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MENOPAUSE ACTUAL EXAM
1. The period of endocrinologic, somatic, and transitory psychologic changes that
occur around the time of menopause is called the:
A) Perimenopause
B) Climacteric phase
C) Menopause transition
D) Postmenopause
Correct Answer: B
Rationale: The climacteric phase encompasses the entire transitional period of
endocrine, physical, and psychological changes surrounding menopause.
Perimenopause is a subset of this period. The menopause transition refers
specifically to the period leading up to the final menstrual period .
2. Early menopause is defined as:
A) Menopause that occurs before age 35
B) Menopause that occurs before age 40
C) Menopause that occurs before age 45
,D) Menopause that occurs before age 50
Correct Answer: C
Rationale: Early menopause is defined as the last menstrual period (LMP)
occurring before age 45. This is distinguished from primary ovarian insufficiency
(POI), which occurs before age 40 .
3. Menopause that occurs before age 40 is termed:
A) Early menopause
B) Primary ovarian insufficiency (POI)
C) Late menopause
D) Premenopause
Correct Answer: B
Rationale: Primary ovarian insufficiency (POI) is defined as menopause occurring
before age 40. It is characterized by menstrual disturbance (oligomenorrhea or
amenorrhea for at least 4 months) and elevated FSH >25 on two occasions at least
4 weeks apart .
4. According to the STRAW+10 staging system, the early menopause transition
(stage -2) is characterized by:
A) 60 or more consecutive days of amenorrhea
B) Persistent difference of 7 days or more in the length of consecutive cycles
,C) Regular menstrual cycles with normal FSH
D) Complete cessation of menses for 12 months
Correct Answer: B
Rationale: The early menopause transition (stage -2) is defined by a persistent
difference of 7 days or more in the length of consecutive cycles. The late transition
(stage -1) is marked by 60 or more consecutive days of amenorrhea .
5. According to the STRAW+10 staging system, the late menopause transition
(stage -1) is characterized by:
A) Persistent difference of 7 days or more in cycle length
B) 60 or more consecutive days of amenorrhea
C) Regular menstrual cycles with elevated FSH
D) Return of regular cycles after amenorrhea
Correct Answer: B
Rationale: The late menopause transition (stage -1) is defined by 60 or more
consecutive days of amenorrhea or 2+ skipped cycles. This stage is characterized
by more significant hormonal changes and increased vasomotor symptoms .
6. The "luteal out of phase" (LOOP) event explains why some perimenopausal
women have:
A) Low FSH levels
, B) Elevated estradiol levels
C) Prolonged menstrual bleeding
D) Absence of ovulation
Correct Answer: B
Rationale: In the early menopause transition, elevated FSH levels are adequate to
recruit a second follicle, resulting in a follicular phase-like rise in estradiol
secretion superimposed on the mid-to-late luteal phase of the ongoing ovulatory
cycle. This explains elevated estrogen levels in some perimenopausal women .
7. Endocrine labs after menopause typically show:
A) Low FSH, low LH
B) Elevated FSH, elevated LH
C) Low FSH, elevated LH
D) Normal FSH, low LH
Correct Answer: B
Rationale: After menopause, both FSH and LH are elevated due to loss of negative
feedback from ovarian estradiol and inhibin production. FSH typically rises higher
than LH .
8. Which hormones work during reproductive years to prevent too rapid depletion
of the ovarian follicle pool?