MSCP Test – Questions With Appropriate Solutions
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Q1. Natural menopause is confirmed Answer: B — No period for 12 consecutive months
when a woman has had: A. No period after the final menstrual period. Natural menopause
for 6 consecutive months | B. No is a retrospective clinical diagnosis after 12
period for 12 consecutive months after consecutive months of amenorrhoea following the
the final menstrual period | C. A single FMP. A single FSH is unreliable during the transition.
FSH level above 25 IU/L [Physiology]
Q2. The approximate mean age of Answer: B — 51 years. Mean age of natural
natural menopause is: A. 45 years | B. menopause is about 51 years; early is before 45 and
51 years | C. 57 years late is after 54. [Physiology]
Q3. Under STRAW+10, the late Answer: B — An interval of amenorrhoea of 60 days
menopause transition (stage −1) is best or more. Stage −1 is defined by an amenorrhoea
characterised by: A. Persistent 7-day interval of 60+ days. The 7-day variability defines
or greater variability in cycle length | stage −2 (early transition). [Physiology]
B. An interval of amenorrhoea of 60
days or more | C. Twelve months of
amenorrhoea
,Q4. Which hormone falls earliest and Answer: B — Anti-Mullerian hormone (AMH). AMH,
is the best marker of ovarian reserve? produced by granulosa cells of small antral follicles,
A. Follicle-stimulating hormone (FSH) declines earliest and most reliably reflects ovarian
| B. Anti-Mullerian hormone (AMH) | C. reserve; FSH rises later and is more variable.
Luteinizing hormone (LH) [Physiology]
Q5. A luteal out-of-phase (LOOP) Answer: A — A luteal-phase FSH rise recruiting a new
event during the transition is caused follicle with an out-of-phase oestradiol surge. A
by: A. A luteal-phase FSH rise sharp luteal FSH rise can recruit a new follicle,
recruiting a new follicle with an out- producing an out-of-phase oestradiol surge that
of-phase oestradiol surge | B. Failure underlies erratic, sometimes heavy bleeding.
of the adrenal gland to produce [Physiology]
DHEAS | C. Premature LH suppression
by rising progesterone
Q6. Primary ovarian insufficiency is Answer: B — 40. POI is ovarian insufficiency before
defined as ovarian insufficiency age 40 and affects about 1% of women; early
occurring before age: A. 35 | B. 40 | C. menopause is an FMP before 45. [Physiology]
45
Q7. The most common identifiable Answer: A — Turner syndrome. Turner syndrome
genetic cause of primary ovarian (complete or partial loss of an X chromosome) is the
insufficiency is: A. Turner syndrome | B. most common identifiable genetic cause of POI.
Fragile X full mutation | C. [Physiology]
Galactosaemia
,Q8. A woman with POI is found to Answer: B — Gonadectomy. A Y chromosome
carry a Y chromosome. The substantially raises the risk of gonadoblastoma, so
recommended management is: A. gonadectomy is recommended. [Physiology]
Combined oral contraception | B.
Gonadectomy | C. Annual pelvic
ultrasound only
Q9. For a 30-year-old with surgical Answer: B — The average age of natural menopause
menopause after bilateral (about 51). In POI/surgical menopause, systemic HT is
oophorectomy and no replacement and is generally continued to the
contraindication, hormone therapy average age of natural menopause (~51) unless
should generally be continued at least contraindicated. [Physiology]
until: A. One year after surgery | B. The
average age of natural menopause
(about 51) | C. Age 65 regardless
Q10. When evaluating new secondary Answer: B — Pregnancy test. Pregnancy must always
amenorrhoea in a perimenopausal- be excluded first before attributing amenorrhoea to
aged woman, the FIRST test to obtain the menopause transition or other causes.
is: A. Karyotype | B. Pregnancy test | C. [Physiology]
FRAX score
Q11. A 32-year-old with confirmed POI Answer: B — Screen for adrenal autoantibodies (21-
(46,XX karyotype) has positive anti- hydroxylase) for autoimmune adrenal insufficiency.
thyroid peroxidase antibodies. Which Thyroid autoimmunity plus POI suggests
evaluation best identifies a treatable polyglandular autoimmunity; the must-not-miss
associated condition? A. Repeat FSH treatable association is adrenal insufficiency,
and estradiol monthly for 6 months | B. screened with 21-hydroxylase antibodies. Repeating
Screen for adrenal autoantibodies (21- confirmatory tests changes nothing and ovarian
hydroxylase) for autoimmune adrenal biopsy is not standard. [Physiology]
insufficiency | C. Proceed with
diagnostic ovarian biopsy
Q12. Autoimmune POI most Answer: A — Thyroid and adrenal. Autoimmune
characteristically clusters with polyglandular syndromes link ovary, thyroid, adrenal,
autoimmunity of which other glands? and pancreatic islets; thyroid and adrenal
A. Thyroid and adrenal | B. Parathyroid autoimmunity are the classic associations with
and pituitary only | C. Salivary and autoimmune POI. [Physiology]
lacrimal glands
, Q13. Approximately what proportion Answer: A — About 4%. Around 4% of POI is
of primary ovarian insufficiency is due autoimmune oophoritis, associated with adrenal
to autoimmune oophoritis? A. About autoimmunity; most POI is idiopathic or genetic.
4% | B. About 40% | C. The majority of [Physiology]
cases
Q14. Perimenopause is best defined as Answer: A — Begins with cycle irregularity and
the period that: A. Begins with cycle extends to 12 months after the final menstrual period.
irregularity and extends to 12 months Perimenopause runs from the onset of cycle
after the final menstrual period | B. irregularity (or other symptoms) until 12 months after
Begins exactly at the final menstrual the FMP — one year longer than the menopause
period | C. Starts 10 years before the transition. [Physiology]
final menstrual period
Q15. Early menopause is defined as a Answer: A — 45. Early menopause is an FMP before
final menstrual period before age: A. 45; late menopause is after 54. POI is loss of ovarian
45 | B. 50 | C. 55 function before 40. [Physiology]
Q16. Which statement about adrenal Answer: A — DHEAS declines gradually with age
androgen (DHEAS) changes is rather than abruptly at menopause. Adrenal DHEAS
correct? A. DHEAS declines gradually declines gradually with age and is not the abrupt
with age rather than abruptly at change seen with ovarian oestradiol at menopause.
menopause | B. DHEAS rises sharply [Physiology]
at menopause | C. DHEAS is
unaffected by ageing
Q17. Induced menopause is most Answer: A — Bilateral oophorectomy. Bilateral
commonly caused by: A. Bilateral oophorectomy is the commonest cause of induced
oophorectomy | B. Hysterectomy with menopause; hysterectomy with ovarian preservation
ovarian preservation | C. Endometrial does not by itself cause menopause. [Physiology]
ablation
Save Groups
Play your way to mastery with fun games
Blast
Terms in this set (169)
Q1. Natural menopause is confirmed Answer: B — No period for 12 consecutive months
when a woman has had: A. No period after the final menstrual period. Natural menopause
for 6 consecutive months | B. No is a retrospective clinical diagnosis after 12
period for 12 consecutive months after consecutive months of amenorrhoea following the
the final menstrual period | C. A single FMP. A single FSH is unreliable during the transition.
FSH level above 25 IU/L [Physiology]
Q2. The approximate mean age of Answer: B — 51 years. Mean age of natural
natural menopause is: A. 45 years | B. menopause is about 51 years; early is before 45 and
51 years | C. 57 years late is after 54. [Physiology]
Q3. Under STRAW+10, the late Answer: B — An interval of amenorrhoea of 60 days
menopause transition (stage −1) is best or more. Stage −1 is defined by an amenorrhoea
characterised by: A. Persistent 7-day interval of 60+ days. The 7-day variability defines
or greater variability in cycle length | stage −2 (early transition). [Physiology]
B. An interval of amenorrhoea of 60
days or more | C. Twelve months of
amenorrhoea
,Q4. Which hormone falls earliest and Answer: B — Anti-Mullerian hormone (AMH). AMH,
is the best marker of ovarian reserve? produced by granulosa cells of small antral follicles,
A. Follicle-stimulating hormone (FSH) declines earliest and most reliably reflects ovarian
| B. Anti-Mullerian hormone (AMH) | C. reserve; FSH rises later and is more variable.
Luteinizing hormone (LH) [Physiology]
Q5. A luteal out-of-phase (LOOP) Answer: A — A luteal-phase FSH rise recruiting a new
event during the transition is caused follicle with an out-of-phase oestradiol surge. A
by: A. A luteal-phase FSH rise sharp luteal FSH rise can recruit a new follicle,
recruiting a new follicle with an out- producing an out-of-phase oestradiol surge that
of-phase oestradiol surge | B. Failure underlies erratic, sometimes heavy bleeding.
of the adrenal gland to produce [Physiology]
DHEAS | C. Premature LH suppression
by rising progesterone
Q6. Primary ovarian insufficiency is Answer: B — 40. POI is ovarian insufficiency before
defined as ovarian insufficiency age 40 and affects about 1% of women; early
occurring before age: A. 35 | B. 40 | C. menopause is an FMP before 45. [Physiology]
45
Q7. The most common identifiable Answer: A — Turner syndrome. Turner syndrome
genetic cause of primary ovarian (complete or partial loss of an X chromosome) is the
insufficiency is: A. Turner syndrome | B. most common identifiable genetic cause of POI.
Fragile X full mutation | C. [Physiology]
Galactosaemia
,Q8. A woman with POI is found to Answer: B — Gonadectomy. A Y chromosome
carry a Y chromosome. The substantially raises the risk of gonadoblastoma, so
recommended management is: A. gonadectomy is recommended. [Physiology]
Combined oral contraception | B.
Gonadectomy | C. Annual pelvic
ultrasound only
Q9. For a 30-year-old with surgical Answer: B — The average age of natural menopause
menopause after bilateral (about 51). In POI/surgical menopause, systemic HT is
oophorectomy and no replacement and is generally continued to the
contraindication, hormone therapy average age of natural menopause (~51) unless
should generally be continued at least contraindicated. [Physiology]
until: A. One year after surgery | B. The
average age of natural menopause
(about 51) | C. Age 65 regardless
Q10. When evaluating new secondary Answer: B — Pregnancy test. Pregnancy must always
amenorrhoea in a perimenopausal- be excluded first before attributing amenorrhoea to
aged woman, the FIRST test to obtain the menopause transition or other causes.
is: A. Karyotype | B. Pregnancy test | C. [Physiology]
FRAX score
Q11. A 32-year-old with confirmed POI Answer: B — Screen for adrenal autoantibodies (21-
(46,XX karyotype) has positive anti- hydroxylase) for autoimmune adrenal insufficiency.
thyroid peroxidase antibodies. Which Thyroid autoimmunity plus POI suggests
evaluation best identifies a treatable polyglandular autoimmunity; the must-not-miss
associated condition? A. Repeat FSH treatable association is adrenal insufficiency,
and estradiol monthly for 6 months | B. screened with 21-hydroxylase antibodies. Repeating
Screen for adrenal autoantibodies (21- confirmatory tests changes nothing and ovarian
hydroxylase) for autoimmune adrenal biopsy is not standard. [Physiology]
insufficiency | C. Proceed with
diagnostic ovarian biopsy
Q12. Autoimmune POI most Answer: A — Thyroid and adrenal. Autoimmune
characteristically clusters with polyglandular syndromes link ovary, thyroid, adrenal,
autoimmunity of which other glands? and pancreatic islets; thyroid and adrenal
A. Thyroid and adrenal | B. Parathyroid autoimmunity are the classic associations with
and pituitary only | C. Salivary and autoimmune POI. [Physiology]
lacrimal glands
, Q13. Approximately what proportion Answer: A — About 4%. Around 4% of POI is
of primary ovarian insufficiency is due autoimmune oophoritis, associated with adrenal
to autoimmune oophoritis? A. About autoimmunity; most POI is idiopathic or genetic.
4% | B. About 40% | C. The majority of [Physiology]
cases
Q14. Perimenopause is best defined as Answer: A — Begins with cycle irregularity and
the period that: A. Begins with cycle extends to 12 months after the final menstrual period.
irregularity and extends to 12 months Perimenopause runs from the onset of cycle
after the final menstrual period | B. irregularity (or other symptoms) until 12 months after
Begins exactly at the final menstrual the FMP — one year longer than the menopause
period | C. Starts 10 years before the transition. [Physiology]
final menstrual period
Q15. Early menopause is defined as a Answer: A — 45. Early menopause is an FMP before
final menstrual period before age: A. 45; late menopause is after 54. POI is loss of ovarian
45 | B. 50 | C. 55 function before 40. [Physiology]
Q16. Which statement about adrenal Answer: A — DHEAS declines gradually with age
androgen (DHEAS) changes is rather than abruptly at menopause. Adrenal DHEAS
correct? A. DHEAS declines gradually declines gradually with age and is not the abrupt
with age rather than abruptly at change seen with ovarian oestradiol at menopause.
menopause | B. DHEAS rises sharply [Physiology]
at menopause | C. DHEAS is
unaffected by ageing
Q17. Induced menopause is most Answer: A — Bilateral oophorectomy. Bilateral
commonly caused by: A. Bilateral oophorectomy is the commonest cause of induced
oophorectomy | B. Hysterectomy with menopause; hysterectomy with ovarian preservation
ovarian preservation | C. Endometrial does not by itself cause menopause. [Physiology]
ablation
