Answer 15

15.  Choice B is the correct answer.  The quantitative HCG needs to be followed until it is zero.  Patients with gestational trophoblastic disease have malignant potential.  DHEA is for assessing adrenal hyperplasia and PCOD.  Alpha fetal protein is for assessing neural tube defects and is a marker for some types of testicular cancer in men.

Question 15

15.  Which of the following serum markers are essential for monitor patients with gestational trophoblastic disease?

A.  DHEA
B.  Quantitative HCG
C.  Alpha Fetal Protein
D.  Beta Fetal Protein

Answer 14

14.  Choice B is the correct answer.  High FSH and LH and low estradiol is to be expected.  The FSH and LH are high because the negative feedback systems from the hypothalamic pituitary axis cannot be shut off because the ovaries "stopped working." The estradiol is simply not produced enough to signal the anterior pituitary to quit producing FSH and LH.  

Question 14

14.  Which of the following lab studies best demonstrates menopause findings:

A.  High estradiol and low FSH and LH
B.  Low estradiol and high FSH and LH
C.  High estradiol and high FSH and LH
D.  Low estradiol and low FSH and LH

Answer 13

13.  Choice C is the correct answer.  Vaginal spotting is not considered benign in a menopausal patient.  In fact it is concerning for cancer until proven otherwise.  Hot flashes, vaginal atrophy, and dry skin are all symptoms that are considered benign with menopause and peri-menopause

Question 13

13.  Your patient is a 50 year old female that presents with no menses for 14 months.  She is concerned about some of her menopausal symptoms.  Which of the following symptoms would not be expected as benign in a menopausal woman?

A.  Dry Skin
B.  Vaginal atrophy
C.  Vaginal spotting
D.  Hot flashes

Answer 12

12.  Choice B is the correct.  Fasting insulin is high in patients with PCOD.  Androstenedione is not helpful.  It is a precursor to testosterone which may be helpful.  DHEA level is a key hormone in evaluating adrenal hyperplasia and PCOD.  Progesterone levels are low.  

Question 12

12.  All of the following studies would be helpful in evaluating a potential diagnosis of polycystic ovarian syndrome except:

A.  Fasting Insulin
B.  Androstenedione
C.  DHEA
D.  Progesterone

Answer 11

11.  Choice A is the correct answer.  This patient is exhibiting secondary amenorrhea.  The most common cause of secondary amenorrhea is pregnancy.  Obesity can cause secondary amenorrhea through the imbalance of estrogen and testosterone.  Pituitary dysfunction can also cause secondary amenorrhea.   Mullerian Agenesis is actually a chromosomal abnormality that causes primary amenorrhea.

Question 11

11.  Your patient is a 34 year old that presents with no menses for 8 months.  She has had previously normal menses.  All of the following are potential causes with the exception of:

A.  Mullerian Agenesis
B.  Pregnancy
C.  Panhypopituitarism
D.  Obesity