NUR 2230 EXAM 1 UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS
Question:
1. Follicular phase
Answer:
The first phase of the ovarian cycle, during which a follicle (an oocyte and its surroudning cells) enlarges
and matures. This phase is under the control of FSH from the anterior pituitary, and typically lasts from
day 1 to day 14 of the menstrual cycle. The follicle secretes estrogen during this time period. It is initiated
by the hypothalamus. There is a surge in luteinizing hormone from anterior pituitary gland affects final
development and rupture of mature follicle.
Question:
2. Ovulation
Answer:
Day 14 in 28 days. release of a mature oocyte from ovary to oviduct -> mature follicle ruptures in response
to Luteinizing hormone, estrogen decreases
Question:
3. Luteal phase
Answer:
(Day 15-28), begins at ovulation and lasts until menstruation. Increased amount of progesterone -->
interacts with endometrium to prepare for implantation. Estrogen and progesterone decreases after
ovulation (if no fertilization), FSH and LH are at the lowest levels during luteal.
Question:
4. Uterine cycle
,Answer:
The uterine cycle is a monthly series of changes in the endometrium that prepares the uterus for
implantation of a fertilized ovum.
Duration: Average 28 days (normal range: 21-35 days) Control: Regulated by ovarian hormones (estrogen
and progesterone)
Phases of the Uterine Cycle
1. Menstrual Phase (Days 1-5) Shedding of endometrial lining Causes: “ estrogen and progesterone Results
in menstrual bleeding
2. Proliferative Phase (Days 6-14) Corresponds with Follicular phase Estrogen-dominant phase
Endometrium regenerates and thickens Glands and blood vessels grow Ends with ovulation
3. Secretory Phase (Days 15-28) Progesterone-dominant phase Endometrium becomes thick, spongy, and
vascular Glands secrete nutrients for embryo
Hormonal Regulation Estrogen ’ builds endometrium (proliferative phase) Progesterone ’ maintains
endometrium (secretory phase) Hormone withdrawal ’ menstruation
Functions Prepares uterus for pregnancy Supports implantation Maintains early embryo (if fertilization
occurs)
If Fertilization Occurs hCG maintains corpus luteum Progesterone remains high No menstruation
Endometrium maintained
If Fertilization Does Not Occur (Ischemic stage) Corpus luteum degenerates Estrogen & progesterone fall
Endometrium sheds ’ menstruation Clinical Importance Irregular cycles ’ hormonal imbalance Basis for
fertility tracking Affected in PCOS, stress, endocrine disorders
Key Points Average cycle = 28 days 3 phases: Menstrual, Proliferative, Secretory Estrogen builds,
progesterone maintains Hormone drop causes menstruation Supports implantation
Question:
5. Gonadotropin-releasing hormone (GnRH)
,Answer:
GnRH is a hypothalamic peptide hormone that regulates the reproductive system by controlling the release
of gonadotropins.
Source: Hypothalamus (arcuate nucleus)
Target: Anterior pituitary gland
Mechanism of Action Released in a pulsatile manner Binds to GnRH receptors in anterior pituitary
Stimulates release of: Luteinizing hormone (LH) Follicle-stimulating hormone (FSH) Note: Continuous
administration ’ suppresses LH & FSH
Functions Initiates puberty Regulates menstrual cycle and ovulation Controls spermatogenesis Maintains
fertility
Regulation Controlled by feedback from estrogen, progesterone, and testosterone Pulsatile secretion is
essential for normal function
Clinical Uses GnRH Agonists (e.g., Leuprolide, Goserelin) Prostate cancer Endometriosis Precocious
puberty Uterine fibroids GnRH Antagonists (e.g., Cetrorelix, Degarelix) IVF protocols Prostate cancer
Adverse Effects Hot flashes Decreased libido Mood changes Osteoporosis (long-term use) Vaginal
dryness
Contraindications Pregnancy Undiagnosed vaginal bleeding Hypersensitivity
Monitoring Sex hormone levels Bone density (long-term therapy) Menstrual pattern Growth in children
Key Points GnRH ’ stimulates LH & FSH Pulsatile = stimulation Continuous = suppression Used in
hormone-dependent diseases Long-term use ’ bone loss
Question:
6. Estrogen
, Answer:
Definition: Estrogen is the main female sex hormone responsible for reproductive function and secondary
sexual characteristics.
Source: Ovaries, placenta, adrenals, fat tissue
Mechanism of Action Binds to estrogen receptors (ERα, ERβ) Alters gene transcription
Functions Reproductive: Endometrial growth, ovulation regulation Secondary sex traits: Breast
development, fat distribution Bone: Prevents osteoporosis CVS: ‘ HDL, “ LDL CNS/Skin: Mood, skin
health
Clinical Uses HRT (menopause symptoms, osteoporosis) Oral contraceptives (with progesterone)
Hypogonadism, amenorrhea Gender-affirming therapy
Adverse Effects Common: Nausea, breast tenderness, weight gain Serious: Thrombosis, stroke, MI, breast
& endometrial cancer
Contraindications Estrogen-dependent cancers Thromboembolic disease Liver disease Pregnancy
Key Drug Types & Routes Drugs: Estradiol, Ethinyl estradiol, Conjugated estrogens Routes: Oral, patch,
vaginal, injection
Monitoring BP, weight Breast exams Watch for clot symptoms
Question:
7. Progesterone
CORRECT ANSWERS
Question:
1. Follicular phase
Answer:
The first phase of the ovarian cycle, during which a follicle (an oocyte and its surroudning cells) enlarges
and matures. This phase is under the control of FSH from the anterior pituitary, and typically lasts from
day 1 to day 14 of the menstrual cycle. The follicle secretes estrogen during this time period. It is initiated
by the hypothalamus. There is a surge in luteinizing hormone from anterior pituitary gland affects final
development and rupture of mature follicle.
Question:
2. Ovulation
Answer:
Day 14 in 28 days. release of a mature oocyte from ovary to oviduct -> mature follicle ruptures in response
to Luteinizing hormone, estrogen decreases
Question:
3. Luteal phase
Answer:
(Day 15-28), begins at ovulation and lasts until menstruation. Increased amount of progesterone -->
interacts with endometrium to prepare for implantation. Estrogen and progesterone decreases after
ovulation (if no fertilization), FSH and LH are at the lowest levels during luteal.
Question:
4. Uterine cycle
,Answer:
The uterine cycle is a monthly series of changes in the endometrium that prepares the uterus for
implantation of a fertilized ovum.
Duration: Average 28 days (normal range: 21-35 days) Control: Regulated by ovarian hormones (estrogen
and progesterone)
Phases of the Uterine Cycle
1. Menstrual Phase (Days 1-5) Shedding of endometrial lining Causes: “ estrogen and progesterone Results
in menstrual bleeding
2. Proliferative Phase (Days 6-14) Corresponds with Follicular phase Estrogen-dominant phase
Endometrium regenerates and thickens Glands and blood vessels grow Ends with ovulation
3. Secretory Phase (Days 15-28) Progesterone-dominant phase Endometrium becomes thick, spongy, and
vascular Glands secrete nutrients for embryo
Hormonal Regulation Estrogen ’ builds endometrium (proliferative phase) Progesterone ’ maintains
endometrium (secretory phase) Hormone withdrawal ’ menstruation
Functions Prepares uterus for pregnancy Supports implantation Maintains early embryo (if fertilization
occurs)
If Fertilization Occurs hCG maintains corpus luteum Progesterone remains high No menstruation
Endometrium maintained
If Fertilization Does Not Occur (Ischemic stage) Corpus luteum degenerates Estrogen & progesterone fall
Endometrium sheds ’ menstruation Clinical Importance Irregular cycles ’ hormonal imbalance Basis for
fertility tracking Affected in PCOS, stress, endocrine disorders
Key Points Average cycle = 28 days 3 phases: Menstrual, Proliferative, Secretory Estrogen builds,
progesterone maintains Hormone drop causes menstruation Supports implantation
Question:
5. Gonadotropin-releasing hormone (GnRH)
,Answer:
GnRH is a hypothalamic peptide hormone that regulates the reproductive system by controlling the release
of gonadotropins.
Source: Hypothalamus (arcuate nucleus)
Target: Anterior pituitary gland
Mechanism of Action Released in a pulsatile manner Binds to GnRH receptors in anterior pituitary
Stimulates release of: Luteinizing hormone (LH) Follicle-stimulating hormone (FSH) Note: Continuous
administration ’ suppresses LH & FSH
Functions Initiates puberty Regulates menstrual cycle and ovulation Controls spermatogenesis Maintains
fertility
Regulation Controlled by feedback from estrogen, progesterone, and testosterone Pulsatile secretion is
essential for normal function
Clinical Uses GnRH Agonists (e.g., Leuprolide, Goserelin) Prostate cancer Endometriosis Precocious
puberty Uterine fibroids GnRH Antagonists (e.g., Cetrorelix, Degarelix) IVF protocols Prostate cancer
Adverse Effects Hot flashes Decreased libido Mood changes Osteoporosis (long-term use) Vaginal
dryness
Contraindications Pregnancy Undiagnosed vaginal bleeding Hypersensitivity
Monitoring Sex hormone levels Bone density (long-term therapy) Menstrual pattern Growth in children
Key Points GnRH ’ stimulates LH & FSH Pulsatile = stimulation Continuous = suppression Used in
hormone-dependent diseases Long-term use ’ bone loss
Question:
6. Estrogen
, Answer:
Definition: Estrogen is the main female sex hormone responsible for reproductive function and secondary
sexual characteristics.
Source: Ovaries, placenta, adrenals, fat tissue
Mechanism of Action Binds to estrogen receptors (ERα, ERβ) Alters gene transcription
Functions Reproductive: Endometrial growth, ovulation regulation Secondary sex traits: Breast
development, fat distribution Bone: Prevents osteoporosis CVS: ‘ HDL, “ LDL CNS/Skin: Mood, skin
health
Clinical Uses HRT (menopause symptoms, osteoporosis) Oral contraceptives (with progesterone)
Hypogonadism, amenorrhea Gender-affirming therapy
Adverse Effects Common: Nausea, breast tenderness, weight gain Serious: Thrombosis, stroke, MI, breast
& endometrial cancer
Contraindications Estrogen-dependent cancers Thromboembolic disease Liver disease Pregnancy
Key Drug Types & Routes Drugs: Estradiol, Ethinyl estradiol, Conjugated estrogens Routes: Oral, patch,
vaginal, injection
Monitoring BP, weight Breast exams Watch for clot symptoms
Question:
7. Progesterone
