Review Practice Exercise 3

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Practice Exercise 3

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Total Questions : 5

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Question 1:

Which condition is characterized by the absence of menstruation for ≥3 months in a woman with previously regular cycles?

A. Oligomenorrhea B. Menorrhagia C. Secondary amenorrhea D. Dysmenorrhea

Answer and Explanation

Choice A:

Oligomenorrhea is infrequent menstruation, with cycles longer than 35 days but less than 90 days. It does not meet the ≥3-month criterion for amenorrhea.

Choice B:

Menorrhagia refers to excessively heavy or prolonged menstrual bleeding, typically >80 mL per cycle or lasting >7 days. It involves presence, not absence, of menstruation.

Choice C:

Secondary amenorrhea is defined as the absence of menstruation for ≥3 consecutive months in a woman with previously normal cycles. This clinical definition distinguishes it from other menstrual abnormalities.

Choice D:

Dysmenorrhea is painful menstruation caused by prostaglandin-induced uterine contractions. It is a disorder of menstrual discomfort, not cycle absence.

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Question 2:

Which condition is characterized by excessive menstrual bleeding (>80 mL)?

A. Hypomenorrhea B. Menorrhagia C. Oligomenorrhea D. Amenorrhea

Answer and Explanation

Choice A:

Hypomenorrhea refers to light or scanty menstrual flow, typically with shortened duration or minimal blood loss (<20 mL per cycle), not excessive bleeding.

Choice B:

Menorrhagia is defined by menstrual blood loss greater than 80 mL per cycle or bleeding lasting more than 7 days. It reflects abnormal uterine bleeding due to various structural or hormonal causes.

Choice C:

Oligomenorrhea is infrequent menstruation, with cycles occurring more than 35 days apart. It concerns frequency, not volume of bleeding.

Choice D:

Amenorrhea is the complete absence of menstruation for at least 3 months (secondary) or by age 15 (primary). It involves no bleeding, not excessive bleeding.

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Question 3:

What is the term for the permanent cessation of menstruation, typically diagnosed after 12 consecutive months of amenorrhea?

A. Dysmenorrhea B. Amenorrhea C. Perimenopause D. Menopause

Answer and Explanation

Choice A:

Dysmenorrhea refers to painful menstruation caused by uterine contractions mediated by prostaglandins. It does not involve cessation of menses.

Choice B:

Amenorrhea is absence of menstruation, either primary or secondary, but is a symptom, not a natural permanent physiological stage like menopause.

Choice C:

Perimenopause is the transition phase leading up to menopause, characterized by menstrual irregularity and vasomotor symptoms, but not complete cessation.

Choice D:

Menopause is diagnosed after 12 months of continuous amenorrhea due to natural decline in ovarian function. It signifies the end of menstrual and reproductive activity.

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Question 4:

Which conditions may cause menstrual irregularities? Select all that apply.

A. Polycystic ovary syndrome (PCOS) B. Thyroid dysfunction C. Endometriosis D. Normal ovulation E. Hyperprolactinemia

Answer and Explanation

Choice A:

Polycystic ovary syndrome causes chronic anovulation due to elevated LH and hyperandrogenism. It leads to irregular, infrequent, or absent periods. Serum LH is typically >10 IU/L with an LH:FSH ratio >2:1.

Choice B:

Thyroid dysfunction alters the release of GnRH from the hypothalamus, affecting FSH and LH secretion. Both hypothyroidism and hyperthyroidism can lead to amenorrhea or menorrhagia due to endometrial instability.

Choice C:

Endometriosis involves ectopic endometrial tissue causing inflammation, fibrosis, and hormonal imbalance, leading to spotting, menorrhagia, or intermenstrual bleeding despite ovulation being mostly preserved.

Choice D:

Normal ovulation maintains a stable hormonal environment that supports predictable endometrial shedding. It is regulated by coordinated release of FSH and LH. Progesterone secreted post-ovulation stabilizes the endometrium and supports regular cycles. It does not cause menstrual irregularities.

Choice E:

Hyperprolactinemia inhibits GnRH secretion, leading to decreased FSH and LH levels. This suppresses ovulation and results in secondary amenorrhea or oligomenorrhea. Normal prolactin is <20 ng/mL in nonpregnant women.

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Question 5:

Which of the following are reasons why hormonal contraceptives are effective in preventing pregnancy? Select all that apply.

A. They suppress GnRH release B. They inhibit ovulation C. They cause the endometrium to become highly receptive to implantation D. They thicken cervical mucus E. They directly stimulate sperm production

Answer and Explanation

Choice A:

Hormonal contraceptives suppress GnRH release from the hypothalamus, disrupting the normal pulsatile release needed to stimulate FSH and LH secretion. This halts the ovarian follicular cycle and prevents ovulation.

Choice B:

By suppressing LH surge, hormonal contraceptives inhibit ovulation. Without the LH peak (normally around day 14), the dominant follicle fails to rupture, preventing release of the ovum.

Choice C:

Hormonal contraceptives make the endometrium less receptive to implantation by causing thinning and glandular atrophy. Progestins suppress endometrial proliferation. A highly receptive endometrium is required for implantation and is stimulated by natural estradiol and progesterone cycles, which are disrupted by contraceptives.

Choice D:

Progestin in contraceptives thickens cervical mucus, making it viscous and impenetrable to sperm. This mechanical barrier further reduces the chance of fertilization.

Choice E:

Hormonal contraceptives do not stimulate sperm production. Spermatogenesis occurs in males and is regulated by FSH and LH acting on Sertoli and Leydig cells, respectively. Female contraceptives have no physiological role in male gametogenesis.

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Practice Exercise 3

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