[MCQ]The Female Reproductive System, Infertility, and Contraception-Part 7

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The Female Reproductive System, Infertility, and Contraception-Part 7

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Question 1

In perimenopause, intermenstrual intervals shorten significantly due to ?

A	Acceleration in follicular phase
B	Acceleration in luteal phase
C	Acceleration in follicular & luteal phase
D	None of the above

Question 1 Explanation:

In perimenopause, intermenstrual intervals shorten significantly (typically by 3 days) due to an accelerated follicular phase.

Question 2

“Perimenopause” time period precedes final cessation of menses by a mean of how many months ?

A	12
B	24
C	36
D	48

Question 2 Explanation:

Onset of perimenopause precedes the final menses by 2 - 8 years, with mean duration of 4 years.

Question 3

“Perimenopause” time period extends up till what time after final menses ?

A	3
B	6
C	9
D	12

Question 3 Explanation:

Perimenopause refers to the time period preceding menopause, when fertility wanes and menstrual cycle irregularity increases, until the first year after cessation of menses

Question 4

Perimenopause is characterized by which of the following ?

A	Hypoestrogenic, hypoprogestagenic environment
B	Hyperestrogenic, hyperprogestagenic environment
C	Hyperestrogenic, hypoprogestagenic environment
D	Hypoestrogenic, hyperprogestagenic environment

Question 4 Explanation:

In perimenopause, anovulatory cycles produce a hyperestrogenic, hypoprogestagenic environment that leads to an increased incidence of endometrial hyperplasia or carcinoma, uterine polyps, and leiomyoma observed among women of perimenopausal age

Question 5

Predominant estrogen formed in menopausal women is ?

A	Estradiol
B	Estrone
C	Estriol
D	None of the above

Question 5 Explanation:

Estradiol is secreted by ovaries and is the most potent estrogen. Most estrone is formed by extraglandular conversion of androstenedione in peripheral tissues, although some estrone is also produced by ovary. Estriol (16-hydroxyestradiol) is the main estrogen in urine and arises from 16- hydroxylation of estrone and estradiol.

Question 6

Which of the following statements about hormone levels is false as regards menopause ?

A	Estradiol levels fall more than estrone levels
B	FSH levels increase more than LH levels
C	Reduced inhibin secretion
D	None of the above

Question 6 Explanation:

In menopause, estradiol levels fall markedly, whereas estrone levels are relatively preserved, reflecting peripheral aromatization of adrenal & ovarian androgens. FSH levels increase more than LH because of the loss of inhibin, as well as estrogen feedback.

Question 7

Which of the following FSH levels on day 3 of menstrual cycle indicate a good likelihood of achieving pregnancy ?

A	< 20 mIU/mL
B	20 to < 30 mIU/mL
C	30 to < 40 mIU/mL
D	>= 40 mIU/mL

Question 7 Explanation:

FSH measurement aid in assessing fertility. Levels of <20 mIU/mL, 20 to <30 mIU/mL, and >=30 mIU/mL measured on day 3 of the cycle indicate a good, fair, and poor likelihood of achieving pregnancy, respectively

Question 8

Which of the following treatments is useful in perimenopausal women ?

A	Low-dose combined oral contraceptives
B	Progestin-only formulations
C	Nonsteroidal anti-inflammatory agents
D	All of the above

Question 8 Explanation:

Perimenopausal women with irregular or heavy menses or hormonally related symptoms benefit with lowdose combined oral contraceptives. Static doses of estrogen & progestin eliminate vasomotor symptoms & restore regular cyclicity. Progestin-only formulations or medroxyprogesterone injections are an alternative for perimenopausal menorrhagia in women who smoke or have cardiovascular risk factors. They reduce volume of menstrual flow. Nonhormonal strategies include NSAIDs or endometrial ablation

Question 9

Premature ovarian failure or premature menopause applies to women who cease menstruating before age of ?

A	30
B	35
C	40
D	45

Question 9 Explanation:

Term premature ovarian failure or premature menopause applies to women who cease menstruating before the age of 40 years.

Question 10

Which hormone is secreted in a pulsatile manner ?

A	FSH
B	LH
C	Prolactin
D	All of the above

Question 10 Explanation:

Following hormones are secreted in a pulsatile manner - FSH, LH, gonadotropin-releasing hormone (GnRH), ACTH, TSH, GH and prolactin.

Question 11

Plasma gonadotropin measurements are of value in ?

A	Evaluating women with suspected ovarian failure
B	In diagnosis of polycystic ovarian syndrome (PCOS)
C	In diagnosis of hypogonadotropic hypogonadism
D	All of the above

Question 12

What value of FSH level is diagnostic of ovarian failure ?

A	> 10 IU/L
B	> 20 IU/L
C	> 30 IU/L
D	> 40 IU/L

Question 13

What value of LH suggests hypogonadotropic hypogonadism ?

A	< 0.8 IU/L
B	< 1.8 IU/L
C	< 2.8 IU/L
D	< 3.8 IU/L

Question 13 Explanation:

FSH levels that are persistently > 40 IU/L are diagnostic of ovarian failure, and an LH value < 0.8 IU/L suggests hypogonadotropic hypogonadism.

Question 14

Which of the following is not useful in controlling vasomotor and genitourinary symptoms of menopause ?

A	Estrogen therapy
B	Clonidine
C	Vitamin E
D	Vitamin D

Question 14 Explanation:

Estrogens, venlafaxine, clonidine, vitamin E are effective for controlling vasomotor and genitourinary symptoms in menopause.

Question 15

Which of the following reduces the risk of osteoporosis-related fractures ?

A	Estrogen
B	Calcium
C	Vitamin D
D	All of the above

Question 16

Dose of vitamin D given to reduce the risk of osteoporosis-related fractures is ?

A	100 to 300 IU/day
B	200 to 500 IU/day
C	400 to 800 IU/day
D	800 to 1500 IU/day

Question 17

Dose of oral calcium given to reduce the risk of osteoporosisrelated fractures is ?

A	100 to 150 mg/day
B	300 to 500 mg/day
C	500 to 750 mg/day
D	1000 to 1500 mg/day

Question 17 Explanation:

Increased physical activity, adequate calcium (1000 to 1500 mg/day) & vitamin D (400 to 800 IU/ day) intakes reduces the risk of osteoporosis-related fractures.

Question 18

Which of the following is a selective estrogen receptor modulator ?

A	Alendronate
B	Residronate
C	Raloxifene
D	All of the above

Question 18 Explanation:

Raloxifene is a selective estrogen receptor modulator (SERM).

Question 19

Postmenopausal Estrogen/Progestin Interventions trial found ?

A	Increased risk of breast cancer
B	Increased risk of endometrial cancer
C	Increased risk of fracture
D	All of the above

Question 19 Explanation:

Postmenopausal Estrogen/Progestin Interventions (PEPI) trial found 24% of women assigned to unopposed estrogen for 3 years developed atypical endometrial hyperplasia, a premalignant lesion, compared to only 1% of women assigned to placebo. Use of a progestin eliminates these risks.

Question 20

In the Heart and Estrogen/progestin Replacement Study (HERS), risk of which of the following cancers was increased ?

A	Breast cancer
B	Endometrial cancer
C	Colorectal cancer
D	Urinary bladder cancer

Question 20 Explanation:

In the Heart & Estrogen/progestin Replacement Study (HERS), 4 years of combination therapy was associated with a 27% increase in breast cancer risk.

Question 21

Exogenous estrogen administration in postmenopausal women produces all except ?

A	Lowers LDL cholesterol
B	Raises HDL cholesterol
C	Lowers lipoprotein(a)
D	Lowers triglycerides

Question 21 Explanation:

Exogenous estrogen lowers plasma LDL cholesterol & Lp(a), raises HDL cholesterol levels and triglyceride levels.

Question 22

Which of the following is a “primary” prevention trial for assessing efficacy of hormone therapy in postmenopausal women ?

A	Heart and Estrogen/progestin Replacement Study (HERS)
B	Women’s Health Initiative trial (WHI)
C	Estrogen Replacement and Atherosclerosis (ERA) trial
D	Estrogen in the Prevention of Reinfarction Trial (ESPRIT)

Question 22 Explanation:

In WHI, women assigned to receive combination hormones for an average of 5.6 years were 24% more likely to develop breast cancer than women assigned to placebo, but 7.1 years of estrogen-only therapy did not increase risk. Indeed, the WHI showed a trend toward a reduction in breast cancer risk with estrogen alone, although it is unclear whether this finding would pertain to formulations of estrogen other than conjugated equine estrogens or to treatment durations longer than 7 years.

Question 23

Estrogen-progestin therapy reduces risk of ?

A	Colorectal cancer
B	Breast cancer
C	Gallbladder disease
D	Coronary heart disease

Question 23 Explanation:

In WHI, estrogen-progestin was associated with a significant 44% reduction in colorectal cancer over a 5.6-year period, although no benefit was seen with 7 years of estrogen-only therapy.

Question 24

In hot flush, a characteristic manifestation of menopause, sudden feeling of heat in felt over ?

A	Face
B	Neck
C	Chest
D	All of the above

Question 25

The average hot flush lasts about ?

A	1 minutes
B	2 minutes
C	3 minutes
D	4 minutes

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See all quizzes of The Female Reproductive System, Infertility, and Contraception at here:

1 In perimenopause, intermenstrual intervals shorten significantly
due to ?
A. Acceleration in follicular phase
B. Acceleration in luteal phase
C. Acceleration in follicular & luteal phase
D. None of the above

2 “Perimenopause” time period precedes final cessation of menses
by a mean of how many months ?
A. 12
B. 24
C. 36
D. 48

2 “Perimenopause” time period extends up till what time after final
menses ?
A. 3
B. 6
C. 9
D. 12

3 Perimenopause is characterized by which of the following ?
A. Hypoestrogenic, hypoprogestagenic environment
B. Hyperestrogenic, hyperprogestagenic environment
C. Hyperestrogenic, hypoprogestagenic environment
D. Hypoestrogenic, hyperprogestagenic environment

4 Predominant estrogen formed in menopausal women is ?
A. Estradiol
B. Estrone
C. Estriol
D. None of the above

5 Which of the following statements about hormone levels is false
as regards menopause ?
A. Estradiol levels fall more than estrone levels
B. FSH levels increase more than LH levels
C. Reduced inhibin secretion
D. None of the above

6 Which of the following FSH levels on day 3 of menstrual cycle
indicate a good likelihood of achieving pregnancy ?
A. < 20 mIU/mL
B. 20 to < 30 mIU/mL
C. 30 to < 40 mIU/mL
D. >= 40 mIU/mL

7 Which of the following treatments is useful in perimenopausal women ?
A. Low-dose combined oral contraceptives
B. Progestin-only formulations
C. Nonsteroidal anti-inflammatory agents
D. All of the above

8 Premature ovarian failure or premature menopause applies to
women who cease menstruating before age of ?
A. 30
B. 35
C. 40
D. 45

9 Which hormone is secreted in a pulsatile manner ?
A. FSH
B. LH
C. Prolactin
D. All of the above

10 Plasma gonadotropin measurements are of value in ?
A. Evaluating women with suspected ovarian failure
B. In diagnosis of polycystic ovarian syndrome (PCOS)
C. In diagnosis of hypogonadotropic hypogonadism
D. All of the above
11 What value of FSH level is diagnostic of ovarian failure ?
A. > 10 IU/L
B. > 20 IU/L
C. > 30 IU/L
D. > 40 IU/L
12 What value of LH suggests hypogonadotropic hypogonadism ?
A. < 0.8 IU/L
B. < 1.8 IU/L
C. < 2.8 IU/L
D. < 3.8 IU/L

13 Which of the following is not useful in controlling vasomotor and
genitourinary symptoms of menopause ?
A. Estrogen therapy
B. Clonidine
C. Vitamin E
D. Vitamin D

14 Which of the following reduces the risk of osteoporosis-related
fractures ?
A. Estrogen
B. Calcium
C. Vitamin D
D. All of the above
15 Dose of vitamin D given to reduce the risk of osteoporosis-related
fractures is ?
A. 100 to 300 IU/day
B. 200 to 500 IU/day
C. 400 to 800 IU/day
D. 800 to 1500 IU/day
16 Dose of oral calcium given to reduce the risk of osteoporosisrelated
fractures is ?
A. 100 to 150 mg/day
B. 300 to 500 mg/day
C. 500 to 750 mg/day
D. 1000 to 1500 mg/day

17 Which of the following is a selective estrogen receptor modulator ?
A. Alendronate
B. Residronate
C. Raloxifene
D. All of the above
18 Postmenopausal Estrogen/Progestin Interventions trial found ?
A. Increased risk of breast cancer
B. Increased risk of endometrial cancer
C. Increased risk of fracture
D. All of the above

19 In the Heart and Estrogen/progestin Replacement Study (HERS),
risk of which of the following cancers was increased ?
A. Breast cancer
B. Endometrial cancer
C. Colorectal cancer
D. Urinary bladder cancer

20 Exogenous estrogen administration in postmenopausal women
produces all except ?
A. Lowers LDL cholesterol
B. Raises HDL cholesterol
C. Lowers lipoprotein(a)
D. Lowers triglycerides

21 Which of the following is a “primary” prevention trial for assessing
efficacy of hormone therapy in postmenopausal women ?
A. Heart and Estrogen/progestin Replacement Study (HERS)
B. Women’s Health Initiative trial (WHI)
C. Estrogen Replacement and Atherosclerosis (ERA) trial
D. Estrogen in the Prevention of Reinfarction Trial (ESPRIT)

22 Estrogen-progestin therapy reduces risk of ?
A. Colorectal cancer
B. Breast cancer
C. Gallbladder disease
D. Coronary heart disease

23 In hot flush, a characteristic manifestation of menopause, sudden
feeling of heat in felt over ?
A. Face
B. Neck
C. Chest
D. All of the above
24 The average hot flush lasts about ?
A. 1 minutes
B. 2 minutes
C. 3 minutes
D. 4 minutes

[MCQ]The Female Reproductive System, Infertility, and Contraception-Part 7

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The Female Reproductive System, Infertility, and Contraception-Part 7

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