Reproductive Endocrinology 2023

Question 1 of 83

A 22-year-old woman patient presents with excess fat accumulation on the back, purple striae, and increased facial hair. Which of the following labs is needed to confirm the suspected diagnosis?

Urine cortisol levels
RBC cortisol levels
Serum cortisol
Dip stick testing
24-hour urinary cortisol

Question 2 of 83

A 25-year-old woman is diagnosed with PCOS and has abnormal uterine bleeding. She refuses to undergo treatment. What is the patient at risk for in the future?

Serous cystadenomas of the ovary
Premature menopause
Endometrial cancer
Atrophic endometrium
Endometriosis

Question 3 of 83

Which of the following patients are not suitable candidates for a transdermal patch?

Patient who is 150 pounds (68 kg).
Patient who is 100 pounds (45.3 kg).
Patient who is 120 pounds (54.4 kg).
Patient who is 80 pounds (36.2 kg).
Patients who is 220 pounds (99.7 kg).

Question 4 of 83

Which of the following is NOT a complication of ovarian hyperstimulatory syndrome?

Pleural effusion
Spontaneous bleeding
DVT
Ascites
Pulmonary embolism

Question 5 of 83

Which of the following is contraindicated in the treatment of thyroid storm?

Propranolol
Lugol's iodine
Propylthiouracil
Lithium carbonate
Levothyroxine

Question 6 of 83

What is considered hirsutism, according to Freeman Galloway method of assessment?

1
6
2
8 and above
4

Question 7 of 83

A 35-year-old woman is diagnosed with PCOS and has abnormal uterine bleeding. She refuses to undergo treatment. At the age of 50, she develops endometrial cancer. What is the most likely cause of this?

Unopposed estrogen
Unopposed progesterone
Unopposed cortisoll
Unopposed estrogen and progesterone
Unopposed thyroid hormones

Question 8 of 83

What is the active principle in progestin implants?

100 micrograms norgestrel
52 mg levonorgestrel
68 mg of etonogestrel
13.5 micrograms levonorgestrel

Question 9 of 83

Which stage of the embryo is required to perform a preimplantation diagnosis?

Blastocyst
Morula
4-cell stage
8-cell stage
2-cell stage

Question 10 of 83

Which of the following criteria is associated with polycystic ovarian syndrome?

Rotterdam criteria
Jones criteria
Light criteria
Duke criteria
Amsterdam criteria

Question 11 of 83

Which of the following is the most common cause of hirsutism?

HAIR-AN syndrome
PCOS
Theca lutein cysts
Pregnancy luteoma
Hyper prolactinemia

Question 12 of 83

Which of the following is a good method to stop acute menstrual bleeding?

Combined oral contraceptive pills
Progesterone only pills
Hysterectomy
Uterine artery embolus
25 mg of conjugated equine IV estrogen

Question 13 of 83

Which of the following is an example of an injectable type of contraception that can be taken once a month?

Ullipristal acetate
Depo medroxyprogesterone acetate
Plan B one step
Yuzpe regimen
Plan B / next choice

Question 14 of 83

Which of the following cases is NOT useful for preimplantation genetic diagnosis?

Juvenile diabetes
Cystic fibrosis
Tay–Sachs disease.
Sickle cell anemia
Osteogenesis imperfecta

Question 15 of 83

Which of the following would you expect to find on pelvic ultrasound in a patient with PCOS?

Heart shaped uterus
Streak ovary
Snow storm appearance
Pearls on a string appearance
Bull's eye appearance

Question 16 of 83

A 25-year-old obese woman comes with jaundice and lab studies show elevated liver enzymes. She has a history of PCOS undergoing treatment. Which of the following drugs for the treatment of PCOS would have caused this presentation?

Flutamide
Finasteride
Spironolactone
Cyproterone acetate
Eflorithine hydrocholride

Question 17 of 83

Which of the following is the most common cause of coagulopathy in teenagers with abnormal uterine bleeding?

Hemophilia A
Hemophilia B
Drug induced
Platelet dysfunction
Iatrogenic

Question 18 of 83

Which of the following risk is increased due to sterilization of the woman using operative procedure?

Ectopic pregnancy
Fallopian tube Cancer
Rupture of fallopian tubes
Ovarian cysts
Ovarian tumors

Question 19 of 83

A neonate is born with congenital cretinism. Which of the following is NOT a likely cause?

Pregnant mother with autoimmune thyroiditis
Pregnant mother with hypothyroidism
Underdeveloped fetal thyroid
Maternal hyperthyroidism
Pregnant mother on carbimazole

Question 20 of 83

Which of the following is NOT associated with PCOS?

Endometrial carcinoma
Cardiovascular disease
Type I diabetes
Psychomotor dysfunction
Infertility

Question 21 of 83

Which of the following is a non-structural cause of abnormal uterine bleeding?

Adenomyosis
Hyperplasia of the endometrium
Coagulopathy
Polyp
Leiomyoma

Question 22 of 83

Which of the following cells are inhibited by prolactin?

Corticotrophs
Somatotrophs
Gonadotrophs
Thyrotrophs
Beta LPH

Question 23 of 83

Which of the following is the most effective method of contraception?

Condoms
Diaphragms
Coitus interruptus
Patch
Vasectomy

Question 24 of 83

What type of anemia is typically seen in patients with hyperthyroidism?

Sideroblastic anemia
Normocytic normochromic anemia
Microcytic hypochromic anemia
Hemolytic anemia
Macrocytic hypochromic anemia

Question 25 of 83

A 20-year-old woman presents with hirsutism and primary amenorrhea. Examination reveals mild clitoromegaly. Her total testosterone level is 69 ng/dL. Blood glucose and TSH were normal and prolactin levels were mildly elevated. Her morning 17-OHP was normal. What is the most likely diagnosis?

Complete CAH
Partial CAH
Hyperprolactinemia
Cushing's syndrome
Polycystic ovarian syndrome

Question 26 of 83

Which of the following is NOT a risk factor of polyps in the female genital tract?

Diabetes
Obesity
Advancing age
Hypertension
Smoking

Question 27 of 83

Which of the following is a derivative of POMC secreted by the corticotrophs?

Beta-PMOC
IGF-1
ACTH
GnRH
TRH

Question 28 of 83

Which of the following is the least effective method of contraception among the following?

Oral contraceptive pills
Intra uterine device
Implant
Tubal sterilization
Vasectomy

Question 29 of 83

Which of the following is a feature of hypothyroidism?

Weight loss
Diaphoresis
Heat intolerance
Proximal myopathy
Myxedema coma

Question 30 of 83

Which of the following enzymes is most likely implicated in idiopathic hirsutism?

17-hydroxylase
DHEAS
11-hydroxylase
21-hydroxylase
5-alpha reductase

Question 31 of 83

Which drug is associated with the formation of endometrial polyps?

NSAIDs
Macrolide antibiotics
Clomifene citrate
Oral contraceptive pills
Tamoxifen

Question 32 of 83

Which of the following is FALSE regarding prolactin secretion?

Stress increases prolactin secretion.
Dopamine inhibits prolactin secretion.
Tricyclic antidepressant increases the dopamine levels promoting prolactin secretion.
VIP and TRH promote prolactin secretion.
Serotonin promotes prolactin secretion.

Question 33 of 83

Which of the following has an increased risk when a patient is on long term oral contraceptive pills usage?

Cervical cancer
Breast cancer
Venous thrombosis
Hepatic adenomas
Weight gain

Question 34 of 83

Which of the following is NOT a typical sign or symptom of hypothyroidism?

Constipation
Delayed tendon reflexes
Pre-tibial myxedema
Cardiomyopathy
Increase in weight

Question 35 of 83

Which of the following is the most effective treatment option for patients with PCOS and desire pregnancy?

Decreasing the weight of the person
Starting on OCP
Stopping OC pills after regularization of the cycle
Use of clomiphene citrate
Use of metformin

Question 36 of 83

Which of the following features is NOT characteristic of an adenomyotic uterus?

Asymmetrical enlargement of the uterus
Boggy
Trabeculated areas on cut sections of uterus
Globular mass
Multiple hemorrhagic spots within the myometrium

Question 37 of 83

Which of the following is NOT a clinical feature of increased prolactin levels?

Secondary bone loss
Loss of libido
Menorrhagia
Galactorrhea
Infertility

Question 38 of 83

Which of the following statements is FALSE regarding oral contraceptives?

Oral contraceptives are useful in the treatment of dysmenorrhea.
Oral contraceptives are useful in the treatment of menorrhagia.
Oral contraceptives are useful in the management of weight loss.
Oral contraceptives are used in the prevention of a menstrual migraine.
Oral contraceptives are useful in the treatment of premenstrual syndrome.

Question 39 of 83

Which of the following is an antibody found in hypothyroidism?

Antimicrosomal antibodies
Anti-thyroid antibodies
Anti-thyroid-stimulating immunoglobulin
Anti-peroxidase antibodies
Anti-TSH antibodies

Question 40 of 83

Which of the following is NOT part of the human sexual response according to Masters and Johnson?

Plateau
Orgasm
Sexual stimulation
Resolution
Excitement

Question 41 of 83

Which population has a higher risk of developing uterine leiomyomas?

African Americans
Caucasians
Latin Americans
Asian Americans
Native Americans

Question 42 of 83

Which of the following is NOT a tumor associated with hyperprolactinemia?

Medulloblastoma
Meningioma
Dysgerminoma
Prolactinoma
Craniopharyngioma

Question 43 of 83

Which of the following population cohorts are at highest risk of unintended pregnancies?

Caucasians
Native American
Mediterranean Americans
African American
Asian American

Question 44 of 83

A 25-year-old woman comes with a history of a distended abdomen and 3 months of amenorrhea. She complains of tremors and heat intolerance. Abdominal ultrasound shows a pelvic mass. What is the probable cause of her symptoms?

Graves disease
Autoimmune thyroiditis
Struma ovarii
Hyperthyroidism in pregnancy.
Metastasis of thyroid cancer

Question 45 of 83

Which of the following is NOT a part of the biopsychosocial model of women’s sexuality?

Biologic factors
Interpersonal factors
Sociocultural factors
Psychologic factors
Pathologic factors

Question 46 of 83

Which of the following scenarios is considered sufficient to suspect a coagulopathy in a patient with AUB?

Epistaxis one or 2 times a month
Family history of bleeding disorders
Frequent gum bleeding
Massive bleeding associated with dental work
Bruising one or 2 times a month

Question 47 of 83

Which of the following hormones is most commonly secreted along with prolactin in prolactinomas?

Thyroid secreting hormone
Cortisol
Growth hormone
FSH
LH

Question 48 of 83

Which of the following statements is FALSE regarding contraception?

A vaginal ring is of the least effective contraceptive method.
Barrier method helps prevent sexually transmitted diseases.
Spermicidal jelly is the least effective contraceptive method.
No method of contraception works 100% except complete abstinence from sex.
No association of OCP and weight gain.

Question 49 of 83

Which of the following is NOT a fetal effect of maternal hyperthyroidism?

Intrauterine growth retardation
Pre-term delivery
Cretinism
Increased perinatal mortality
Low birth weight

Question 50 of 83

Which of the following disorders refers to recurrent or persistent involuntary contractions of the perineal muscles surrounding the outer third of the vagina when penetration is attempted?

Dyspareunia
Hypoactive sexual desire disorder
Sexual aversion disorder
Female sexual arousal disorder
Vaginismus

Question 51 of 83

When do hair follicles develop from epidermal cells during gestation?

5 – 6 weeks
1 – 2 weeks
7- 8 weeks
3 – 4 weeks
8 – 10 weeks

Question 52 of 83

Which of the following is NOT an iatrogenic cause of abnormal uterine bleeding?

Anticoagulants
Spironolactone
Contraceptives
Antitubercular drugs
Chemotherapy

Question 53 of 83

Which of the following syndromes can be associated with a pregnant patient with prolactinoma?

MEN – 2A
Cowden syndrome
MEN -1
Turcot syndrome
MEN -2B

Question 54 of 83

What is the definition of infertility?

The inability to achieve pregnancy as a result of a procedure—such as tubal ligation, hysterectomy, or vasectomy.
The probability of achieving a pregnancy in one menstrual cycle.
The inability of a couple to conceive after 12 months of regular intercourse without the use of contraception.
The probability that one cycle will result in a live birth.

Question 55 of 83

Which of the following is the most common cause of primary maternal hypothyroidism in developed countries?

Thyroid agenesis
Iodine deficiency
Postpartum thyroiditis
Hashimoto's thyroiditis
Drug-induced hypothyroidism

Question 56 of 83

Which of the following does not help increase the desire to perform sexual intercourse?

Good partner
Good health
Testosterone
Antidepressants
Erotic stimuli

Question 57 of 83

Which of the following hormones has an effect on hair?

T3 and T4
Epinephrine and norepinephrine
Cortisol and thyroid hormones
Dihydrotestosterone and estrogen
Estrogen and progesterone

Question 58 of 83

Which of the following can present in neonates as abnormal uterine bleeding and grape-like vesicles protruding through the vagina?

Estrogen withdrawal
Foreign bodies
Precocious puberty
Sexual abuse
Sarcoma botryoides

Question 59 of 83

Which of the following is NOT a treatment used for macroprolactinomas?

Cabergoline
Dopamine antagonists
Transsphenoidal surgery
Radiation
Bromocriptine

Question 60 of 83

Which of the following values is abnormal in a semen analysis test?

Percent motility = 50%
Volume = 2.5 ml
pH = 7.3
Normal morphology = 6%
Sperm concentration = 8 million/mL

Question 61 of 83

Which of the following is an example of primary hypothyroidism in pregnancy?

Lymphocytic hypophysitis
Drug-induced hypothyroidism
Empty sella syndrome
CNS sarcoidosis
Pituitary adenoma

Question 62 of 83

At which phase of the menstrual cycle does testosterone peak in patients who have not undergone an oophorectomy?

Secretory phase
The levels remain constant throughout the menstrual cycle.
Proliferative phase
Bleeding phase
Mid-cycle

Question 63 of 83

Which of the following is the “growth phase” of a hair?

Vellous
Telogen
Catagen
Anagen
Tetagen

Question 64 of 83

A mother frantically comes to pediatrician complaining of blood in the diaper of her newborn baby girl. The mother claims to have recently hired a man as housekeeper and a maid since she is busy. What is the next step?

Thorough examination to rule out sexual abuse
Tell the mother that the baby might have cancer
Explain estrogen withdrawal is usually the cause
Tell the mother that the baby might have an infection of the female genital area
Perform ultrasound for sarcoma botryoides

Question 65 of 83

A 32-year-old lady with primary infertility is diagnosed with a micro prolactinoma. She was started on bromocriptine and she got pregnant. Bromocriptine was discontinued. About 12 weeks into the pregnancy she complains of headaches. Her blood pressures are normal. What is the next best step of management?

Provide radiation
Check prolactin levels to confirm increase in size
Prescribe cabergoline
Restart bromocriptine
Perform transsphenoidal surgery

Question 66 of 83

Which of the following is the best option to assess a patient with suspected tubal factor infertility?

Pelvic X-ray
Hysterosalpingogram
Laparoscopy
FSH, LH
TSH, B-HCG

Question 67 of 83

Which of the following is the most common cause of maternal hyperthyroidism during pregnancy?

Toxic nodular goiter
Graves' disease
Autoimmune thyroiditis
Iodine-induced thyrotoxicosis
Struma ovarii

Question 68 of 83

Which of the following restores desire for sexual activity?

Decrease in testosterone levels
Eating chocolate
Use of selective serotonin receptor inhibitor drugs
Trying to treat depression
Finding a compatible partner

Question 69 of 83

Which of the following is FALSE regarding hirsutism and virilization?

The albumin bound testosterone is same in a patient with hirsutism and normal women.
The testosterone attached to the sex binding globulin is decreased in a patient with hirsutism.
Hirsutism reflects the interaction between circulating androgen levels and sensitivity of hair follicles to androgen stimulation.
Total circulating testosterone is decreased in hirsutism.
The testosterone level in a hirsutism patient is less than normal testosterone levels seen in men.

Question 70 of 83

A 15-year-old girl complains that she has been having irregular periods every 2 months. She has not menstruated for about 3 months and comes to the doctor primarily for that reason. She refuses to give details on her sexual activity. What is the next step?

Explain that it's a result of excess stress
Explain that she has a sexually transmitted disease
Examine for cancer
Explain that she has hypothalamic pituitary axis immaturity causing delayed menstrual cycles
Performing a pregnancy test

Question 71 of 83

Which of the following is FALSE regarding management of prolactinomas?

Breastfeeding is contraindicated in patients who are on dopamine agonists.
Radiation is NOT a therapeutic option for macroadenomas in patients who are pregnant.
Minimize the dose of dopamine agonists before referral to surgery.
Prolactin level in pregnancy with prolactinoma is not useful for the diagnosis.
MRI can be performed to visualize prolactinomas in pregnant women.

Question 72 of 83

Which of the following statements regarding ovulation induction is correct?

Clomiphene citrate induces ovulation by inhibiting estrogen production, leading to stimulation of follicle-stimulating hormone release.
Letrozole is associated with the highest risk of twins among controlled ovarian hyperstimulation therapy.
Letrozole is the first-line therapy for ovulation induction in females with polycystic ovary syndrome.
Clomiphene citrate is used for ovulation induction in hypothalamic-pituitary-gonadal axis dysfunction

Question 73 of 83

Which of the following is NOT a common cause of goiter?

Hashimoto's thyroiditis
Nutritional deficiency of Iodine in the diet
Diffuse toxic goiter
Anaplastic cancer of thyroid
Diffuse malignant disease

Question 74 of 83

Which of the following is a non-androgenic cause of hirsutism?

Arrhenoblastoma
Idiopathic hirsutism
Non-classical CAH
Acromegaly
PCOS

Question 75 of 83

Which of the following is NOT a cause of abnormal uterine bleeding in a reproductive age group?

Leiomyomas
Polyps
Infection
Pregnancy
Sarcoma botryroides

Question 76 of 83

Which of the following is FALSE regarding hook effect?

Hook effect is not restricted only to prolactin hormone.
Dilution helps to obtain the appropriate values in hormones that are affected by a hook effect.
Repeated measurements of the hormone levels will provide accurate measurement.
The hormone is in high concentrations that it gets attached to the antibodies that provide a signal and is unable to bind to the immobilized antibodies on the surface.
Hook effect is when the hormone is so largely elevated that the test results as false negative.

Question 77 of 83

Which of the following hormonal changes is expected during the luteal phase of the menstrual cycle?

Increased progesterone
Increased FSH
Increased LH
Decreased B-HCG
Decreased estrogen

Question 78 of 83

For a woman to be considered to have post-partum thyroiditis, features of hypothyroidism or hyperthyroidism must be developed within what period of time after childbirth?

3 months
12 months
18 months
24 months
6 months

Question 79 of 83

Which of the following medications does NOT result in hirsutism?

Cyclosporine
Thiazides
Calcium channel blockers
Erythropoietin
Minoxidil

Question 80 of 83

Which of the following is LEAST appropriate for diagnosing abnormal uterine bleeding?

Saline infusion sonohysterography
Transvaginal ultrasonography
Magnetic resonance imaging
CT with contrast
Hysteroscopy

Question 81 of 83

Which of the following is NOT a mechanism by which progestin causes contraception?

Progestins alter the peristalsis in the fallopian tubes.
Suppression of FSH
Progestin causes atrophy of the endometrial glands.
Progestin inhibits LH surge.
Progestin causes thickening of the cervical mucus.

Question 82 of 83

Which kind of patient is suitable for ICSI?

A patient whose partner has a decreased sperm cell count.
A patient whose partner has decreased motility of sperm cells.
A patient whose partner has an increased number of abnormal forms of sperm cells.
A patient whose partner has increased motility of sperm cells.
A patient whose partner has normal sperm.

Question 83 of 83

Breastfeeding is contraindicated in which of the following therapies used in the management of thyroid problems?

Post thyroidectomy
Levothyroxine
Methimazole
Propylthiouracil
Radioactive iodine

Reproductive Endocrinology 2023

Reproductive Endocrinology 2023

Quiz Summary

Information

Results

Results

Categories

1. Question

2. Question

3. Question

4. Question

5. Question

6. Question

7. Question

8. Question

9. Question

10. Question

11. Question

12. Question

13. Question

14. Question

15. Question

16. Question

17. Question

18. Question

19. Question

20. Question

21. Question

22. Question

23. Question

24. Question

25. Question

26. Question

27. Question

28. Question

29. Question

30. Question

31. Question

32. Question

33. Question

34. Question

35. Question

36. Question

37. Question

38. Question

39. Question

40. Question

41. Question

42. Question

43. Question

44. Question

45. Question

46. Question

47. Question

48. Question

49. Question

50. Question

51. Question

52. Question

53. Question

54. Question

55. Question

56. Question

57. Question

58. Question

59. Question

60. Question

61. Question

62. Question

63. Question

64. Question

65. Question

66. Question

67. Question

68. Question

69. Question

70. Question

71. Question

72. Question

73. Question