Chapter 25 - Alterations of the Female Reproductive System EVOLVE

Which is the correct term for a prolapse of a portion of the bladder into the vaginal canal? A. Cystocele B. Uterine prolapse C. Rectocele D. Urethrocele

A. Cystocele Cystocele is descent of a portion of the posterior bladder wall and trigone into the vaginal canal and is usually caused by the trauma of childbirth. Uterine prolapse is the descent of the cervix or entire uterus into the vaginal canal. Urethrocele is a sagging urethra. A rectocele is the bulging of the rectum and posterior vaginal wall into the vaginal canal.

Which conditions represent nonproliferative changes in breast tissue? (Select all that apply.) A. Fibrocystic changes (FCCs) B. Cysts C. Florid hyperplasia D. Mammary dysplasia E. Interductal papillomas

A. Fibrocystic changes (FCCs) B. Cysts D. Mammary dysplasia Nonproliferative breast lesions are generally not associated with an increased risk in breast cancer. FCCs or physiologic nodularity and cysts, fibrocystic disease, chronic cystic mastitis, and mammary dysplasia are nonproliferative lesions. Florid hyperplasia and intraductal papillomas (solitary papillomas that grow from the wall of a cyst into the lumen of the duct) are considered proliferative breast lesions.

Regarding infertility, which statements are true? (Select all that apply.) A. Infertility affects 15% of couples trying to conceive. B. Infertility rates are declining. C. The man is the sole cause of the infertility in 50% of cases. D. Age is a major factor in female fertility. E. Ovulatory factors account for 40% of female infertility.

A. Infertility affects 15% of couples trying to conceive D. Age is a major factor in female fertility E. Ovulatory factors account for 40% of female infertility Infertility affects approximately 15% of all couples and is defined as the inability to conceive after 1 year of unprotected intercourse with the same, opposite-sex partner. Age is a major factor in female fertility, as the regularity of ovulation and the quality of ova decrease with age. Ovulatory factors account for 40% of female infertility. The rate of infertility may be increasing because of an increase in sexually transmitted diseases. The man is the sole cause of the infertility in 40% of cases.

1. Which clinical diagnosis is consistent with symptoms of painful menstruation in the absence of pelvic disease? A. Primary dysmenorrhea B. Primary amenorrhea C. Secondary dysmenorrhea D. Secondary amenorrhea

A. Primary dysmenorrhea Dysmenorrhea is painful menstruation; primary dysmenorrhea is due to the release of prostaglandins in ovulatory cycles. Secondary dysmenorrhea is related to pelvic pathologic conditions (e.g., ovarian cysts, endometriosis), which are expressed in later reproductive years and may occur any time in the menstrual cycle. Primary amenorrhea is failure of menarche by 14 years of age. Secondary amenorrhea is the absence of menarche for the equivalent of three cycles.

Which factors are believed to increase the risk for developing cervical cancer? (Select all that apply.) A. Smoking B. Chlamydia trachomatis infection C. Breast cancer D. Human immunodeficiency viral (HIV) infection Correct E. Human papillomavirus (HPV) infection

A. Smoking B. Chlamydia trachoma's infection D. Human immunodeficiency viral (HIV) infection E. Human papilloma virus (HPV) infection Cervical cancer is now established as almost exclusively caused by the cervical HPV infection. Smoking, immunosuppression (HIV infection), and poor nutrition are cofactors. In addition, infection with Chlamydia trachomatis has been correlated with the risk for developing cervical cancer.

Which female is at greatest risk for developing a benign ovarian cyst? A. A 26-year-old with regular menstrual cycle B. A 48-year-old diagnosed as premenopausal C. A 13-year-old experiencing delayed puberty D. A 70-year-old diagnosed with a cystocele

B. A 48-year-old diagnosed as premenopausal Benign cysts of the ovary may occur at any time during the life span, but an increase in benign ovarian cysts occurs when hormonal imbalances are more common, around puberty and menopause.

Which clinical diagnosis is associated with hirsutism, amenorrhea, and infertility? A. Premenstrual syndrome (PMS) B. Polycystic ovary syndrome (PCOS) C. Pelvic inflammatory disease (PID) D. Primary amenorrhea

B. Polycystic ovary syndrome (PCOS) Clinical manifestations of PCOS usually appear within 2 years of puberty and include dysfunctional bleeding or amenorrhea, hirsutism, acne, and infertility. PMS is the cyclic recurrence of distressing physical, psychologic, or behavioral changes that impair interpersonal relationships or interfere with usual activities. The clinical manifestations of PID vary from sudden, severe abdominal pain with fever to no symptoms at all. Primary amenorrhea is the continued absence of menarche and menstrual function by 14 years of age without the development of secondary sex characteristics or by 16 years of age if these changes have occurred.

Regarding breast cancer, which statements are true? (Select all that apply.) A. The older the woman at her first childbirth, the lower her risk. B. Breast cancer is the second most common cause of cancer in women. C. The incidence of breast cancer has declined since 1955. D. More than two thirds of those with breast cancer occur in women older than 55 years of age. E. The incidence for all races combined is approximately 125 per 100,000 women annually.

D. More than two thirds of those with breast cancer occur in women older than 55 years of age. E. The incidence for all races combined is approximately 125 per 100,000 women annually. More than two thirds of those with breast cancer occur in women older than 55 years of age. The incidence for all races combined is approximately 125 per 100,000 women annually. Breast cancer rates have been on the rise since the 1970s and is the most common cause of cancer in American women. Early childbirth lowers the risk of having breast cancer.

Which condition must be ruled out when identifying the cause of secondary amenorrhea? A. Abnormal thyroid function B. Irregular prolactin production C. Pituitary gland dysfunction D. Unknown pregnancy

D. Unknown pregnancy The most common cause of amenorrhea is pregnancy and should be ruled out as the cause of amenorrhea before any other evaluation or treatment is considered.

A patient presents with an inflammation of one of the ducts that lead from the introitus. What is the appropriate term for this condition? A. Vaginitis B. Cervicitis C. Bartholinitis D. Vulvovestibulitis

C. Bartholinitis Bartholin glands are the ducts that lead from the vaginal opening. Vaginitis is the inflammation of the vagina itself. Inflammation of the cervix is generally termed cervicitis, while pathology in the vulval area is called vulvovestibulitis.

Regarding uterine fibroids (leiomyomas), which statements are true? (Select all that apply.) A. Fibroids are more common in white women. B. Fibroids are most prevalent before the age 20 years. C. Fibroid incidence decreases with menopause. D. Fibroids develop from cartilage. E. Fibroid complications can require hospitalization.

C. Fibroid incidence decreases with menopause E. Fibroid complications can require hospitalization Leiomyomas, commonly called myomas or uterine fibroids, are benign smooth muscle tumors in the myometrium. They are the most common benign tumors of the uterus, affecting as many as 70% to 80% of all women; prevalence increases in women 30-50 years of age but decreases with menopause. Leiomyomas are more common in black and Asian women, and complications related to leiomyomas are the number one reason for gynecologic hospitalizations.

Which is the most important difference between proliferative and nonproliferative breast tissue changes? A. Genetic aberrations are more common in nonproliferative lesions. B. Cancer prognosis is better for nonproliferative breast tissue changes. C. Nonproliferative breast lesions do not increase the risk of breast cancer. D. Cancer resulting from nonproliferative breast lesions has a higher cure rate.

C. Nonproliferative breast lesions do not increase the risk of breast cancer. Nonproliferative breast lesions do not increase the risk of breast cancer. The remaining statements are not true of this type of breast tissue change.