NURS 611 ADVANCED PATHO Exam 4 Questions and answers

Exam 4 Questions Chapter 24: Structure and Function of the Reproductive Systems MULTIPLE CHOICE 1. The initial reproductive structures of the male and female embryos appear the same until which week of gestation? a. Third c. Twentieth b. Eighth d. Thirtieth ANS: B Between 6 and 7 weeks’ gestation, the male embryo differentiates under the influence of testes-determining factor (TDF). In the absence of testosterone, a loss of the wolffian system occurs and the two gonads develop into ovaries at 6 to 8 weeks’ gestation. 2. The absence of which major hormone is a determinant of sexual differentiation (wolffian system) in utero? a. Estrogen c. Growth hormone b. Progesterone d. Testosterone ANS: D In the absence of testosterone, a loss of the wolffian system occurs and the two gonads develop into ovaries at 6 to 8 weeks’ gestation. Between 6 and 7 weeks’ gestation, the male embryo differentiates under the influence of TDF. The presence of estrogen is a determinating factor. None of the other options function as a major determinant to sexual differentiation in utero. 3. Which gland produces the associated hormones that are found in high levels in a female fetus? a) Posterior pituitary excretes gonadotropin-releasing hormone (GnRH) and luteinizing hormone (LH). b) Hypothalamus excretes luteinizing hormone (LH) and gonadotropinreleasing hormone (GnRH). c) Anterior pituitaryfollicle-stimulating hormone (FSH) and luteinizing hormone (LH). d) Hypothalamus excretes gonadotropin-releasing hormone (GnRH) and follicle-stimulating hormone (FSH). ANS: C In the female fetus, the anterior pituitary excretes high levels of two gonadotropins—FSH and LH. The other sequences are not correct. 4. Which hormone is linked to an increase in appetite during puberty? a. Inhibin c. Activin b. Leptin d. Follistatin ANS: B Sensitivity to leptin, which regulates appetite and energy metabolism, increases during puberty; in theory, the adolescent consumes more calories to meet the caloric needs of the pubertal growth spurt. The percent of body fat and leptin levels in girls continue to increase, whereas muscle mass increases in boys. No apparent link exists between increased appetite during puberty and any of the other options. 5. The Skene glands are located on either side of which structure? a. Introitus c. Clitoris b. Urinary meatus d. Vestibule ANS: B The ducts of the Skene glands (also called the lesser vestibular or paraurethral glands) are related only to the urinary meatus. 6. What is the function of the mucus secreted by the Bartholin glands? a) Enhancement of the motility of sperm b) Lubrication of the urinary meatus and vestibule c) Maintenance of an acid-base balance to discourage proliferation of pathogenic bacteria d) Enhancement of the size of the penis during intercourse ANS: A In response to sexual stimulation, the Bartholin glands secrete mucus that serves only to lubricate the inner labial surfaces, as well as to enhance the viability and motility of sperm. 7. Which change is a result of puberty and defends the vagina from infection? a) The pH stabilizes between 7 and 8. b) A thin squamous epithelial lining develops. c) V aginal pH becomes more acidic. d) Estrogen levels are low. ANS: C At puberty, the pH becomes more acidic (4 to 5) and the squamous epithelial lining thickens. These changes are maintained until menopause (cessation of menstruation), at which time the pH rises again to more alkaline levels and the epithelium thins out. Therefore protection from infection is greatest during the years when a woman is most likely to be sexually active. Estrogen does not play a role in infection protection. 8. What happens to the vagina’s lining at puberty? a) It becomes thinner. c. It assumes a neutral pH. b) It becomes thicker. d. It undergoes atrophy. ANS: B Before puberty, vaginal pH is approximately 7 (neutral) and the vaginal epithelium is thin. At puberty, the pH becomes more acidic (4 to 5) and the squamous epithelial lining thickens. Cell atrophy is not associated with puberty. 9. Which structure is lined with columnar epithelial cells? a. Perimetrium c. Myometrium b. Endocervical canal d. Vagina ANS: B Of the available options, only the endocervical canal does not have an endometrial layer; rather, the layer is lined with columnar epithelial cells. 10.Where is the usual site of fertilization of an ovum? a) Trumpet end of the fallopian tubes c. Ampulla of the fallopian tubes b) Fimbriae of the fallopian tubes d. Os of the fallopian tubes ANS: C The ampulla, or distal third, of the fallopian tube is the usual site of fertilization 11.Where is the usual site of cervical dysplasia or cancer in situ? a) Squamous epithelium of the cervix meets the cuboidal epithelium of the vagina. b) Columnar epithelium of the cervix meets the squamous epithelium of the uterus. c) Squamous epithelium of the cervix meets the columnar epithelium of the uterus. d) Columnar epithelium of the cervix meets the squamous epithelium of the vagina. ANS: D The point at which the columnar epithelium of the cervix meets the squamous epithelium of the vagina is called the transformation zone or the squamous-columnar junction. The transformation zone is especially susceptible to the oncogenic human papillomavirus (HPV), which leads to cervical dysplasia and, ultimately, cervical cancer; these are the cells sampled during a Papanicolaou (Pap) test.