WOMEN'S HEALTH NP BOARD EXAM
PREP QUESTIONS WITH VERIFIED
ANSWERS
\.PID S/S - ANSWERS-Minimum criteria: presence of one or more of the following
1) cervical motion tenderness
2) Uterine tenderness
3) Adnexal tenderness
Accompanied by fever (>38.4), mucopurulent discharge, WBC's, elevated ESR,
elevated C-reactive protein
\.Treatment of PID - ANSWERS-Oral: Ceftriaxone 250mg IM then Doxy 100mg /
Flagyl 500mg po bid x 14d
Consider Hospitalization: appendicitis cannot be ruled out, suspect tubo-ovarian
abscess, pregnancy, severe illness such as N/V or an oral temperature of 38.5, no
clinical response after initiation
\.Lichen planus S/S and Physical findings - ANSWERS-Mild to severe pruritic,
vaginal discharge/bleeding, dyspareunia, dysuria. A RAW SENSATION
violaceous, flat-topped papules with lacy white streaks. Symmetric distribution.
Lacy lesions on buccal, vulvar, vaginal mucosa.
Nail dystrophy.
,\.Lichen Simplex Chronicus S/S - ANSWERS-Leukoplakia with thick, leathery vulvar
skin associated with chronic irritation and scratching., hyperplasia of the vulvar
squamous epithelium
\.DES in Utero - ANSWERS-A synthetic non steroidal estrogen approved by the FDA
for use from 1940 to 1971 to prevent miscarriage and PTL; prenatal DES exposure
Increased risk for reproductive abnormalities, infertility, clear cell adenocarcinoma
of the cerivix and vagina
\.Follicular Phase - ANSWERS--GnRH released from hypothalamus to anterior
pituitary
-Anterior pituitary PULSES FSH and LH
-FSH stimulates proliferation of granulosa cells that produce estradiol
-Days 5-7 many follicles recruited
-Increasing estradiol induces more FSH receptors, producing greater amounts of
estradiol
-increasing estradiol and now INHIBIN give negative feedback to FSH secretion
-One of the recruited follicles becomes dominant, producing the most estradiol,
largest number of granulosa cells, and the most FSH receptors
-This entire phase lasts about 10-17 days.
\.Ovulation Phase - ANSWERS--Estradiol exceeds a critical level for 2-3 days
-Positive feedback occurs in the pituitary, causing surge in LH
-Oocyte and follicular fluid exude about 32-44 hours after onset of LH surge and
10-12 hours after LH peak
, \.Luteal Phase - ANSWERS--After rupture of the follicle, granulosa and theca cells
take up steroids and lutein pigment to give the corpus luteum (yellow body a
yellow appearance)
-Hallmark shift from ESTROGEN to PROGESTERONE dominance
Progesterone suppresses follicular growth, cause secretory changes in the
endometrium, and increases basal body temperature by .58
-Peak progesterone occurs 7-8 days after the LH surge, approixmate time of
implantation if fertilization has occurred
-Length is more stable about 14 days
\.Sex hormone binding globulin (SHBG) - ANSWERS-A protein produced in the liver
that binds with the sex hormones testosterone and estrogen. These hormones are
inactive when bound to SHBG, but are available for use when needed.
-Low levels of SHBG are related to increased availability of testosterone and
estrogen in the body. Examples: PCOS, DM, hypothyroid
High levels: pregnancy, anorexia, hyperthyroid
\.Colorectal screening - ANSWERS-Every year between age 50 and 75 for high
sensitivity fecal occult blood testing, or flexible sigmoidoscopy every 5 years, or
colonoscopy every 10 years. Consult with the provider if screen should continue
after age 76
\.MCV (mean corpuscle volume) - ANSWERS-RBC size
microcytic (<80 fL)
macrocytic (>96 fL)
PREP QUESTIONS WITH VERIFIED
ANSWERS
\.PID S/S - ANSWERS-Minimum criteria: presence of one or more of the following
1) cervical motion tenderness
2) Uterine tenderness
3) Adnexal tenderness
Accompanied by fever (>38.4), mucopurulent discharge, WBC's, elevated ESR,
elevated C-reactive protein
\.Treatment of PID - ANSWERS-Oral: Ceftriaxone 250mg IM then Doxy 100mg /
Flagyl 500mg po bid x 14d
Consider Hospitalization: appendicitis cannot be ruled out, suspect tubo-ovarian
abscess, pregnancy, severe illness such as N/V or an oral temperature of 38.5, no
clinical response after initiation
\.Lichen planus S/S and Physical findings - ANSWERS-Mild to severe pruritic,
vaginal discharge/bleeding, dyspareunia, dysuria. A RAW SENSATION
violaceous, flat-topped papules with lacy white streaks. Symmetric distribution.
Lacy lesions on buccal, vulvar, vaginal mucosa.
Nail dystrophy.
,\.Lichen Simplex Chronicus S/S - ANSWERS-Leukoplakia with thick, leathery vulvar
skin associated with chronic irritation and scratching., hyperplasia of the vulvar
squamous epithelium
\.DES in Utero - ANSWERS-A synthetic non steroidal estrogen approved by the FDA
for use from 1940 to 1971 to prevent miscarriage and PTL; prenatal DES exposure
Increased risk for reproductive abnormalities, infertility, clear cell adenocarcinoma
of the cerivix and vagina
\.Follicular Phase - ANSWERS--GnRH released from hypothalamus to anterior
pituitary
-Anterior pituitary PULSES FSH and LH
-FSH stimulates proliferation of granulosa cells that produce estradiol
-Days 5-7 many follicles recruited
-Increasing estradiol induces more FSH receptors, producing greater amounts of
estradiol
-increasing estradiol and now INHIBIN give negative feedback to FSH secretion
-One of the recruited follicles becomes dominant, producing the most estradiol,
largest number of granulosa cells, and the most FSH receptors
-This entire phase lasts about 10-17 days.
\.Ovulation Phase - ANSWERS--Estradiol exceeds a critical level for 2-3 days
-Positive feedback occurs in the pituitary, causing surge in LH
-Oocyte and follicular fluid exude about 32-44 hours after onset of LH surge and
10-12 hours after LH peak
, \.Luteal Phase - ANSWERS--After rupture of the follicle, granulosa and theca cells
take up steroids and lutein pigment to give the corpus luteum (yellow body a
yellow appearance)
-Hallmark shift from ESTROGEN to PROGESTERONE dominance
Progesterone suppresses follicular growth, cause secretory changes in the
endometrium, and increases basal body temperature by .58
-Peak progesterone occurs 7-8 days after the LH surge, approixmate time of
implantation if fertilization has occurred
-Length is more stable about 14 days
\.Sex hormone binding globulin (SHBG) - ANSWERS-A protein produced in the liver
that binds with the sex hormones testosterone and estrogen. These hormones are
inactive when bound to SHBG, but are available for use when needed.
-Low levels of SHBG are related to increased availability of testosterone and
estrogen in the body. Examples: PCOS, DM, hypothyroid
High levels: pregnancy, anorexia, hyperthyroid
\.Colorectal screening - ANSWERS-Every year between age 50 and 75 for high
sensitivity fecal occult blood testing, or flexible sigmoidoscopy every 5 years, or
colonoscopy every 10 years. Consult with the provider if screen should continue
after age 76
\.MCV (mean corpuscle volume) - ANSWERS-RBC size
microcytic (<80 fL)
macrocytic (>96 fL)
