Notes in 01b Menstruation and Menopause

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Published	03/04/2024	What is the most common cause of abnormal uterine bleeding (AUB)?{{c1::Anovulatory cycles}}
Published	03/04/2024	The female gonads consist of three cell types: {{c1::germ}} cells, {{c1::granulosa}} cells, and {{c1::theca}} cells
Published	03/04/2024	The germ cells of the female gonads produce {{c1::oogonia}}
Published	03/04/2024	The onset of menstrual cycles in females is referred to as {{c1::menarche}}
Published	03/04/2024	Pulsatile secretion of GnRH stimulates the anterior pituitary to secrete {{c1::FSH}} and {{c1::LH}}
Published	03/04/2024	The function of the ovaries are {{c1::oogenesis}} and secretion of the female sex steroid hormones {{c2::progesterone}} and {{c2::estrogen}}
Published	03/04/2024	The outer, and largest, layer of the ovary is the {{c1::cortex}}, which contains all the oocytes enclosed in a follicle
Published	03/04/2024	The middle layer of the ovary is the {{c1::medulla}}, which contains a mixture of cell types
Published	03/04/2024	The inner layer of the ovary is the {{c1::hilum}}, through which blood vessels and lymphatics pass
Published	03/04/2024	The functional unit of the ovaries is the single {{c1::ovarian follicle}}, which comprises one germ cell surrounded by endocrine cells
Published	03/04/2024	In the developing ovaries, primordial germ cells produce {{c1::oogonia}} by {{c2::mitotic}} divisions until gestational weeks {{c3::20}} to {{c3::24}}…
Published	03/04/2024	{{c1::DNA replication (interphase)}} of oogonia generates the {{c2::primary oocytes}} (arrested in prophase 1)
Published	03/04/2024	Which phase of the cell cycle are primary oocytes arrested in until ovulation?{{c1::Prophase I (of meiosis I)}}
Published	03/04/2024	Beginning at ovulation, primary oocytes begin to complete {{c1::meiosis I}} (diploid) to form {{c2::secondary oocytes}} (haploid)
Published	03/04/2024	Which phase of the cell cycle are secondary oocytes arrested in until fertilization?{{c1::Metaphase II (of meiosis II)}}
Published	03/04/2024	After fertilization, the secondary oocyte completes {{c1::meiosis II}} to form a(n) {{c2::ovum}}
Published	03/04/2024	Primary oocytes are arrested in prophase I of meiosis I for years until {{c1::ovulation}}
Published	03/04/2024	Secondary oocytes are arrested in metaphase II of meiosis II until {{c1::fertilization}}
Published	03/04/2024	The first stage (long) of ovarian follicle development involves development of a(n) {{c1::primary}} follicle from a primordial follicle
Published	03/04/2024	The second stage (short) of ovarian follicle development involves the development of a(n) {{c1::graafian}} follicle from a primary/secondary foll…
Published	03/04/2024	In the third stage (rapid) of ovarian follicle development, a single graafian follicle achieves dominance and ruptures, releasing its oocyte into the …
Published	03/04/2024	If fertilization occurs, the residual elements of the ruptured ovarian follicle form the {{c1::corpus luteum}}, which synthesizes and secretes steroid…
Published	03/04/2024	If fertilization does not occur, the residual elements of the ruptured ovarian follicle is replaced by a scar called the {{c1::corpus albicans}}
Published	03/04/2024	Hypothalamic control of oogenesis and progesterone/estradiol secretion are regulated via the hormone {{c1::GnRH}}
Published	03/04/2024	Ovarian granulosa cells may produce {{c1::inhibin}}, which inhibits FSH secretion from the anterior pituitary
Published	03/04/2024	Which female sex steroid is responsible for growth of the ovarian follicle and endometrial proliferation?{{c1::Estrogen}}
Published	03/04/2024	What is the effect of estrogen on LH, estrogen, and progesterone receptors? {{c1::Up-regulation::up- or down-regulation}}
Published	03/04/2024	Which female sex steroid is responsible for stimulation of endometrial glandular secretions?{{c1::Progesterone}}
Published	03/04/2024	Elevated levels of {{c1::progesterone}} in a non-pregnant patient is an indication that {{c2::ovulation}} has occurred
Published	03/04/2024	Variation in menstrual cycle length is attributed to the variability in duration of the {{c1::follicular}} phase
Published	03/04/2024	By convention, day 0 of the menstrual cycle marks the {{c1::onset of menses}}
Published	03/04/2024	The first phase of the menstrual cycle is the {{c1::follicular (proliferative)}} phase, which lasts from days 0 to 14
Published	03/04/2024	During the follicular phase a graafian follicle develops into a(n) {{c1::dominant}} follicle with atresia of neighboring follicles
Published	03/04/2024	In the middle of the menstrual cycle {{c1::ovulation}} occurs, which occurs {{c2::14}} days prior to menses
Published	03/04/2024	Ovulation follows the {{c1::LH surge}}, which occurs due to a burst of {{c2::estradiol}}
Published	03/04/2024	At ovulation, cervical mucus {{c1::increases}} in quantity and becomes more {{c1::watery}} and penetrable by sperm
Published	03/04/2024	Ovarian follicular growth is fastest during the {{c1::2nd}} week of the follicular phase
Published	03/04/2024	The second phase of the menstrual cycle is the {{c1::luteal}} phase, which lasts from days 14 to 28, ending with the {{c2::onset of menses}}
Published	03/04/2024	During the luteal phase of the menstrual cycle, the {{c1::corpus luteum}} begins to develop
Published	03/04/2024	The corpus luteum synthesizes {{c1::estradiol}} and {{c1::progesterone}}
Published	03/04/2024	During the luteal phase of the menstrual cycle, basal body temperature {{c1::increases}} due to the effect of progesterone on the hypothalamic tempera…
Published	03/04/2024	During the luteal phase of menstruation, cervical mucus becomes more {{c1::thick (less watery)}} and less penetrable by sperm
Published	03/04/2024	If fertilization does not occur, the corpus luteum regresses and estradiol and progesterone levels {{c1::decrease}} abruptly
Published	03/04/2024	Abnormal uterine bleeding is characterized as either {{c1::heavy menstrual}} bleeding (AUB/{{c1::HMB}}) or {{c2::intermenstrual}} bleeding (AUB/{{c2::…
Published	03/04/2024	Abnormal uterine bleeding is further subcategorized by PALM-COEIN; with Structural causes including:- P{{c1::olyp}}- A{{c2::denomyosis}}- L{{c3::eiomy…
Published	03/04/2024	Abnormal uterine bleeding is further subcategorized by PALM-COEIN; with Non-structural causes including:- C{{c1::oagulopathy}}- O{{c2::vulatory dysfun…
Published	03/04/2024	Very elevated levels of {{c1::FSH}} is specific for menopause
Published	03/04/2024	Menopause is associated with {{c1::increased}} levels of FSH, LH, and GnRH with {{c1::decreased}} levels of estrogen
Published	03/04/2024	Menopause before age 40 suggests {{c1::primary ovarian}} insufficiency
Published	03/04/2024	The symptoms/complications of menopause may be remembered with the mnemonic "HAVOCS": H: {{c1::Hot flashes}}, {{c1::Hirsutism}}AV: {{c2::Atrophy of th…
Published	03/04/2024	The source of {{c1::estrogen}} after menopause becomes peripheral conversion of androgens
Published	03/04/2024	Menopause is due to decreased {{c1::estrogen}} production due to age-linked decline in the number of ovarian follicles
Published	03/04/2024	{{c1::Estrogen/progesterone}} replacement therapy may be used to minimize the symptoms of menopause
Published	03/04/2024	Growth of endometrium is {{c1::estrogen}} driven (proliferative phase)
Published	03/04/2024	Preparation of endometrium for implantation is {{c1::progesterone}} driven (secretory phase)
Published	03/04/2024	Shedding of the endometrium occurs with loss of {{c1::progesterone}} support (menstrual phase)
Published	03/04/2024	{{c1::Endometrial polyp}} is a well-circumscribed, hyperplastic protrusion of endometrial tissue
Published	03/04/2024	Endometrial polyps may be asymptomatic or may present with painless abnormal {{c1::uterine bleeding}}
Published	03/04/2024	{{c1::Leiomyoma (uterine fibroid)}} is a benign neoplastic proliferation of smooth muscle arising from myometrium
Published	03/04/2024	What is the most common symptom of leiomyoma (fibroids)?{{c1::Nothing (asymptomatic)>Heavy menstrual bleeding (when symptomatic)}}
Published	03/04/2024	An ovarian follicle consists of an oocyte surrounded by {{c1::granulosa}} and {{c1::theca}} cells
Published	03/04/2024	After menopause, breast tissue undergoes {{c1::atrophy}}
Published	03/04/2024	Premature {{c1::ovarian}} failure presents with symptoms of menopause after puberty but before age 40
Published	03/04/2024	Secondary amenorrhea is defined as the absence of menses for > 3 cycles or > {{c1::6}} months in women who menstruated previously
Published	03/04/2024	What is the most effective treatment for menopausal hot flashes?{{c1::Hormone replacement therapy}}
Published	03/04/2024	Adenomyosis grossly presents with a uniformly enlarged, soft, {{c1::globular}} uterus
Published	03/04/2024	How does hormone replacement therapy change cardiovascular disease risk in postmenopausal women?{{c1::Increase::Increase/Decrease}}
Published	03/04/2024	Anovulatory cycles leads to irregular or heavy bleeding -- why? {{c1::↑ Estrogen proliferation of endometrium until exceed blood supply}}
Published	03/04/2024	What is the most effective treatment for menopausal hot flashes, night sweats, and vaginal dryness?{{c1::Hormone replacement therapy}}
Published	03/04/2024	{{c1::Estrogen::Hormone}} = endometrium proliferation phase{{c1::Progesterone::Hormone}} = endometrium secretory phase
Published	03/04/2024	How do you treat menopausal hot flashes?{{c1::Venlafaxine}}
Published	03/04/2024	What is the term for menopause that occurs before age 40?{{c1::Primary ovarian insufficiency}}
Published	03/04/2024	Hormone replacement therapy is only indicated for the treatment of {{c1::vasomotor symptoms}} in women age < 60 who have undergone menopause within…
Published	03/04/2024	Hormone replacement therapy in women with an intact uterus is {{c1::estrogen and progestin}}
Published	03/04/2024	Hormone replacement therapy in women without an intact uterus is {{c1::estrogen}}
Published	03/04/2024	In the follicular phase, what hormone stimulates development of multiple follicles?{{c1::FSH}}
Published	03/04/2024	What hormone is responsible for developing a single dominant follicle?{{c1::LH}}
Published	03/04/2024	Primary amenorrhea is defined by absence of menarche by age {{c1::15}}
Published	03/04/2024	In menopause, pulsations in sex steroids {{c1::increase}} in amplitude and {{c1::increase}} in frequency
Published	03/04/2024	At puberty, release of {{c1::FSH::hormone}} from the anterior pituitary stimulates a group of primordial follicles to start growing
Published	03/04/2024	At birth, the ovarian follicles are in the {{c1::primordial}} stage
Published	03/04/2024	If a woman has a 40-day uterine cycle instead of the standard 28-day one, her {{c1::proliferative}} phase will be longer and the rest will stay t…
Published	03/04/2024	The uterine cycle has 4 phases:{{c1::Menstrual}}: day 1-5{{c1::Proliferative}}: day 6-14{{c1::Secretory}}: day 15-27{{c1::Premenstrual/Ischemic}}: day…
Published	03/04/2024	The {{c1::proliferative}} phase of the uterine cycle corresponds to the {{c2::follicular}} phase of the ovarian cycle
Published	03/04/2024	The {{c1::secretory}} phase of the uterine cycle corresponds to the {{c2::luteal}} phase of the ovarian cycle
Published	03/04/2024	After menopause, FSH levels are {{c1::high}}, LH levels are {{c1::high}}, and estrogen levels are {{c1::low}}
Published	03/04/2024	Average age of menopause in the US is {{c1::51}}
Published	03/04/2024	{{c1::Oligomenorrhea}} is a decrease in the frequency of menstruation
Published	03/04/2024	{{c1::Polymenorrhea}} is when menstrual periods occur at < 21-day intervals
Published	03/04/2024	{{c1::Menorrhagia}} is when menstrual cycle is too heavy, {{c1::metrorrhagia}} is when menstrual cycle is too frequent
Published	03/04/2024	Abnormal uterine bleeding due to PCOS would be classified as AUB-{{c1::O (Ovulatory dysfunction)}}
Published	03/04/2024	At a hormonal level, the primary problem in menopause is deficiency of {{c1::estrogen}}
Published	03/04/2024	Hot flashes in menopausal women usually occur during the {{c1::night::day/night}}
Published	03/04/2024	The most common symptom of menopause is {{c1::hot flashes}}
Published	03/04/2024	In addition to HRT, hot flashes can also be treated with {{c1::paroxetine::only FDA-approved}}, {{c2::clonidine::off-label}}, and {{c3:…
Published	03/04/2024	Bioidentical hormones are fine for patient to take as long as they are {{c1::FDA-approved}}, and not {{c1::compounded}}
Published	03/04/2024	The luteal phase of the menstrual cycle is dominated by the hormone {{c1::progesterone}}, causing increased {{c2::secretory}} activity and {{c2::vascu…
Published	03/04/2024	The follicular phase of the menstrual cycle is dominated by the hormone {{c1::17β-estradiol (estrogen)}}, causing endometrial {{c2::proliferation}}
Published	03/04/2024	The ovarian cycle has 3 phases:{{c1::Follicular}}: day 1-13{{c1::Ovulation}}: day 14{{c1::Luteal}}: day 15-28
Published	03/04/2024	Female reproductive hormone pulsations increase in amplitude during the {{c1::luteal}} phase of the ovarian cycle
Published	03/04/2024	Female reproductive hormone pulsations increase in frequency during the {{c1::follicular}} phase of the ovarian cycle
Published	03/04/2024	During the follicular phase of the menstrual cycle, estradiol {{c1::inhibits}} FSH and LH secretion
Published	03/04/2024	During the follicular phase of the menstrual cycle, progesterone levels are {{c1::low}}
Published	03/04/2024	In the middle of the menstrual cycle, estradiol {{c1::stimulates}} FSH and LH secretion
Published	03/04/2024	Estradiol levels {{c1::decrease}} just after ovulation, but {{c1::increase}} again during the luteal phase
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