inflammation of the cervix caused by sexually transmitted pathogens

B) Infection of the uterus by a bacterial pathogen

C) Inflammation of the vaginal walls

D) Inflammation of the ovaries due to hormonal imbalance

A) Inflammation of the cervix caused by sexually transmitted pathogens

What are the clinical manifestations of cervicitis? (Select all that apply)

A) Red, edematous cervix

B) Mucopurulent exudate draining from the external os

C) Abdominal pain without any vaginal symptoms

D) Clear, watery discharge

E) Fever and chills

A, B

What is the recommended treatment for cervicitis?

A) Bed rest, avoid intercourse, and improve personal hygiene

B) Antiviral medications and hormonal therapy

C) Surgery to remove infected tissue

D) High-dose antibiotics for systemic infection

A) Bed rest, avoid intercourse, and improve personal hygiene

What is Pelvic Inflammatory Disease?

A) Inflammation of the uterus only

B) Acute inflammation of any organ in the upper genital tract

C) Chronic inflammation of the cervix

D) Inflammation of the lower genital tract

B) Acute inflammation of any organ in the upper genital tract

Match each term to the correct description.

1. Oophoritis

2. Salpingitis

A) Fallopian tube

B) Ovaries

1. B

2. A

Which of the following are common causes of Pelvic Inflammatory Disease?

A) Chlamydia

B) Gonorrhea

C) E. coli

D) Mycoplasma genitalium

E) Intrauterine devices

F) All of the above

F) All of the above

Which of the following are potential long-term sequelae of Pelvic Inflammatory Disease?

A) Infertility

B) Ectopic pregnancy

C) Painful intercourse

D) Pelvic adhesions

E) Chronic headaches

F) Tubo-ovarian abscesses

A, B, C, D, F

Also peri-hepatitis

What is not a common clinical manifestation of Pelvic Inflammatory Disease?

A) Fever

B) Lower abdominal pain

C) Dysmenorrhea

D) Dysuria

E) Green vaginal discharge

F) Irregular bleeding

E) Green vaginal discharge

What is part of the treatment for Pelvic Inflammatory Disease? (Select all that apply)

A) Bed rest

B) Hydration

C) Surgery

D) Antibiotics

E) Avoiding intercourse

A, B, D, E

Also better personal care

What is the primary cause of Pelvic Relaxation Disorders?

A) Genetic factors

B) Progressive weakening of supporting tissue due to aging, trauma, childbirth, and surgery

C) Poor nutrition

D) Hormonal imbalances

B) Progressive weakening of supporting tissue due to aging, trauma, childbirth, and surgery

What can Pelvic Relaxation Disorders lead to?

A) Mal-positioning of bladder, urethra, rectum, and uterus

B) Kidney stones

C) Ovarian cysts

D) Uterine fibroids

A) Mal-positioning of bladder, urethra, rectum, and uterus

What is a cystocele?

A) Descent of the uterus into the vaginal canal

B) Descent of the bladder and anterior vaginal wall into the vaginal canal

C) Prolapse of the rectum into the vaginal canal

D) Infection of the vaginal canal

B) Descent of the bladder and anterior vaginal wall into the vaginal canal

Which of the following symptoms are commonly associated with a cystocele? (Select all that apply)

A) Frequency of urination

B) Urinary urgency

C) Leakage of urine

D) Painful intercourse

E) Vaginal dryness

A, B, C

What condition is usually accompanied by a cystocele?

A) Rectocele

B) Urethrocele

C) Endometriosis

D) Ovarian cysts

B) Urethrocele

What is a rectocele?

A) Bulging of the rectum and posterior vaginal wall into the vaginal canal

B) Descent of the bladder into the vaginal canal

C) Infection of the vaginal canal

D) Prolapse of the uterus into the vaginal canal

A) Bulging of the rectum and posterior vaginal wall into the vaginal canal

What symptoms are commonly associated with a rectocele? (Select all that apply)

A) Difficulty with defecation

B) Hemorrhoids

C) Urinary urgency

D) Vaginal discharge

A, B

What treatment options are recommended for rectocele? (Select all that apply)

A) High-residual diet

B) Low-residual diet if surgery or recurrence occurs

C) Increased fluids to prevent constipation

D) Surgery for all cases

E) Increase in physical activity

B, C

What is uterine prolapse?

A) Descent of the cervix or entire uterus into the vaginal canal

B) Infection of the uterine lining

C) Inability to conceive

D) Prolapse of the rectum into the vaginal canal

A) Descent of the cervix or entire uterus into the vaginal canal

Match each degree of uterine prolapse with the correct description.

1. 1st degree

2. 2nd degree

3. 3rd degree

A) Cervix protrudes through vaginal orifice

B) Vagina completely everted

C) Descent within vagina but no visible

1. C

2. A

3. B

When are benign ovarian cysts most common?

A) Between puberty and menopause

B) After menopause

C) Only in post-menopausal women

D) During pregnancy

A) Between puberty and menopause

What causes follicular cysts to form?

A) The corpus luteum becomes inflamed

B) The corpus luteum persists and continues to secrete hormones

C) The egg fails to implant in the uterus

D) The Graafian follicle does not release its ovum or does not shrink after releasing the ovum

D) The Graafian follicle does not release its ovum or does not shrink after releasing the ovum

What are the symptoms of a follicular cyst? (Select all that apply)

A) Usually asymptomatic

B) Severe abdominal pain

C) Symptoms occur when cysts form a chain

D) Fever and chills

A, C

What is the most common cause of a corpus luteum cyst?

A) Rapid growth of the ovarian follicle

B) The corpus luteum persists and continues producing hormones

C) An infection of the ovaries

D) A tumour in the ovary

B) The corpus luteum persists and continues producing hormones

What could be symptoms of a corpus luteum cyst? (Select all that apply)

A) Delayed menses

B) Heavier-than-normal bleeding

C) Amenorrhea

D) Severe abdominal cramps

A, B, C

When should a biopsy be performed on an ovarian cyst?

A) If it is greater than 5 cm and the woman is over 45 years old

B) If the woman is pregnant

C) If the cyst causes extreme pain

D) If the woman is under 25 years old and cyst is less than 5 cm

A) If it is greater than 5 cm and the woman is over 45 years old

What are endometrial polyps?

A) Growth of uterine tissue attached by a pedicle to the inner uterine lining

B) Masses of muscle tissue in the uterus

C) Thickened endometrium causing infertility

D) Abnormal growth in the cervix

A) Growth of uterine tissue attached by a pedicle to the inner uterine lining

What is the most common symptom of endometrial polyps in younger women?

A) Severe pelvic pain

B) Premenstrual spotting and intermenstrual bleeding

C) Heavy menstrual bleeding

D) Pelvic inflammation

B) Premenstrual spotting and intermenstrual bleeding

What is a concern for post-menopausal women with endometrial polyps?

A) They are usually benign

B) They frequently lead to premenstrual spotting

C) They tend to be malignant

D) They are asymptomatic

C) They tend to be malignant

How are endometrial polyps diagnosed?

A) Blood tests

B) Ultrasound and biopsy

C) Pap smear and surgery

D) MRI and CT scan

B) Ultrasound and biopsy

What is the next step if cancer is detected in a patient with endometrial polyps after the removal of the polyps?

A) Administer radiation therapy

B) Remove a chain of lymph nodes for pathology; if cancer is confirmed, chemotherapy is needed

C) Prescribe hormone therapy

D) Monitor the patient without further action

B) Remove a chain of lymph nodes for pathology; if cancer is confirmed, chemotherapy is needed

What is the primary origin of uterine fibroids (leiomyomas)?

A) Endometrial tissue

B) Myometrial smooth muscle cells

C) Cervical tissue

D) Ovarian cells

B) Myometrial smooth muscle cells

Benign tumours

What is a common characteristic of large uterine fibroids?

A) They are always symptomatic

B) They are estrogen-independent

C) They can ulcerate and become necrotic if they outgrow their blood supply

D) They always cause infertility

C) They can ulcerate and become necrotic if they outgrow their blood supply

What hormone is uterine fibroid growth dependent on?

A) Progesterone

B) Testosterone

C) Cortisol

D) Estrogen

D) Estrogen

How are uterine fibroids typically diagnosed?

A) Complete blood count and urinalysis

B) Physical exam and radiological study

C) Pap smear

D) MRI scan

B) Physical exam and radiological study

What is a potential treatment for uterine fibroids to correct symptoms?A) Estrogen therapy

B) Progesterone

C) Antidepressants

D) Radiation therapy

B) Progesterone

What are potential symptoms of large uterine fibroids? (Select all that apply)

A) Cramping

B) Pressure on nearby structures

C) Vaginal discharge

D) Heavy bleeding

E) Painful urination

A, B, D

What characterizes adenomyosis?

A) Endometrial glands and stroma present within the myometrium

B) Presence of only endometrial glands within the myometrium

C) The thickening of the cervix

D) The growth of fibroids in the uterus

A) Endometrial glands and stroma present within the myometrium

What causes pain in adenomyosis?

A) Estrogen-dependent tumor growth

B) Thickened layer of muscle due to progesterone

C) Necrosis of fibroids

D) Cyst formation in the ovaries

B) Thickened layer of muscle due to progesterone

What are possible symptoms of adenomyosis? (Select all that apply)

A) Dysmenorrhea (painful menstruation)

B) Uterine enlargement

C) Tenderness during menstruation

D) Painful urination

E) Abnormal menstrual cycles

A, B, C, E

What are potential treatments for adenomyosis? (Select all that apply)

A) Surgery resection of the affected area

B) Chemotherapy

C) Hysterectomy

D) Radiation therapy

E) Hormone therapy

A, C

Where is endometrial tissue typically found in endometriosis?

A) Inside the uterus only

B) Outside the uterus, usually in abdominal/pelvic areas

C) In the cervix

D) In the vaginal canal

B) Outside the uterus, usually in abdominal/pelvic areas

What is a possible cause of endometriosis?

A) Infection of the fallopian tubes

B) Lack of hormone production

C) Menstrual blood moving upward into fallopian tubes or ovaries

D) Blockage of the uterus

C) Menstrual blood moving upward into fallopian tubes or ovaries

Retrograde menstruation

What are the effects of endometrial tissue outside the uterus?

A) Responds to hormonal fluctuations and bleeds with the menstrual cycle

B) Does not cause any symptoms

C) Results in decreased blood flow to the uterus

D) Increases the size of the ovaries

A) Responds to hormonal fluctuations and bleeds with the menstrual cycle

Which of the following conditions can result from endometriosis? (Select all that apply)

A) Inflammation

B) Pain

C) Fibrosis

D) Scarring

E) Increased ovulation

F) Adhesions

A, B, C, D, F

Which of the following is not a potential symptom of endometriosis?

A) Infertility

B) Dysmenorrhea

C) Nausea unrelated to menstruation

D) Constipation

E) Difficulty passing stool (dyschezia)

C) Nausea unrelated to menstruation

What are potential treatments for endometriosis? (Select all that apply)

A) Hormonal suppression of periods

B) Laparoscopic surgery for removal of tissue

C) Radiation therapy

D) Chemotherapy

A, B

What is the rarest form of female genital cancer?

A) Cervical cancer

B) Ovarian cancer

C) Uterine cancer

D) Vaginal cancer

D) Vaginal cancer

May be squamous cell carcinoma, melanoma, sarcoma, adenocarcinoma

What are risk factors for vaginal cancer? (Select all that apply)

A) HPV infection

B) History of cervical cancer

C) Increased exercise

D) Sexual activity

E) Healthy diet

A, B, D

What symptoms might be present in advanced stages of vaginal cancer? (Select all that apply)

A) Vaginal bleeding

B) Discharge

C) Urinary symptoms

D) Frequent headaches

E) Pyuria

F) Pain

A, B, C, F

What is the 3rd most prevalent gynecological cancer?

A) Uterine cancer

B) Ovarian cancer

C) Cervical cancer

D) Vaginal cancer

C) Cervical cancer

What is the most common cause of cervical cancer?

A) Hereditary factors

B) HPV infection

C) Smoking

D) HIV infection

B) HPV infection

At what age do 1 in 8 women have dysplasia, a precursor to cervical cancer?

A) By age 30

B) By age 40

C) By age 20

D) By age 50

C) By age 20

Which of the following are risk factors for cervical cancer? (Select all that apply)

A) Early sexual activity

B) Smoking

C) Multiple sexual partners

D) Increased physical activity

A, B, C

What is the primary method for detecting early changes in cervical cancer?

A) Ultrasound

B) Pap smear

C) Biopsy

D) MRI

B) Pap smear

What are common manifestations of cervical cancer? (Select all that apply)

A) Abnormal menses

B) Post-menopausal bleeding

C) Excessive weight gain

D) Bleeding after intercourse

E) Insomnia

F) Serosanguinous vaginal discharge

A, B, D, F

Which of the following are appropriate treatments for cervical cancer? (Select all that apply)

A) Cryosurgery

B) Mastectomy

C) Laser surgery

D) Radiation

E) Chemotherapy

A, C, D

Premalignant lesion precedes invasive carcinoma by months in cervical cancer.

A) True

B) False

B) False

By YEARS

What is the most prevalent gynaecological malignancy?

A) Cervical cancer

B) Ovarian cancer

C) Endometrial cancer

D) Vaginal cancer

C) Endometrial cancer

What is the primary location of endometrial cancer?

A) Ovaries

B) Uterine lining

C) Fallopian tubes

D) Vaginal wall

B) Uterine lining

What hormone is most associated with the development of endometrial cancer?

A) Progesterone

B) Estrogen

C) Testosterone

D) Insulin

B) Estrogen