Reproductive physiology (menstrual cycle, pregnancy)

Reproductive physiology (menstrual cycle, pregnancy) US Medical PG Question 1: A 26-year-old woman comes to the emergency department because of a 3-day history of nausea and vomiting. Her last menstrual period was 9 weeks ago. A urine pregnancy test is positive. Ultrasonography shows an intrauterine pregnancy consistent in size with a 7-week gestation. The hormone that was measured in this patient's urine to detect the pregnancy is also directly responsible for which of the following processes?

• A. Development of breast tissue
• B. Preparation of the uterine endometrium for implantation
• C. Inhibition of preterm uterine contractions
• D. Maintenance of the corpus luteum (Correct Answer)
• E. Inhibition of ovulation

Reproductive physiology (menstrual cycle, pregnancy) Explanation: ***Maintenance of the corpus luteum*** - The hormone measured in the urine pregnancy test is **human chorionic gonadotropin (hCG)**. - **hCG** acts like **luteinizing hormone (LH)** to maintain the **corpus luteum** in early pregnancy, ensuring continued progesterone production until the placenta takes over. *Development of breast tissue* - **Estrogen** and **progesterone** are the primary hormones responsible for the development of breast tissue during pregnancy, preparing the breasts for lactation. - While hCG indirectly supports these hormones, it does not directly cause breast tissue development. *Preparation of the uterine endometrium for implantation* - The **preparation of the uterine endometrium** for implantation is primarily driven by **progesterone**, produced by the corpus luteum initially and later by the placenta. - hCG’s role is to maintain the corpus luteum, thus indirectly supporting progesterone production. *Inhibition of preterm uterine contractions* - **Progesterone** is the main hormone responsible for **inhibiting uterine contractions** during pregnancy to prevent preterm labor. - While hCG supports progesterone production, it does not directly inhibit uterine contractions itself. *Inhibition of ovulation* - High levels of **estrogen** and **progesterone** during pregnancy suppress the hypothalamic-pituitary-gonadal axis, thereby **inhibiting ovulation**. - While hCG maintains the corpus luteum which produces these hormones, hCG itself is not the direct inhibitor of ovulation.

Reproductive physiology (menstrual cycle, pregnancy) US Medical PG Question 2: A scientist in Chicago is studying a new blood test to detect Ab to EBV with increased sensitivity and specificity. So far, her best attempt at creating such an exam reached 82% sensitivity and 88% specificity. She is hoping to increase these numbers by at least 2 percent for each value. After several years of work, she believes that she has actually managed to reach a sensitivity and specificity much greater than what she had originally hoped for. She travels to China to begin testing her newest blood test. She finds 2,000 patients who are willing to participate in her study. Of the 2,000 patients, 1,200 of them are known to be infected with EBV. The scientist tests these 1,200 patients' blood and finds that only 120 of them tested negative with her new exam. Of the patients who are known to be EBV-free, only 20 of them tested positive. Given these results, which of the following correlates with the exam's specificity?

• A. 82%
• B. 90%
• C. 84%
• D. 86%
• E. 98% (Correct Answer)

Reproductive physiology (menstrual cycle, pregnancy) Explanation: ***98%*** - **Specificity** measures the proportion of **true negatives** among all actual negatives. - In this case, 800 patients are known to be EBV-free (actual negatives), and 20 of them tested positive (false positives). This means 800 - 20 = 780 tested negative (true negatives). Specificity = (780 / 800) * 100% = **98%**. *82%* - This value represents the *original sensitivity* before the scientist’s new attempts to improve the test. - It does not reflect the *newly calculated specificity* based on the provided data. *90%* - This value represents the *newly calculated sensitivity* of the test, not the specificity. - Out of 1200 EBV-infected patients, 120 tested negative (false negatives), meaning 1080 tested positive (true positives). Sensitivity = (1080 / 1200) * 100% = 90%. *84%* - This percentage is not directly derived from the information given for either sensitivity or specificity after the new test results. - It does not correspond to any of the calculated values for the new test's performance. *86%* - This percentage is not directly derived from the information given for either sensitivity or specificity after the new test results. - It does not correspond to any of the calculated values for the new test's performance.

Reproductive physiology (menstrual cycle, pregnancy) US Medical PG Question 3: A 15-year-old female presents to her family physician for an annual school physical exam and check-up. She is accompanied by her mother to the visit and is present in the exam room. The patient has no complaints, and she does not have any past medical problems. She takes no medications. The patient reports that she remains active, exercising 5 times a week, and eats a healthy and varied diet. Which of the following would be the best way for the physician to obtain a more in-depth social history, including sexual history and use of alcohol, tobacco, or recreational drugs?

• A. Disallow the mother to be present in the examination room throughout the entirety of the visit
• B. Give the patient a social history questionnaire to fill out in the exam room
• C. Ask the mother to step outside into the hall for a portion of the visit (Correct Answer)
• D. Ask the patient the questions directly, with her mother still in the exam room
• E. Speak softly to the patient so that the mother does not hear and the patient is not embarrassed

Reproductive physiology (menstrual cycle, pregnancy) Explanation: ***Ask the mother to step outside into the hall for a portion of the visit*** - This approach allows the physician to speak with the adolescent **privately and confidentially**, which is crucial for obtaining sensitive information such as sexual history, drug use, and mental health concerns. - Adolescents are more likely to disclose personal information when their parents are not present, fostering trust and ensuring **comprehensive history-taking** vital for their well-being. *Disallow the mother to be present in the examination room throughout the entirety of the visit* - This is an **overly restrictive** approach that might create tension or distrust between the physician, patient, and parent, especially at the start of the visit. - While privacy is essential for sensitive topics, parental presence can be valuable for discussing general health, family history, and **treatment plans**, especially for younger adolescents. *Give the patient a social history questionnaire to fill out in the exam room* - While questionnaires can be useful for gathering basic information, they often **lack the nuance** of a direct conversation and may not prompt the patient to elaborate on sensitive issues. - Furthermore, having the mother present while the patient fills out a questionnaire on sensitive topics still **compromises confidentiality** and may lead to incomplete or dishonest answers. *Ask the patient the questions directly, with her mother still in the exam room* - Asking sensitive questions with a parent present is **unlikely to yield truthful and complete answers**, as adolescents may feel embarrassed, judged, or fear parental disapproval. - This approach compromises the **confidentiality** that is fundamental to building trust with adolescent patients. *Speak softly to the patient so that the mother does not hear and the patient is not embarrassed* - Speaking softly is **unprofessional** and still does not guarantee privacy, as the mother might still overhear parts of the conversation. - This method also **fails to establish true confidentiality**, which is central to building rapport and encouraging open communication with adolescent patients about sensitive topics.

Reproductive physiology (menstrual cycle, pregnancy) US Medical PG Question 4: A 24-year-old woman comes to the physician for preconceptional advice. She has been married for 2 years and would like to conceive within the next year. Menses occur at regular 30-day intervals and last 4 days with normal flow. She does not smoke or drink alcohol and follows a balanced diet. She takes no medications. She is 160 cm (5 ft 3 in) tall and weighs 55 kg (121 lb); BMI is 21.5 kg/m2. Physical examination, including pelvic examination, shows no abnormalities. She has adequate knowledge of the fertile days of her menstrual cycle. Which of the following is most appropriate recommendation for this patient at this time?

• A. Begin high-dose vitamin A supplementation
• B. Begin vitamin B12 supplementation
• C. Begin folate supplementation (Correct Answer)
• D. Begin iron supplementation
• E. Gain 2 kg prior to conception

Reproductive physiology (menstrual cycle, pregnancy) Explanation: ***Begin folate supplementation*** - **Folate supplementation** of 400 mcg daily is recommended for all women of childbearing age to reduce the risk of **neural tube defects** (NTDs) in the fetus. This should ideally begin at least one month before conception and continue through the first trimester. - The patient is planning to conceive, making preemptive folate supplementation critical for preventing serious birth defects. *Begin high-dose vitamin A supplementation* - **High-dose vitamin A** (more than 10,000 IU/day) can be **teratogenic** and is therefore contraindicated during preconception and pregnancy. - While vitamin A is essential for fetal development, excessive amounts can lead to fetal abnormalities. *Begin vitamin B12 supplementation* - **Vitamin B12 supplementation** is generally not necessary unless the patient has a diagnosed deficiency, such as in strict vegetarians or those with malabsorption issues. - There is no indication of B12 deficiency in this patient's history or presentation. *Begin iron supplementation* - Routine **iron supplementation** is not recommended preconception unless the patient is diagnosed with **iron deficiency anemia**. - Excessive iron intake without a clear indication can cause gastrointestinal upset and has not been shown to improve pregnancy outcomes in non-anemic women. *Gain 2 kg prior to conception* - The patient has a **healthy BMI of 21.5 kg/m2**, which is within the normal range (18.5-24.9 kg/m2). - There is no medical indication for her to gain weight prior to conception.

Reproductive physiology (menstrual cycle, pregnancy) US Medical PG Question 5: A newborn infant with karyotype 46, XY has male internal and external reproductive structures. The lack of a uterus in this infant can be attributed to the actions of which of the following cell types?

• A. Granulosa
• B. Theca
• C. Leydig
• D. Reticularis
• E. Sertoli (Correct Answer)

Reproductive physiology (menstrual cycle, pregnancy) Explanation: ***Sertoli*** - **Sertoli cells** in the fetal testis produce **Anti-Müllerian Hormone (AMH)**, which is crucial for the regression of the **Müllerian ducts**. - The **Müllerian ducts** (also called paramesonephric ducts) would otherwise develop into the uterus, fallopian tubes, and upper vagina in the female fetus. In a male fetus, AMH from Sertoli cells causes these structures to degenerate, leading to the absence of a uterus. *Granulosa* - **Granulosa cells** are found in the ovarian follicles of females and are involved in **estrogen synthesis** and support of oocyte development. - They do not play a role in Müllerian duct regression; in fact, the absence of AMH in female fetuses allows the Müllerian ducts to develop. *Theca* - **Theca cells** are also found in the ovarian follicles and are responsible for producing **androgens** (which are then converted to estrogen by granulosa cells). - Like granulosa cells, theca cells are involved in ovarian function and estrogen production, not in the regression of Müllerian ducts. *Leydig* - **Leydig cells** are located in the interstitium of the testes and are responsible for producing **androgens** (primarily testosterone) in response to luteinizing hormone (LH). - Testosterone from Leydig cells promotes the development of the **Wolffian ducts** (which form male internal reproductive structures like the epididymis, vas deferens, and seminal vesicles), but it does not directly cause the regression of the Müllerian ducts. *Reticularis* - The **zona reticularis** is the innermost layer of the adrenal cortex and produces **adrenal androgens**. - While adrenal androgens play a role in puberty and certain endocrine conditions, they are not involved in the differentiation of fetal reproductive tracts or the regression of Müllerian ducts.

Reproductive physiology (menstrual cycle, pregnancy) US Medical PG Question 6: A 16-year-old female presents to her pediatrician’s office because she has not yet started menstruating. On review of systems, she states that she has been increasingly tired, constipated, and cold over the last 6 months. She also endorses a long history of migraines with aura that have increased in frequency over the last year. She complains that these symptoms have affected her performance on the track team. She states that she is not sexually active. Her mother and sister both underwent menarche at age 15. The patient is 5 feet, 4 inches tall and weighs 100 pounds (BMI 17.2 kg/m^2). Temperature is 98.4°F (36.9°C), blood pressure is 98/59 mmHg, pulse is 98/min, and respirations are 14/min. On exam, the patient appears pale and has thinning hair. She has Tanner stage IV breasts and Tanner stage III pubic hair. Which of the following would be most useful in determining this patient’s diagnosis?

• A. TSH level (Correct Answer)
• B. GnRH level
• C. FSH and estrogen levels
• D. Prolactin level
• E. Pelvic exam

Reproductive physiology (menstrual cycle, pregnancy) Explanation: ***TSH level*** - The patient presents with classic symptoms of **hypothyroidism**, including fatigue, constipation, cold intolerance, and potentially **menstrual irregularities** (primary amenorrhea). - An elevated **TSH** would confirm primary hypothyroidism, which can cause delayed puberty and amenorrhea by affecting the **hypothalamic-pituitary-gonadal axis**. *GnRH level* - **GnRH levels** are pulsatile and difficult to measure accurately; they are not a standard diagnostic test for primary amenorrhea. - Evaluation of the **hypothalamic-pituitary axis** typically involves assessing downstream hormones like LH and FSH. *FSH and estrogen levels* - While important for evaluating primary amenorrhea, **FSH and estrogen levels** would primarily help differentiate between ovarian (**hypergonadotropic hypogonadism**) and central (**hypogonadotropic hypogonadism**) causes. - However, given the systemic symptoms suggestive of hypothyroidism, evaluating TSH is a more immediate and likely diagnostic step. *Prolactin level* - An elevated **prolactin level** could cause amenorrhea by suppressing GnRH, but the patient's other symptoms (fatigue, constipation, cold intolerance) are not typical of hyperprolactinemia. - While useful in some cases of amenorrhea, it's less likely to be the primary cause of this patient's constellation of symptoms. *Pelvic exam* - A **pelvic exam** would assess for anatomical abnormalities of the reproductive tract, such as imperforate hymen or vaginal agenesis, which can cause primary amenorrhea. - However, the patient's systemic symptoms strongly suggest an endocrine disorder rather than an anatomical issue.

Reproductive physiology (menstrual cycle, pregnancy) US Medical PG Question 7: A 39-year-old woman seeks evaluation from her gynecologist due to recent changes in her menstrual cycle. Her last menstrual period was greater than 12 months ago. She has 2 children and had regular menstrual periods in the past. She also complains of difficulty in falling and staying asleep, occasional hot flashes, vaginal dryness, and decreased libido. The physical examination is unremarkable, and the height and weight are 1.68 m (5 ft 6 in) and 70 kg (154 lb), respectively. She has the following hormonal panel from 2 months ago when she first sought help for her symptoms. Hormonal panel results Human Chorionic Gonadotropin 4 IU/L (0.8 - 7.3 IU/L) Thyroid Stimulating Hormone 2.5 mIU/L (0.4 - 4.2 mIU/L) Prolactin 5 ng/mL (2-29 ng/mL) Follicle Stimulating Hormone 45 mIU/mL (Follicular phase: 3.1-7.9 mIU/mL; Ovulation peak: 2.3-18.5 mIU/mL; Luteal phase: 1.4-5.5 mIU/mL) Estradiol 5 pg/mL (Mid-follicular phase: 27-123 pg/mL; Periovulatory: 96-436 pg/mL; Mid-luteal phase: 49-294 pg/mL) Which of the following is the most likely diagnosis in this patient?

• A. Primary ovarian insufficiency (POI) (Correct Answer)
• B. Pituitary adenoma
• C. Hyperthyroidism
• D. Breast cancer
• E. Polycystic ovary syndrome (PCOS)

Reproductive physiology (menstrual cycle, pregnancy) Explanation: ***Primary ovarian insufficiency (POI)*** - The patient's age (39 years old), amenorrhea (last menstrual period >12 months ago), and symptoms like hot flashes, vaginal dryness, and decreased libido are highly consistent with **menopause**. - The hormonal panel showing **elevated FSH (45 mIU/mL)** and **low estradiol (5 pg/mL)** confirms ovarian failure, and given the patient's age (under 40), this points to **Primary Ovarian Insufficiency**. *Pituitary adenoma* - While pituitary adenomas can cause menstrual irregularities, they typically manifest with **galactorrhea** (if prolactin-secreting) and visual field defects, none of which are present. - The hormonal profile in this patient (high FSH, low estradiol) is inconsistent with a pituitary adenoma, which would more commonly show **low FSH** and estradiol if it caused hypogonadism. *Hyperthyroidism* - Hyperthyroidism can cause menstrual irregularities, but typically presents with symptoms like **weight loss**, **tachycardia**, anxiety, and heat intolerance, which are not described. - The patient's **TSH level is normal** (2.5 mIU/L), ruling out hyperthyroidism as the cause of her symptoms. *Breast cancer* - Breast cancer is a malignancy and does not directly cause the constellation of symptoms (amenorrhea, hot flashes, vaginal dryness) or the specific hormonal changes (high FSH, low estradiol) seen in this patient. - While hormonal changes can influence breast cancer risk, breast cancer itself is not a diagnostic explanation for these endocrine findings. *Polycystic ovary syndrome (PCOS)* - PCOS is characterized by chronic anovulation, **hyperandrogenism**, and polycystic ovaries; however, it typically presents with **oligomenorrhea** or amenorrhea but not usually total ovarian failure with very high FSH and low estradiol. - In PCOS, FSH levels are typically normal or low, and estradiol levels can be normal or slightly elevated due to peripheral conversion of androgens, which contrasts sharply with this patient's findings.

Reproductive physiology (menstrual cycle, pregnancy) US Medical PG Question 8: A 65-year-old man is admitted to the hospital because of a 1-month history of fatigue, intermittent fever, and weakness. Results from a peripheral blood smear taken during his evaluation are indicative of possible acute myeloid leukemia. Bone marrow aspiration and subsequent cytogenetic studies confirm the diagnosis. The physician sets aside an appointed time-slot and arranges a meeting in a quiet office to inform him about the diagnosis and discuss his options. He has been encouraged to bring someone along to the appointment if he wanted. He comes to your office at the appointed time with his daughter. He appears relaxed, with a full range of affect. Which of the following is the most appropriate opening statement in this situation?

• A. Your lab reports show that you have an acute myeloid leukemia
• B. What is your understanding of the reasons we did bone marrow aspiration and cytogenetic studies? (Correct Answer)
• C. You must be curious and maybe even anxious about the results of your tests.
• D. I may need to refer you to a blood cancer specialist because of your diagnosis. You may need chemotherapy or radiotherapy, which we are not equipped for.
• E. Would you like to know all the details of your diagnosis, or would you prefer I just explain to you what our options are?

Reproductive physiology (menstrual cycle, pregnancy) Explanation: ***"What is your understanding of the reasons we did bone marrow aspiration and cytogenetic studies?"*** - This **open-ended question** allows the patient to express their current knowledge and perceptions, which helps the physician tailor the discussion. - It establishes a **patient-centered approach**, respecting the patient's existing understanding and preparing them for further information. *"You must be curious and maybe even anxious about the results of your tests."* - While empathic, this statement makes an **assumption about the patient's feelings** rather than inviting them to share their own. - It is often better to ask directly or use more open-ended questions that allow the patient to express their true emotions, especially given their **relaxed demeanor**. *"I may need to refer you to a blood cancer specialist because of your diagnosis. You may need chemotherapy or radiotherapy, which we are not equipped for.”"* - This statement immediately introduces **overwhelming and potentially alarming information** (referral, chemotherapy, radiotherapy) without first establishing the diagnosis or assessing the patient's readiness to receive it. - It prematurely jumps to treatment and logistics, potentially causing **unnecessary distress** before the patient has processed the core diagnosis. *"Would you like to know all the details of your diagnosis, or would you prefer I just explain to you what our options are?""* - While it attempts to assess the patient's preference for information, this question is a **closed-ended "either/or" choice** that might limit the patient's ability to express nuanced needs. - It also prematurely introduces the idea of "options" without first explaining the diagnosis in an understandable context. *"Your lab reports show that you have an acute myeloid leukemia"* - This is a **direct and blunt delivery of a serious diagnosis** without any preparatory context or assessment of the patient's existing knowledge or emotional state. - Delivering such news abruptly can be shocking and overwhelming, potentially **hindering effective communication** and rapport building.

Reproductive physiology (menstrual cycle, pregnancy) US Medical PG Question 9: A 26-year-old woman comes to the physician because she has not had a menstrual period for 5 weeks. Menarche was at the age of 14 years and menses occurred at regular 30-day intervals. She reports having unprotected sexual intercourse 3 weeks ago. A urine pregnancy test is positive. Which of the following best describes the stage of development of the embryo at this time?

• A. Fetal heart is beating, but cardiac activity is not yet visible on ultrasound
• B. Limb buds have formed, but fetal movements have not begun
• C. Sexual differentiation has begun, but fetal movement has not started
• D. Neural crest has formed, but limb buds have not yet formed (Correct Answer)
• E. Implantation has occurred, but notochord has not yet formed

Reproductive physiology (menstrual cycle, pregnancy) Explanation: ***Neural crest has formed, but limb buds have not yet formed*** - At **5 weeks gestational age (3 weeks post-fertilization)**, neurulation is completing or recently completed - **Neural crest cells** migrate from the neural folds during weeks 3-4 post-fertilization and are definitely present by this time - **Limb buds** appear later, around week 4-5 post-fertilization (week 6-7 gestational age), making this the most accurate description for the current developmental stage *Fetal heart is beating, but cardiac activity is not yet visible on ultrasound* - The primitive heart tube begins contracting around day 22-23 post-fertilization (early week 4) - At 3 weeks post-fertilization (5 weeks gestational age), the heart may just be starting to beat, but this timing is less precise - Cardiac activity becomes visible on transvaginal ultrasound around 5.5-6 weeks gestational age, so this option is close but less precise than the correct answer *Limb buds have formed, but fetal movements have not begun* - **Limb buds** typically appear around week 4-5 post-fertilization (week 6-7 gestational age) - This is **too advanced** for 3 weeks post-fertilization - While fetal movements aren't perceptible to the mother until 16-20 weeks, they begin much later than the current stage *Sexual differentiation has begun, but fetal movement has not started* - **Sexual differentiation** of the gonads begins around week 7 post-fertilization (week 9 gestational age) - External genitalia differentiation occurs even later (weeks 9-12 post-fertilization) - This stage is **far too advanced** for the current 3-week post-fertilization timeframe *Implantation has occurred, but notochord has not yet formed* - **Implantation** occurs 6-12 days after fertilization, which is approximately 2-3 weeks before a positive pregnancy test - The **notochord** forms during gastrulation in the **3rd week post-fertilization** (5th week gestational age) - By the time of this positive pregnancy test (5 weeks gestational age), the notochord has **already formed**, making this statement incorrect

Reproductive physiology (menstrual cycle, pregnancy) US Medical PG Question 10: A 34-year-old woman comes to a physician for a routine health maintenance examination. She moved to Denver 1 week ago after having lived in New York City all her life. She has no history of serious illness and takes no medications. Which of the following sets of changes is most likely on analysis of a blood sample obtained now compared to prior to her move? Erythropoietin level | O2 saturation | Plasma volume

• A. ↑ unchanged unchanged
• B. ↑ ↓ ↓ (Correct Answer)
• C. Unchanged ↓ unchanged
• D. ↓ unchanged ↑
• E. Unchanged unchanged ↓

Reproductive physiology (menstrual cycle, pregnancy) Explanation: ***↑ ↓ ↓*** - Moving to a high altitude like Denver (from sea level NYC) leads to **hypoxia**, which triggers increased **erythropoietin (EPO)** production to stimulate red blood cell formation. - The immediate physiological response to high altitude is a **decrease in arterial PO2** and thus **oxygen saturation**, along with a **reduction in plasma volume** due to increased diuresis and fluid shifts. *↑ unchanged unchanged* - While **erythropoietin** would increase due to hypoxia at higher altitudes, **oxygen saturation** would decrease, not remain unchanged. - **Plasma volume** also tends to decrease acutely at high altitudes, rather than staying unchanged. *Unchanged ↓ unchanged* - **Erythropoietin** would be expected to increase, not remain unchanged, as a compensatory mechanism to hypoxia. - While **oxygen saturation** would decrease, **plasma volume** typically decreases acutely, not remaining unchanged. *↓ unchanged ↑* - **Erythropoietin** would increase, not decrease, in response to the lower atmospheric oxygen. - Both **oxygen saturation** and **plasma volume** would decrease, not remain unchanged or increase, respectively. *Unchanged unchanged ↓* - **Erythropoietin** would increase, not remain unchanged, to stimulate red blood cell production in response to hypoxia. - **Oxygen saturation** would decrease, not remain unchanged, at higher altitudes.

Reproductive physiology (menstrual cycle, pregnancy) Flashcard 1 of 9

Question: In the third stage (rapid) of ovarian follicle development, a single graafian follicle achieves dominance and ruptures, releasing its oocyte into the peritoneal cavity via the process of _____

Answer: ovulation

Reproductive physiology (menstrual cycle, pregnancy) Flashcard 2 of 9

Question: Pregnancy is characterized by steadily _____ levels of estrogen and progesterone

Answer: increasing

Reproductive physiology (menstrual cycle, pregnancy) Flashcard 3 of 9

Question: If fertilization does not occur, the corpus luteum regresses and estradiol and progesterone levels _____ abruptly

Answer: decrease

Reproductive physiology (menstrual cycle, pregnancy) Flashcard 4 of 9

Question: Ovarian follicular growth is fastest during the _____ week of the follicular phase

Answer: 2nd

Reproductive physiology (menstrual cycle, pregnancy) Flashcard 5 of 9

Question: How does GFR change during pregnancy? _____

Answer: Increased

Reproductive physiology (menstrual cycle, pregnancy) Flashcard 6 of 9

Question: Growth of endometrium is _____ driven (proliferative phase)

Answer: estrogen

Reproductive physiology (menstrual cycle, pregnancy) Flashcard 7 of 9

Question: Preparation of endometrium for implantation is _____ driven (secretory phase)

Answer: progesterone

Reproductive physiology (menstrual cycle, pregnancy) Flashcard 8 of 9

Question: Which neuronal populations have the ability to regenerate after injury?

Answer: PNS, but not CNS

Reproductive physiology (menstrual cycle, pregnancy) Flashcard 9 of 9

Question: What physiological changes are expected during REM sleep?

Answer: extraocular movement increased HR and BP penile/clitoral tumescence