Womens Health EOR Questions with Answers All Correctly Verified Updates
1. failure of menses to occur by age 15 years (some sources say 16 years),
in the presence of normal growth and secondary sexual characteristics
(breast development, axillary or pubic hair).
if no period by 13 needs eval
XX normal female: primary amenorrhea
2. Absence of menses for 3 months in a woman with previously normal men-
struation or 6 months in a woman with a history of irregular cycles:
secondary amenorrhea
3. What are the progesterone formulations that are used to manage
endome- trial cancer?: Megestrol acetate and medroxyprogesterone.
4. endometrial biopsy shows endometrial hyperplasia, irregular
menstrual cycle, would like to conceive: Medroxyprogesterone acetate
5. reasons for secondary amenorrhea?: pregnancy most common
- weigth changes, hypothyroid, prolactinoma
always check beta HCG, TSH and prolactin
6. what is a progesterone challenge test?: medroxyprogesterone 5 to 10
mg orally once a day or another progestogen for 7 to 10 days.
If bleeding occurs = anovulatory cycles
7. pt has galactorrhea what test should you order?: serum prolactin
The combination of galactorrhea, amenorrhea, infertility, and decreased libido is
almost certainly the result of a prolactinoma.
8. labs for primary amenorrhea: BHCG
FSH, proactin, TSH, T3, free T4 estrogen, progesterone
9. labs for secondary amenorrhea: - Check a quant
²HCG TSH
- Prolactin - if > 200, order a CT of sella
- Progesterone challenge - give progesterone for 10 days. If there is no
bleeding, repeat HCG
- FSH - if > 40 ovarian failure if low or normal HPO abnormality
10. Excessive uterine bleeding and prolonged menses that are NOT caused
by pregnancy or miscarriage, diagnosis of exclusion, look for an
underlying endocrine disorder: dysfunctional uterine bleeding
,Womens Health EOR Questions with Answers All Correctly Verified Updates
11. dysfunctional uterine bleed: Polymenorrhea: menses that occur more
fre- quently (menses < 21 days apart)
Hemorrhagic or hypermenorrhea: menses that involve more blood loss (> 7 days or
> 80 mL) during menses
Menorrhagia: prolonged/heavy bleeding (>7 days or >80 mL); regular intervals
Metrorrhagia: uterine bleeding that occurs frequently and irregularly between
menses
Menometrorrhagia: more blood loss during menses and frequent and irregular
bleeding between menses
Oligomenorrhea: long intervals > 35 days
12. Gold standard diagnosis of AUB: uterine dilation and curettage
13. most common cause of dysfunctional uterine bleed?: fibroids
iron def anemia
14. DUB in patients < 16 years old: - Pregnancy
- Anovulation
- Breakthrough bleeding on OCP's - expect 3 months of breakthrough bleeding
- Blood dyscrasias (ex. VWD)
15. DUB in patients 16-40 years old: - Pregnancy
- Anovulation
- BTP on OCPs
- STIs/PID
- Endometriosis/Adenomyosis
- Endometrial Cancer
16. DUB in patients > 40 years old: - Pregnancy
- Anovulation
- OCPs or hormone replacement therapy
- Endometrial Cancer all patients > 40 need endometrial sampling
17. Refers to uterine pain around the time of menses, which can either
be primary or secondary
Reserved for women whose pain prevents normal activity and requires med-
ication, whether an over-the-counter or a prescription drug
Pain tends to peak 24 h after the onset of menses and subside after 2 to 3
,Womens Health EOR Questions with Answers All Correctly Verified Updates
days: dysmenorrhea
18. primary dysmenorrhea: Painful uterine muscle activity due to an excess
of prostaglandins (F2a)
no associated pelvic pathology
early 20s and teens
RF menarche before 12, nulliparity, smoking, fam hx, obesity
19. secondary dysmenorrhea: Painful menstruation caused by clinically
identifi- able cause
Etiology: Endometriosis, adenomyosis, polyps, fibroids, PID, IUD, tumors, adhe-
sions, cervical stenosis/lesions, psych
Pain with menstruation begins mid-cycle and increases in severity until end
Common women age (20-40 s)
20. retrospective diagnosis based on 12 or more months of amenorrhea
oc- curring at a mean age of 51 years: menopause
FSH > 30
21. the transition between reproductive capability and menopause hallmark
is irregular menstrual function, lasts 3-5 years: perimenopause
22. tx of menopause: Estrogens are used to treat hot flashes
If uterus: HRT (estrogen + progesterone), if no uterus (ERT).
Women with an intact uterus should not use estrogen alone because of the in-
creased risk of endometrial cancer.
Progestins: Hot flashes, increased risk of breast cancer
23. chance of fertilization is highest between what days?: day 11 and 15
24. first part of menstrual cycle?: follicular (proliferative)
phase 0 to day 14
GnRH (from the hypothalamus) stimulates FSH and LH release (from anterior
pituitary).
, follicle grows, secreting estrogen
Once estrogen levels are high enough from follicle secretion, it begins to give
positive feedback on FSH and LH, which then surge
Estrogen secretion is increased even more from the follicle. It induces an LH spike,
which causes ovulation
25. luteal (secretory) phase: days 15-28 of the cycle
After ovulation, the follicle becomes the corpus luteum, which secretes progesterone
and provides negative feedback to FSH and LH
If pregnancy does not occur, the corpus albicans is formed, which no longer secretes
estrogen and progesterone
This decrease in hormones leads to endometrial sloughing or menses
To begin a new follicular phase of the menstrual cycle, GnRH is secreted.
26. PMDD occurs during which part of the menstrual cycle?: luteal phase
and resolve with menstruation premens
27. disorder marked by repeated episodes of significant depression and re-
lated symptoms during the week before menstruation: premenstrual
dysphoric disorder
28. premenstrual syndrome: A group of symptoms that occur in women,
typically between ovulation and period (a week or two before their period)
Caused by an imbalance of estrogen and progesterone along with excess
prostaglandin production
Symptoms during the luteal phase (1-2 weeks before menses) - Bloating,
irritability. PMDD- causes marked disruption in functioning.
29. gonorrhea: purulent discharge
mucopurulent vaginal discharge gram neg intracellular diplococci
Dx: NAAT
Tx: CDC recommends ceftriaxone 500 mg IM as a single dose for persons weighing
<150 kg (300 lb)
1. failure of menses to occur by age 15 years (some sources say 16 years),
in the presence of normal growth and secondary sexual characteristics
(breast development, axillary or pubic hair).
if no period by 13 needs eval
XX normal female: primary amenorrhea
2. Absence of menses for 3 months in a woman with previously normal men-
struation or 6 months in a woman with a history of irregular cycles:
secondary amenorrhea
3. What are the progesterone formulations that are used to manage
endome- trial cancer?: Megestrol acetate and medroxyprogesterone.
4. endometrial biopsy shows endometrial hyperplasia, irregular
menstrual cycle, would like to conceive: Medroxyprogesterone acetate
5. reasons for secondary amenorrhea?: pregnancy most common
- weigth changes, hypothyroid, prolactinoma
always check beta HCG, TSH and prolactin
6. what is a progesterone challenge test?: medroxyprogesterone 5 to 10
mg orally once a day or another progestogen for 7 to 10 days.
If bleeding occurs = anovulatory cycles
7. pt has galactorrhea what test should you order?: serum prolactin
The combination of galactorrhea, amenorrhea, infertility, and decreased libido is
almost certainly the result of a prolactinoma.
8. labs for primary amenorrhea: BHCG
FSH, proactin, TSH, T3, free T4 estrogen, progesterone
9. labs for secondary amenorrhea: - Check a quant
²HCG TSH
- Prolactin - if > 200, order a CT of sella
- Progesterone challenge - give progesterone for 10 days. If there is no
bleeding, repeat HCG
- FSH - if > 40 ovarian failure if low or normal HPO abnormality
10. Excessive uterine bleeding and prolonged menses that are NOT caused
by pregnancy or miscarriage, diagnosis of exclusion, look for an
underlying endocrine disorder: dysfunctional uterine bleeding
,Womens Health EOR Questions with Answers All Correctly Verified Updates
11. dysfunctional uterine bleed: Polymenorrhea: menses that occur more
fre- quently (menses < 21 days apart)
Hemorrhagic or hypermenorrhea: menses that involve more blood loss (> 7 days or
> 80 mL) during menses
Menorrhagia: prolonged/heavy bleeding (>7 days or >80 mL); regular intervals
Metrorrhagia: uterine bleeding that occurs frequently and irregularly between
menses
Menometrorrhagia: more blood loss during menses and frequent and irregular
bleeding between menses
Oligomenorrhea: long intervals > 35 days
12. Gold standard diagnosis of AUB: uterine dilation and curettage
13. most common cause of dysfunctional uterine bleed?: fibroids
iron def anemia
14. DUB in patients < 16 years old: - Pregnancy
- Anovulation
- Breakthrough bleeding on OCP's - expect 3 months of breakthrough bleeding
- Blood dyscrasias (ex. VWD)
15. DUB in patients 16-40 years old: - Pregnancy
- Anovulation
- BTP on OCPs
- STIs/PID
- Endometriosis/Adenomyosis
- Endometrial Cancer
16. DUB in patients > 40 years old: - Pregnancy
- Anovulation
- OCPs or hormone replacement therapy
- Endometrial Cancer all patients > 40 need endometrial sampling
17. Refers to uterine pain around the time of menses, which can either
be primary or secondary
Reserved for women whose pain prevents normal activity and requires med-
ication, whether an over-the-counter or a prescription drug
Pain tends to peak 24 h after the onset of menses and subside after 2 to 3
,Womens Health EOR Questions with Answers All Correctly Verified Updates
days: dysmenorrhea
18. primary dysmenorrhea: Painful uterine muscle activity due to an excess
of prostaglandins (F2a)
no associated pelvic pathology
early 20s and teens
RF menarche before 12, nulliparity, smoking, fam hx, obesity
19. secondary dysmenorrhea: Painful menstruation caused by clinically
identifi- able cause
Etiology: Endometriosis, adenomyosis, polyps, fibroids, PID, IUD, tumors, adhe-
sions, cervical stenosis/lesions, psych
Pain with menstruation begins mid-cycle and increases in severity until end
Common women age (20-40 s)
20. retrospective diagnosis based on 12 or more months of amenorrhea
oc- curring at a mean age of 51 years: menopause
FSH > 30
21. the transition between reproductive capability and menopause hallmark
is irregular menstrual function, lasts 3-5 years: perimenopause
22. tx of menopause: Estrogens are used to treat hot flashes
If uterus: HRT (estrogen + progesterone), if no uterus (ERT).
Women with an intact uterus should not use estrogen alone because of the in-
creased risk of endometrial cancer.
Progestins: Hot flashes, increased risk of breast cancer
23. chance of fertilization is highest between what days?: day 11 and 15
24. first part of menstrual cycle?: follicular (proliferative)
phase 0 to day 14
GnRH (from the hypothalamus) stimulates FSH and LH release (from anterior
pituitary).
, follicle grows, secreting estrogen
Once estrogen levels are high enough from follicle secretion, it begins to give
positive feedback on FSH and LH, which then surge
Estrogen secretion is increased even more from the follicle. It induces an LH spike,
which causes ovulation
25. luteal (secretory) phase: days 15-28 of the cycle
After ovulation, the follicle becomes the corpus luteum, which secretes progesterone
and provides negative feedback to FSH and LH
If pregnancy does not occur, the corpus albicans is formed, which no longer secretes
estrogen and progesterone
This decrease in hormones leads to endometrial sloughing or menses
To begin a new follicular phase of the menstrual cycle, GnRH is secreted.
26. PMDD occurs during which part of the menstrual cycle?: luteal phase
and resolve with menstruation premens
27. disorder marked by repeated episodes of significant depression and re-
lated symptoms during the week before menstruation: premenstrual
dysphoric disorder
28. premenstrual syndrome: A group of symptoms that occur in women,
typically between ovulation and period (a week or two before their period)
Caused by an imbalance of estrogen and progesterone along with excess
prostaglandin production
Symptoms during the luteal phase (1-2 weeks before menses) - Bloating,
irritability. PMDD- causes marked disruption in functioning.
29. gonorrhea: purulent discharge
mucopurulent vaginal discharge gram neg intracellular diplococci
Dx: NAAT
Tx: CDC recommends ceftriaxone 500 mg IM as a single dose for persons weighing
<150 kg (300 lb)
