An amenorrheic 17-year-old female is diagnosed with Kallmann syndrome. Blood testing of this patient would indicate which of the following results?
Answer(s): E
Kallmann syndrome is a genetic problem due to failure of migration of olfactory and GnRH secreting neurons to make their appropriate connections in the brain. Classically, this leads to anosmia (inability to smell), delayed puberty, and amenorrhea. The GnRH is not secreted, and pituitary FSH and LH release does not occur. In the absence of stimulation the ovaries do not produce significant estrogen. This is an example of hypogonadotropic hypogonadism, also termed hypothalamic amenorrhea.
A woman complains of amenorrhea for several months following a dilation and curettage.Which of the following is the most likely reason?
Answer(s): B
Asherman syndrome describes intrauterine synechiae (scarring) of the uterine cavity following a surgery of infection of the uterine endometrium. Asherman syndrome is seen following uterine surgery (such as a uterine curettage or myomectomy), septic abortion, or other endometrial cavity infection. The damaged endometrium scars together lead to impairment of the endometrial function. This may result in amenorrhea, dysmenorrhea, infertility, or miscarriage. If the scarring causes obstruction of outflow of menstrual tissue, then hematometra and dysmenorrhea can occur. Severe scarring leads to complete obliteration of the uterine cavity
Implantation of the embryo into the endometrium occurs how many days after ovulation?
Answer(s): D
Following ovulation, fertilization of the egg by the sperm occurs in the Fallopian tube. The embryo then divides and grows as it migrates down the Fallopian tube and into the uterine cavity. As early as 6 days postovulation the embryo implants in the uterine endometrium. Trophoblast invasion then occurs allowing the embryo to burrow into the endometrium. A uteroplacental circulation is established by 1112 days after ovulation allowing -hCG to be detectable in maternal serum or urine.
A 24-year-old G1 presents to you for initiation of obstetric care. She informs you that she is on a medication that was prescribed for acne. The drug is listed as category X in your pharmacy book.The pregnancy risk factor category X for a drug indicates which of the following?
The pregnancy risk factor category assists the physician and patient to understand the safety of the use of a medication during pregnancy. The summary of the categories is as follows: category A-- controlled human studies demonstrate no risk to a fetus. Category B--animal-reproduction studies have not demonstrated fetal risk but there are no controlled human studies to assess the risk. Category C-- animal- reproduction studies have demonstrated risk to a fetus and no controlled human studies are available. Category D--evidence of human teratogenic risk exists but in some cases the known risks may be outweighed in serious situations, such as lifethreatening disease. Class X--this drug should never be used by a pregnant female under any circumstances. The principle of autonomy states that the patient has the right and capability to control the course of her medical care and to participate in the decision-making process.
A 24-year-old G1 presents to you for initiation of obstetric care. She informs you that she is on a medication that was prescribed for acne. The drug is listed as category X in your pharmacy book.The patient reports that she is going to continue the medication because she would be too embarrassed to go to work if her acne were to return. You counsel the patient about the possible risks of this approach but she desires to proceed. You counsel the patient that her best option may be to terminate the pregnancy and continue the medication. Allowing her to make this decision is an example of which of the following?
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