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 32-year-old woman comes to the physician because of a 3-month history of irregular menses, milky discharge from her nipples, fatigue, and weight gain. Menses occur at irregular 25–40-day intervals and last 1–2 days with minimal flow. 5 months ago, she was started on clozapine for treatment of schizophrenia. She has hypothyroidism but has not been taking levothyroxine over the past 6 months. Visual field examination show no abnormalities. Her serum thyroid-stimulating hormone is 17.0 μU/mL and serum prolactin is 85 ng/mL. Which of the following is the most likely explanation for the nipple discharge in this patient?

AProlactinoma

BThyrotropic pituitary adenoma

CEctopic prolactin production

DHypothyroidism

EAdverse effect of medication

3

A patient with a pituitary tumor demonstrates elevated prolactin levels. Which of the following changes in dopamine signaling best explains the hyperprolactinemia?

AIncreased D1 receptor activation

BEnhanced dopamine reuptake

CIncreased dopamine synthesis

DDecreased tuberoinfundibular dopamine release

EIncreased D2 receptor activation

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