MCN 538 LATEST 2026 STUDY GUIDE QUESTIONS AND
ANSWERS GRADED A+
✔✔[Topic: Menopause] Unopposed estrogen therapy risk - ✔✔Endometrial cancer
✔✔[Topic: Menopause] Estrogen + progesterone therapy risk - ✔✔Similar risk to
general population; may lower risk of endometrial cancer
✔✔[Topic: Menopause] Hormone therapy and breast cancer risk - ✔✔Higher risk from
endogenous factors like obesity and breast density than hormone therapy
✔✔[Topic: Menopause] Mortality rate with estrogen therapy - ✔✔Some reports show
improved mortality compared to women not taking hormones
✔✔[Topic: Menopause] Oral contraceptives effect on ovarian cancer - ✔✔Decrease risk
✔✔[Topic: Menopause] Hormone therapy effect on colorectal cancer - ✔✔33% less
likely
✔✔[Topic: Menopause] Disease prevention after menopause - ✔✔Opportunity to
screen and prevent cardiovascular disease, obesity, diabetes, cancer, Alzheimer's,
cognitive decline
✔✔[Topic: Menopause] Women with a uterus on estrogen therapy - ✔✔Require
progestogen to protect endometrium
✔✔[Topic: Menopause] Non-hormonal therapies for vasomotor symptoms - ✔✔SSRIs,
gabapentin, clonidine, isoflavones (red clover, black cohosh), CBT, acupuncture,
stellate ganglion block
✔✔[Topic: PCOS] Most common endocrine disorder in reproductive age women -
✔✔Polycystic ovary syndrome (PCOS)
✔✔[Topic: PCOS] Classic features of PCOS - ✔✔Elevated androgens, oligomenorrhea
or amenorrhea
✔✔[Topic: PCOS] Symptoms of PCOS - ✔✔Menstrual irregularity, hyperandrogenism,
polycystic ovaries on ultrasound
✔✔[Topic: PCOS] PCOS without symptoms - ✔✔10%-25% of reproductive age women
may have polycystic ovaries on ultrasound without clinical signs; not a diagnosis of
PCOS
, ✔✔[Topic: PCOS] Teenage PCOS diagnosis - ✔✔Should be reassessed 8 years post-
menarche; oral contraceptives or progestogens for irregular cycles in meantime
✔✔[Topic: PCOS] Menstrual irregularity - ✔✔Oligomenorrhea (cycles >35 days),
frequency every few months
✔✔[Topic: PCOS] Difficulty diagnosing androgen excess - ✔✔Blood testosterone may
be inaccurate
✔✔[Topic: PCOS] LH levels in PCOS - ✔✔Obese women: normal LH; Thin women:
elevated LH
✔✔[Topic: PCOS] LH/FSH ratio - ✔✔Neither specific nor required for diagnosis
✔✔[Topic: PCOS] Mildly elevated prolactin in PCOS - ✔✔20%-30% of women, levels
20-35 ng/mL
✔✔[Topic: PCOS] Insulin resistance in PCOS - ✔✔Primarily in peripheral tissues;
euglycemia common; beta cell dysfunction in severe cases increases type 2 diabetes
risk
✔✔[Topic: PCOS] Acanthosis nigricans - ✔✔Present in ≥50% of hyperandrogenic
obese women with PCOS
✔✔[Topic: PCOS] Malarian inhibiting substance (MIS) - ✔✔Produced by granulosa cells
of preantral follicles; elevated in PCOS; involved in anovulation
✔✔[Topic: PCOS] Genetic/environmental contribution - ✔✔MIS levels in utero may
predispose to PCOS; other genes and environmental factors also contribute
✔✔[Topic: PCOS] Metabolic syndrome risk - ✔✔Increases risk for cardiovascular
disease and diabetes
✔✔[Topic: PCOS] First-line PCOS treatment - ✔✔Diet and exercise for diabetes
prevention; screen for depression/anxiety; weight loss improves quality of life
✔✔[Topic: PCOS] Cardiovascular risk in PCOS - ✔✔No increased mortality unless
classic features with obesity and diabetes present
✔✔[Topic: PCOS] Cancer risk in PCOS - ✔✔Endometrial cancer increased 2-3x;
ovarian cancer ~2.5x; metformin may reduce risk
✔✔[Topic: PCOS] Fertility treatment - ✔✔Letrozole first-line; clomiphene citrate also
used; IVF higher OHSS risk
ANSWERS GRADED A+
✔✔[Topic: Menopause] Unopposed estrogen therapy risk - ✔✔Endometrial cancer
✔✔[Topic: Menopause] Estrogen + progesterone therapy risk - ✔✔Similar risk to
general population; may lower risk of endometrial cancer
✔✔[Topic: Menopause] Hormone therapy and breast cancer risk - ✔✔Higher risk from
endogenous factors like obesity and breast density than hormone therapy
✔✔[Topic: Menopause] Mortality rate with estrogen therapy - ✔✔Some reports show
improved mortality compared to women not taking hormones
✔✔[Topic: Menopause] Oral contraceptives effect on ovarian cancer - ✔✔Decrease risk
✔✔[Topic: Menopause] Hormone therapy effect on colorectal cancer - ✔✔33% less
likely
✔✔[Topic: Menopause] Disease prevention after menopause - ✔✔Opportunity to
screen and prevent cardiovascular disease, obesity, diabetes, cancer, Alzheimer's,
cognitive decline
✔✔[Topic: Menopause] Women with a uterus on estrogen therapy - ✔✔Require
progestogen to protect endometrium
✔✔[Topic: Menopause] Non-hormonal therapies for vasomotor symptoms - ✔✔SSRIs,
gabapentin, clonidine, isoflavones (red clover, black cohosh), CBT, acupuncture,
stellate ganglion block
✔✔[Topic: PCOS] Most common endocrine disorder in reproductive age women -
✔✔Polycystic ovary syndrome (PCOS)
✔✔[Topic: PCOS] Classic features of PCOS - ✔✔Elevated androgens, oligomenorrhea
or amenorrhea
✔✔[Topic: PCOS] Symptoms of PCOS - ✔✔Menstrual irregularity, hyperandrogenism,
polycystic ovaries on ultrasound
✔✔[Topic: PCOS] PCOS without symptoms - ✔✔10%-25% of reproductive age women
may have polycystic ovaries on ultrasound without clinical signs; not a diagnosis of
PCOS
, ✔✔[Topic: PCOS] Teenage PCOS diagnosis - ✔✔Should be reassessed 8 years post-
menarche; oral contraceptives or progestogens for irregular cycles in meantime
✔✔[Topic: PCOS] Menstrual irregularity - ✔✔Oligomenorrhea (cycles >35 days),
frequency every few months
✔✔[Topic: PCOS] Difficulty diagnosing androgen excess - ✔✔Blood testosterone may
be inaccurate
✔✔[Topic: PCOS] LH levels in PCOS - ✔✔Obese women: normal LH; Thin women:
elevated LH
✔✔[Topic: PCOS] LH/FSH ratio - ✔✔Neither specific nor required for diagnosis
✔✔[Topic: PCOS] Mildly elevated prolactin in PCOS - ✔✔20%-30% of women, levels
20-35 ng/mL
✔✔[Topic: PCOS] Insulin resistance in PCOS - ✔✔Primarily in peripheral tissues;
euglycemia common; beta cell dysfunction in severe cases increases type 2 diabetes
risk
✔✔[Topic: PCOS] Acanthosis nigricans - ✔✔Present in ≥50% of hyperandrogenic
obese women with PCOS
✔✔[Topic: PCOS] Malarian inhibiting substance (MIS) - ✔✔Produced by granulosa cells
of preantral follicles; elevated in PCOS; involved in anovulation
✔✔[Topic: PCOS] Genetic/environmental contribution - ✔✔MIS levels in utero may
predispose to PCOS; other genes and environmental factors also contribute
✔✔[Topic: PCOS] Metabolic syndrome risk - ✔✔Increases risk for cardiovascular
disease and diabetes
✔✔[Topic: PCOS] First-line PCOS treatment - ✔✔Diet and exercise for diabetes
prevention; screen for depression/anxiety; weight loss improves quality of life
✔✔[Topic: PCOS] Cardiovascular risk in PCOS - ✔✔No increased mortality unless
classic features with obesity and diabetes present
✔✔[Topic: PCOS] Cancer risk in PCOS - ✔✔Endometrial cancer increased 2-3x;
ovarian cancer ~2.5x; metformin may reduce risk
✔✔[Topic: PCOS] Fertility treatment - ✔✔Letrozole first-line; clomiphene citrate also
used; IVF higher OHSS risk
