Chapter·PhysiologyReproductive physiology (menstrual cycle, pregnancy)

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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?

ADevelopment of breast tissue

BPreparation of the uterine endometrium for implantation

CInhibition of preterm uterine contractions

DMaintenance of the corpus luteum

EInhibition of ovulation

2

A 22-year-old woman comes to the physician to discuss the prescription of an oral contraceptive. She has no history of major medical illness and takes no medications. She does not smoke cigarettes. She is sexually active with her boyfriend and has been using condoms for contraception. Physical examination shows no abnormalities. She is prescribed combined levonorgestrel and ethinylestradiol tablets. Which of the following is the most important mechanism of action of this drug in the prevention of pregnancy?

AInhibition of rise in luteinizing hormone

BSuppression of ovarian folliculogenesis

CThickening of cervical mucus

DPrevention of endometrial proliferation

EIncrease of sex-hormone binding globulin

3

A 51-year-old woman presents to the primary care clinic complaining of trouble sleeping. She reports that she has episodes of "overheating" and "sweating" during the day and at night. The nightly episodes keep her from staying asleep. She also explains how embarrassing it is when she suddenly becomes hot and flushed during work meetings. The patient becomes visibly upset and states that she is worried about her marriage as well. She says she has been fighting with her husband about not going out because she is "too tired." They have not been able to have sex the past several months because "it hurts." Labs are drawn, as shown below: Follicle stimulating hormone (FSH): 62 mIU/mL Estradiol: 34 pg/mL Progesterone: 0.1 ng/mL Luteinizing hormone (LH): 46 mIU/mL Free testosterone: 2.1 ng/dL Which of the following contributes most to the production of estrogen in this patient?

AAdrenal glands

BAdipose tissue

CBartholin glands

DMammary glands

EOvaries

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