PTCB REPRODUCTIVE SYSTEM STUDY GUIDE

Chapter 24: Therapeutic Agents for the Reproductive System

What are the two main types of hormones in combined oral contraceptives (COCs)?

A. Testosterone and progesterone

B. Estrogen and progestin

C. Estrogen and testosterone

D. Progesterone and insulin

B. Estrogen and progestin

Which hormone in oral contraceptives is primarily responsible for preventing pregnancy?

A. Estrogen

B. Testosterone

C. Progestin (progesterone)

D. Cortisol

C. Progestin (progesterone)

What is the primary mechanism of action for combined oral contraceptives?

A. Kill sperm

B. Prevent ovulation

C. Destroy the egg

D. Close the cervix

B. Prevent ovulation

Which progestin-only pill is available over-the-counter (OTC) without a prescription?

A. Norethindrone

B. Drospirenone

C. Norgestrel (Opill)

D. Levonorgestrel

C. Norgestrel (Opill)

How effective are birth control pills when taken correctly every day?

A. 85%

B. 92%

C. 95%

D. 99%

D. 99%

Do oral contraceptives protect against sexually transmitted infections (STIs)?

A. Yes, completely

B. Yes, partially

C. No

D. Only certain types

C. No

Modern COCs typically contain less than how many micrograms (mcg) of estrogen?

A. 20 mcg

B. 35 mcg

C. 50 mcg

D. 75 mcg

C. 50 mcg

When should a patient typically start taking oral contraceptives?

A. Any time during the month

B. First day of menstrual period or first Sunday after bleeding begins

C. Only on Mondays

D. After ovulation

B. First day of menstrual period or first Sunday after bleeding begins

What is another name for progestin-only pills?

A. "The shot"

B. "Mini pill" or POPs

C. "Mega pill"

D. "Combo pill"

Which medication can decrease the effectiveness of oral contraceptives?

A. Ibuprofen

B. Acetaminophen

C. St. John's Wort

D. Vitamin C

C. St. John's Wort

Combined oral contraceptives contain only estrogen.

False__

Most traditional birth control pill packs provide 21 days of hormone pills and 7 days of placebo pills.

True____

Oral contraceptives must be taken at the same time each day for maximum effectiveness.

True____

Progestin-only pills (POPs) are safe for women who cannot take estrogen.

True____

Antiseizure medications can make birth control pills less effective.

True____

Extended cycle pills (like Seasonique) allow women to have periods only every 3 months.

True__

Sprintec

B. Norgestimate/ethinyl estradiol

Yaz

C. Drospirenone/ethinyl estradiol

Opill

A. Progestin only (norgestrel) - OTC

NuvaRing

D. Etonogestrel/ethinyl estradiol (vaginal ring)

What does BPH stand for?

A. Benign Prostatic Hypertrophy

B. Benign Prostatic Hyperplasia

C. Bilateral Prostate Hypoplasia

D. Benign Penile Hypertension

B. Benign Prostatic Hyperplasia

BPH affects approximately what percentage of men by age 60?

A. 20-30%

B. 40-50%

C. Up to 60%

D. 90%

C. Up to 60%

What is the brand name for tamsulosin?

A. Proscar

B. Avodart

C. Flomax

D. Cardura

C. Flomax

What is the brand name for finasteride 5 mg (for BPH)?

A. Proscar

B. Propecia

C. Flomax

D. Avodart

A. Proscar

Tamsulosin belongs to which drug class?

A. 5-alpha reductase inhibitors

B. Alpha-1 blockers

C. Beta blockers

D. ACE inhibitors

B. Alpha-1 blockers

How do alpha blockers like tamsulosin work?

A. Shrink the prostate

B. Relax smooth muscle in prostate and bladder

C. Increase testosterone

D. Block DHT production

B. Relax smooth muscle in prostate and bladder

How long does it take for alpha blockers to start working?

A. 6-12 months

B. 2-4 weeks

C. 2-3 days

D. Immediately

C. 2-3 days

What is the generic name for Avodart?

A. Finasteride

B. Dutasteride

C. Tamsulosin

D. Doxazosin

B. Dutasteride

How do 5-alpha reductase inhibitors (5-ARIs) work?

A. Relax bladder muscles

B. Block conversion of testosterone to DHT, shrinking the prostate

C. Increase urine production

D. Stimulate prostate growth

B. Block conversion of testosterone to DHT, shrinking the prostate

How long does it take for 5-ARIs like finasteride to show improvement?

A. 2-3 days

B. 1-2 weeks

C. 3-6 months

D. 1-2 years

C. 3-6 months

Which medication is more effective for IMMEDIATE symptom relief in BPH?

A. Finasteride

B. Dutasteride

C. Tamsulosin (alpha blocker)

D. Both are equally fast

C. Tamsulosin (alpha blocker)

By approximately what percentage can finasteride reduce prostate size?

A. 5-10%

B. 20-30%

C. 50-60%

D. 80-90%

B. 20-30%

What is a common side effect of 5-alpha reductase inhibitors?

A. Hypertension

B. Sexual side effects (reduced libido, erectile dysfunction)

C. Weight gain

D. Hair loss

B. Sexual side effects (reduced libido, erectile dysfunction)

Which two medications are often combined for treating BPH?

A. Metformin and insulin

B. Finasteride and tamsulosin

C. Aspirin and warfarin

D. Levothyroxine and liothyronine

B. Finasteride and tamsulosin

Finasteride reduces PSA levels by approximately:

A. 10-20%

B. 25-30%

C. 40-50%

D. 70-80%

C. 40-50%

Tamsulosin is a highly selective alpha-1A blocker.

T__

5-alpha reductase inhibitors work immediately to relieve BPH symptoms.

F__

Dutasteride inhibits both Type I and Type II 5-alpha reductase enzymes. T____

T____

Finasteride only inhibits Type II 5-alpha reductase.

T__

Alpha blockers can cause dizziness and orthostatic hypotension.

T__

5-ARIs are most effective in men with larger prostates (>30-40 cc).

T____

Combination therapy (alpha blocker + 5-ARI) is more effective than either drug alone for preventing BPH progression.

T__

Tamsulosin (Flomax)

A. Alpha-1 blocker (selective)

Finasteride (Proscar)

C. 5-alpha reductase inhibitor

Dutasteride (Avodart)

C. 5-alpha reductase inhibitor

Alfuzosin (Uroxatral)

A. Alpha-1 blocker (selective)

Terazosin (Hytrin)

B. Alpha-1 blocker (nonselective)

Doxazosin (Cardura) 

B. Alpha-1 blocker (nonselective)

Estrogen is primarily produced by which organs in females?

A. Adrenal glands

B. Ovaries

C. Thyroid

D. Pancreas

B. Ovaries

Testosterone is primarily produced by which organs in males?

A. Prostate

B. Testes

C. Adrenal glands

D. Pituitary

B. Testes

Which hormone stimulates ovulation in females?

A. Progesterone

B. Estrogen

C. Luteinizing hormone (LH)

D. Insulin

C. Luteinizing hormone (LH)

What is the precursor molecule for all sex hormones?

A. Glucose

B. Cholesterol

C. Protein

D. Glycogen

B. Cholesterol

Which hormone is responsible for developing and maintaining male secondary sex characteristics?

A. Estrogen

B. Progesterone

C. Testosterone

D. Cortisol

C. Testosterone

What is DHT (dihydrotestosterone)?

A. A more potent form of testosterone

B. A type of estrogen

C. A synthetic hormone

D. An enzyme

A. A more potent form of testosterone

Estrogen and progesterone are both steroid hormones.

True__

Sex hormones are derived from cholesterol.

True____

The pituitary gland produces FSH and LH which regulate reproductive function.

True______

Testosterone levels naturally decline with age in men.

True___

Polycystic ovary syndrome (PCOS) is characterized by:

A. Low testosterone in males

B. Abnormal production of male hormones (androgens) in females

C. Enlarged prostate

D. Low estrogen levels

B. Abnormal production of male hormones (androgens) in females

Which medication is commonly used off-label to treat PCOS?

A. Finasteride

B. Tamsulosin

C. Metformin

D. Levothyroxine

C. Metformin

Erectile dysfunction (ED) medications like sildenafil (Viagra) belong to which drug class?

A. Alpha blockers

B. 5-alpha reductase inhibitors

C. PDE-5 inhibitors

D. Beta blockers

C. PDE-5 inhibitors

Premature ejaculation may be treated with:

A. SSRIs (selective serotonin reuptake inhibitors)

B. Insulin

C. Levothyroxine

D. Metformin

A. SSRIs (selective serotonin reuptake inhibitors)

The condition where the prostate gland becomes enlarged and presses against the urethra is called .

____BPH_________

Medications that prevent pregnancy by altering hormone levels are called .

___OC__________

The conversion of testosterone to DHT is blocked by ____ inhibitors.

5 alpha reductase_____

The most common type of oral contraceptive contains both estrogen and .

___progestin__________

Flomax

Tamsulosin

Proscar

Finasteride

Avodart

Dutasteride

Sprintec

Norgestimate/ethinyl estradiol

Yaz

Drospirenone/ethinyl estradiol

When should oral contraceptives be taken?

A. Any time during the day

B. Same time every day

C. Only at bedtime

D. Only in the morning

B. Same time every day

What should a patient do if they miss ONE birth control pill?

A. Skip it and continue normally

B. Take it as soon as remembered and take the next pill at the regular time

C. Stop taking the pills

D. Double the dose the next day

B. Take it as soon as remembered and take the next pill at the regular time

When should tamsulosin be taken?

A. On an empty stomach in the morning

B. 30 minutes after the same meal each day

C. At bedtime

D. Any time without regard to meals

B. 30 minutes after the same meal each day

What counseling point is important for patients starting finasteride?

A. May see results in 2-3 days

B. Takes 3-6 months to see full effect

C. Must take on empty stomach

D. Requires refrigeration

B. Takes 3-6 months to see full effect

Alpha blockers like tamsulosin may cause:

A. Weight gain

B. Dizziness, especially when standing up quickly

C. Increased appetite

D. Hair growth

B. Dizziness, especially when standing up quickly

Backup contraception should be used during the first 7 days of starting birth control pills.

T__

Pregnant women can handle finasteride tablets without any risk.

F__

Patients on finasteride should have their PSA levels monitored.

T__

Birth control pills protect against all STIs.

F__

Which is a contraindication for combined oral contraceptives?

A. Diabetes

B. History of blood clots/VTE

C. Mild acne

D. PCOS

B. History of blood clots/VTE

Who should NOT take combined oral contraceptives containing estrogen?

A. Women who smoke and are over age 35

B. All teenagers

C. Women with regular periods

D. Women taking vitamins

A. Women who smoke and are over age 35

Common side effects of oral contraceptives include:

A. Hair loss

B. Nausea, breast tenderness, breakthrough bleeding

C. Severe weight loss

D. Increased blood pressure only

B. Nausea, breast tenderness, breakthrough bleeding

Which side effect is associated with tamsulosin?

A. Abnormal ejaculation (reduced semen volume)

B. Increased prostate size

C. Weight gain

D. Hair loss

A. Abnormal ejaculation (reduced semen volume)

What is a serious but rare side effect associated with combined oral contraceptives?

A. Mild headache

B. Venous thromboembolism (blood clots)

C. Stomach upset

D. Dry mouth

B. Venous thromboembolism (blood clots)

Sexual side effects (decreased libido, erectile dysfunction) can occur with 5-ARIs.

T__

Progestin-only pills are safer for women with contraindications to estrogen.

T__

Finasteride can be safely handled by pregnant women.

F__

When should Ms. Thompson start taking her first pill?

A. Immediately, any day

B. First day of her next period or first Sunday after bleeding starts

C. One week before her next period

D. Only on the first of the month

B. First day of her next period or first Sunday after bleeding starts

What should you counsel Ms. Thompson about taking her pills?

A. Take whenever convenient

B. Take at the same time every day

C. Take only when sexually active

D. Take twice daily

B. Take at the same time every day

Ms. Thompson is taking antibiotics. What should she be told?

A. Stop birth control while on antibiotics

B. Some antibiotics may reduce effectiveness; use backup contraception

C. Double her birth control dose

D. Nothing - no interaction exists

B. Some antibiotics may reduce effectiveness; use backup contraception

When should Mr. Garcia take his Flomax?

A. First thing in the morning on empty stomach

B. 30 minutes after the same meal each day

C. At bedtime

D. With breakfast

B. 30 minutes after the same meal each day

What common side effect should Mr. Garcia be counseled about?

A. Weight gain

B. Dizziness, especially when standing up

C. Increased appetite

D. Constipation

B. Dizziness, especially when standing up

How quickly can Mr. Garcia expect symptom relief?

A. 6-12 months

B. 2-3 weeks

C. Within 2-3 days

D. After 1 year

C. Within 2-3 days

Why is Mr. Johnson on combination therapy?

A. He requested two medications

B. One wasn't working

C. Combination is more effective for large prostates and preventing progression

D. It's always required

C. Combination is more effective for large prostates and preventing progression

(significantly enlarged prostate and is prescribed both finasteride 5 mg and tamsulosin)

Which medication will provide faster symptom relief?

A. Finasteride

B. Tamsulosin

C. Both work at the same speed

D. Neither will help

B. Tamsulosin

How long before Mr. Johnson notices the full effect of finasteride?

A. 2-3 days

B. 1-2 weeks

C. 3-6 months

D. Immediately

C. 3-6 months

A prescription for Sprintec reads: "Take one tablet daily for 28 days." How many tablets are dispensed?

A. 21 tablets

B. 28 tablets

C. 30 tablets

D. 84 tablets

B. 28 tablets

Tamsulosin 0.4 mg is prescribed "Take one capsule daily." How many capsules are needed for a 90-day supply?

A. 30 capsules

B. 60 capsules

C. 90 capsules

D. 180 capsules

C. 90 capsules

A patient takes finasteride 5 mg daily. How many tablets are needed for a 30-day supply?

A. 15 tablets

B. 30 tablets

C. 60 tablets

D. 90 tablets

B. 30 tablets