exam 4 group study guide test

Questions and Answers

What length range defines a 'normal' cycle?

28 to 31 days

21 to 35 days

24 to 38 days (correct)

30 to 40 days

Which phase of the ovarian cycle directly follows ovulation?

Follicular phase

Luteal phase (correct)

Proliferative phase

Desquamation phase

During which phase does the shedding of the endometrial lining occur?

Follicular phase

Secretory phase

Desquamation phase (correct)

Proliferative phase

What is the typical duration of the luteal phase?

14 days Signup and view all the answers

Which hormone is primarily responsible for stimulating follicular development?

FSH Signup and view all the answers

What typically happens to the follicular phase during perimenopause?

It becomes shorter and more frequent Signup and view all the answers

Which phase involves the maturation of spiral arteries in the endometrium?

Secretory phase Signup and view all the answers

What defines a 'regular' menstrual cycle?

Cycle length variation ≤ 7‒9 days Signup and view all the answers

Which treatment is commonly used for rosacea?

Azelaic acid Signup and view all the answers

What type of skin lesion is defined as flat and non-palpable measuring ≤ 1 cm?

Macule Signup and view all the answers

Which of the following is a characteristic feature of impetigo?

Honey-colored crust lesions Signup and view all the answers

Which of the following describes a nodule?

Large, firm raised lesion measuring 1-5 cm. Signup and view all the answers

Which type of skin lesion is described as a vesicle filled with pus?

Pustule Signup and view all the answers

In the context of dermatological conditions, which characteristic is NOT associated with shingles?

Symmetrical lesions Signup and view all the answers

What is a defining characteristic of urticaria?

It consists of sharply demarcated and elevated lesions that disappear within 24 hours. Signup and view all the answers

What is the primary treatment for folliculitis?

Oral antibiotics Signup and view all the answers

Which term refers to blackheads resulting from clogged skin oil glands?

Comedone Signup and view all the answers

Which type of skin lesion is characterized as raised, palpable, and ≤ 1 cm in diameter?

Papule Signup and view all the answers

What type of skin lesion is a bulla?

Large, clear-fluid blister. Signup and view all the answers

Which of the following conditions is associated with older age and presents with greasy, yellow scales?

Seborrheic dermatitis Signup and view all the answers

Which example corresponds with the diagnosis of psoriasis?

Seborrheic dermatitis Signup and view all the answers

What triggers are known to exacerbate rosacea symptoms?

Sunlight, alcohol consumption, caffeine, spicy food Signup and view all the answers

What is the definition of a furuncle?

A painful, pus-filled bump caused by bacterial infection of a hair follicle Signup and view all the answers

What type of bacterium is responsible for causing furuncles?

Staphylococcus aureus Signup and view all the answers

Which of the following is true about carbuncles?

They are a cluster of boils caused by bacterial infection of multiple hair follicles. Signup and view all the answers

What is the correct description of onychomycosis?

A fungal nail infection Signup and view all the answers

Which condition is characterized by a diffuse vesicular rash?

Varicella Signup and view all the answers

What can occur 1-30 years after the initial infection of certain conditions?

Tertiary complications Signup and view all the answers

Which of the following conditions can lead to neurosyphilis?

Tertiary syphilis Signup and view all the answers

What describes a common consequence of varicella?

Pneumonia and neurologic impact Signup and view all the answers

Which type of psoriasis is characterized by symmetric well-defined salmon-colored plaques with thick silvery scales?

Chronic Plaque Psoriasis Signup and view all the answers

What triggers Guttate Psoriasis?

Strep infection Signup and view all the answers

Which option correctly describes a symptom of Pustular Psoriasis?

Painful plaques Signup and view all the answers

What does the Auspitz Sign indicate in relation to psoriasis?

Pinpoint bleeding Signup and view all the answers

In the context of melanoma, when is a sentinel lymph node biopsy indicated?

For clinically negative nodes with lesions having any ulceration Signup and view all the answers

Which bacteria is commonly associated with the pathophysiology of acne vulgaris?

Cutibacteria acne Signup and view all the answers

What is a common treatment option for severe nodulocystic scarring acne?

Isotretinoin Signup and view all the answers

What is the primary factor leading to the formation of acne lesions?

Accumulation of lipids and keratin in follicular units Signup and view all the answers

Which of the following treatments is inappropriate for managing rosacea?

Benzoyl peroxide Signup and view all the answers

What is the primary clinical feature distinguishing macules from patches?

Macules are non-palpable and measure ≤ 1 cm. Signup and view all the answers

Which skin condition is characterized by honey-colored crust lesions?

Impetigo Signup and view all the answers

Which of the following best represents a common treatment for shingles?

Acyclovir Signup and view all the answers

What term is used to describe a flat skin lesion that is greater than 1 cm in size?

Patch Signup and view all the answers

Which characteristic is NOT typically associated with folliculitis?

Commonly treated with topical corticosteroids Signup and view all the answers

Which of the following is NOT a trigger known to exacerbate rosacea symptoms?

Cold weather Signup and view all the answers

Which skin condition primarily affects older individuals and presents with greasy, yellow scales?

Seborrheic dermatitis Signup and view all the answers

Which of the following characteristics is true for Guttate Psoriasis?

Small salmon colored papules with dew drop fine scales Signup and view all the answers

What is an important clinical indication for conducting a sentinel lymph node biopsy in melanoma patients?

For lesions greater than 0.8 mm thick or that have any ulceration Signup and view all the answers

Which of the following statements about Chronic Plaque Psoriasis is accurate?

It shows symmetric well-defined salmon colored plaques with thick silvery scales Signup and view all the answers

Which of the following best describes Pustular Psoriasis?

It includes painful plaques potentially leading to systemic symptoms Signup and view all the answers

What is the primary pathogenic mechanism that leads to acne vulgaris?

Accumulation of lipids and keratin in the follicular unit Signup and view all the answers

What role does Cutibacteria acne play in the pathophysiology of acne?

It converts sebum into fatty acids, causing inflammation Signup and view all the answers

Which treatment is specifically indicated for severe nodulocystic scarring acne?

Isotretinoin Signup and view all the answers

Which characteristic feature is associated with Erythrodermic Psoriasis?

Widespread erythema covering large areas of the body Signup and view all the answers

What is the role of luteinizing hormone (LH) in the female reproductive system?

It signals the theca cells to produce testosterone. Signup and view all the answers

Which type of estrogen is primarily associated with pregnancy?

Estirol Signup and view all the answers

What is the main purpose of estrogen and progesterone during the menstrual cycle?

To inhibit follicle stimulating hormone (FSH) and luteinizing hormone (LH). Signup and view all the answers

During what stage of development does puberty occur?

From the onset of secondary sexual characteristics until complete sexual development. Signup and view all the answers

What type of feedback does estrogen provide in relation to the hypothalamic-pituitary-ovarian (HPO) axis?

Negative feedback to inhibit FSH and LH production. Signup and view all the answers

What hormone is primarily responsible for stimulating the production of estradiol (E2)?

Follicle-stimulating hormone (FSH) Signup and view all the answers

Which hormone's secretion is inhibited as a result of the feedback loop created by estrogen during the menstrual cycle?

Gonadotropin-releasing hormone (GnRH) Signup and view all the answers

What is the first hormone released in the hypothalamic-pituitary-ovarian (HPO) axis in response to the onset of puberty?

Gonadotropin-releasing hormone (GnRH) Signup and view all the answers

What defines a carbuncle in relation to skin infections?

A cluster of interconnected boils caused by bacterial infection Signup and view all the answers

Which of the following conditions can occur 1-30 years after the initial infection?

Tertiary syphilis Signup and view all the answers

What is the primary microorganism responsible for furuncles?

Staphylococcus aureus Signup and view all the answers

Which statement accurately describes onychomycosis?

It is a fungal infection of the nails. Signup and view all the answers

What is the significance of the latent phase in the context of certain infections?

It represents a period that can vary widely in duration. Signup and view all the answers

What type of rash is associated with a small percentage of neurologic impact in varicella?

Vesicular rash Signup and view all the answers

Which condition does NOT typically arise from a Staphylococcus aureus infection?

Varicella Signup and view all the answers

Which of the following conditions may lead to neurosyphilis?

Tertiary syphilis Signup and view all the answers

What is the first sign of puberty in females?

Breast development Signup and view all the answers

Which condition is characterized by painful periods with no identifiable pelvic pathology?

Primary dysmenorrhea Signup and view all the answers

Which test is commonly used to confirm HIV infection?

4th-generation enzyme immunoassay Signup and view all the answers

What defines secondary amenorrhea?

Absence of periods for more than 3 cycles in previously menstruating individuals Signup and view all the answers

Which of the following conditions involves an abnormal opening of the urethra on the ventral side of the penis?

Hypospadias Signup and view all the answers

Which of the following is a typical characteristic of osteoporosis?

Compromised bone strength Signup and view all the answers

What clinical sign is associated with testicular torsion?

Prehn's sign Signup and view all the answers

Which phase of syphilis is characterized by a painless local infection?

Primary phase Signup and view all the answers

What is the likely presentation of a testicular cancer mass?

Often painless mass Signup and view all the answers

What is a significant risk factor for the acceleration of bone loss after menopause?

Decrease in estrogen levels Signup and view all the answers

Study Notes

Menstrual Cycle Overview

Normal cycle length ranges from 24 to 38 days.
Regular cycles exhibit variations in length of ≤ 7-9 days.
Cycles remain consistent until perimenopause, where follicular phases shorten and frequency increases.

Ovarian Cycle Phases

Follicular Phase:
- Duration from menstrual onset (Day 1) to LH surge before ovulation.
- Lasts 14 to 21 days, may shorten in perimenopause.
- Involves development of follicles and oocytes.
Luteal Phase:
- Occurs after ovulation, where hormones support potential pregnancy and endometrial health.
- Lasts approximately 14 days, concluding with the start of the next menses.

Endometrial Cycle Phases

Desquamation: Shedding of endometrial lining (menses).
Proliferative Phase: Endometrium proliferation with straight, tubular glands.
Secretory Phase: Maturation of spiral arteries and endometrial glands for pregnancy.

FSH (Follicle Stimulating Hormone): Stimulates follicular development and egg maturation.
Luteinizing Hormone (LH): Triggers ovulation during the cycle.

Dermatology Insights

Sequela of Varicella: Includes diffuse vesicular rash, potential neurological impact, and pneumonia.
Onychomycosis: Fungal nail infection affecting nail health.
Furuncle (Boil): Painful, pus-filled bump due to Staphylococcus aureus infection of a hair follicle.
Carbuncle: Cluster of boils indicating severe skin infection, often from bacteria entering through breaks in the skin.

Common Skin Conditions and Treatments

Rosacea: Facial erythema in Northern Europeans; treated with Azelaic acid.
Acne: Characterized by comedones, typically in teenagers; treatments include benzoyl peroxide and tetracycline.
Seborrheic Dermatitis: Greasy, yellow scaling in older adults; treated with antifungal agents.
Folliculitis: Hair follicle infection requiring oral antibiotics for treatment.
Impetigo: Honey-colored crust lesions in children; treated with topical and oral antibiotics.
Shingles: Caused by varicella virus; presents with unilateral lesions; treated with Acyclovir.

Terminology of Skin Lesions

Macule: Flat, non-palpable lesion ≤ 1 cm; differs in color (e.g., freckles).
Patch: Flat lesion > 1 cm; also differs in color (e.g., vitiligo).
Papule: Raised, palpable lesion ≤ 1 cm; may be red or brown (e.g., nevi).
Plaque: Raised lesion > 1 cm; examples include psoriasis.
Nodule: Firm raised lesion; measures 1-5 cm (e.g., lipomas).
Vesicle: Small, fluid-filled blister (e.g., chickenpox).
Bulla: Large clear-fluid blister (e.g., burns).
Pustule: Vesicle filled with pus (e.g., folliculitis).

Clinical Findings and Management of Psoriasis

Chronic Plaque Psoriasis: Symmetric, well-defined salmon-colored plaques with thick silvery scales.
Guttate Psoriasis: Associated with strep infections; presents as small, salmon-colored papules.
Pustular Psoriasis: Painful plaques indicating severe skin condition.
Erythrodermic Psoriasis: Generalized erythema affecting large areas of skin.

Sentinel Lymph Node Biopsy in Melanoma

Indicated for the first draining lymph node in a tumor when nodes appear clinically negative.
Necessary for lesions > 0.8 mm thick or those with ulceration.

Pathophysiology of Acne Vulgaris

Involves the accumulation of lipids and keratin in hair follicles.
Common bacteria, Cutibacteria acnes, convert sebum into fatty acids, eliciting inflammation.
Management includes benzoyl peroxide and antibiotics like doxycycline; isotretinoin is used for severe cases.

Hormonal Regulation in Reproductive System

Granulosa cells produce estradiol (E2) under stimulation from Follicle Stimulating Hormone (FSH).
Luteinizing Hormone (LH) stimulates theca cells to produce testosterone, which is then converted to E2.
Estrogens include:
- E2: Primary estrogen.
- E1: Weaker estrogen significant during menopause.
- Estiol: Predominantly produced during pregnancy.
After ovulation, progestin is produced, playing a role in the menstrual cycle.
During the menstrual phase, estrogen and progesterone inhibit FSH and LH, establishing a negative feedback mechanism.

Hypothalamic-Pituitary-Ovarian (HPO) Axis

GnRH (Gonadotropin-Releasing Hormone) leads to the release of FSH and LH.
This hormonal cascade is crucial for the production of estrogen and progesterone.

Puberty Milestones

Puberty is defined as the onset of secondary sexual characteristics until full sexual maturity.
Thelarche: Breast development; first sign in girls (ages 7-14).
Pubarche: Growth of armpit and pubic hair occurs between ages 8-15.
Growth spurts driven by insulin growth hormone.
Menarche: First menstrual bleed typically occurs between ages 9-16, about one year post growth spurt.

Precocious and Delayed Puberty

Precocious puberty causes isosexual secondary sex characteristics.
Delayed puberty may show significant growth restriction.

Tanner Stages

Developmentally categorized stages for sexual maturation (not detailed here).

Common Gynecological Terms

Oligomenorrhea: Menstrual cycles > 35 days apart (less than 9 cycles/year).
Polymenorrhea: Menstrual cycles < 21 days apart.
Menorrhagia: Excessive menstrual bleeding (> 80ml in 7 days), termed AUB/HMB.
Metrorrhagia: Irregular bleeding between menstrual periods.
Dysmenorrhea: Painful menstrual periods, classified into primary (absence of pathology) and secondary (due to conditions like endometriosis).
Amenorrhea: Absence of menstrual periods.

Amenorrhea Types

Primary: Menstrual cycles do not begin in adolescence; no pelvic pathology identified.
Secondary: Occurs post-menarche; linked to medical conditions such as endometriosis.

Osteoporosis

Characterized by reduced bone density, increasing fracture risk.
Peak bone mass occurs at age 30; loss starts around age 40-50, accelerated post-menopause.
Criteria for osteoporosis diagnosis includes DEXA scanning and screening for secondary causes (e.g., hyperparathyroidism).

HIV/AIDS Screening and Management

4th generation EIA tests for HIV-1 and -2; positive must further assess with antibody tests and Western blot methods.
Viral load and CD4 T-cell counts monitored before initiating HIV treatment, with expected viral load decrease and CD4 increase indicating effective treatment.

Male Genitourinary Abnormalities

Priapism: Painful, prolonged erection, often linked with sickle cell disease; managed via phenylephrine injection or surgery.
Hypospadias: Abnormal urethra opening; requires surgical correction.
Epispadias: Similar abnormality on the dorsal side; also requires surgery.
Peyronie’s disease: Fibrous plaques causing penile curvature; treatments include Pentoxyfilline, Verapamil, or Collegenase.
Balanitis: Inflammation of the penis head due to trauma or infections; managed with hygiene and treating underlying infections.

Testicular Abnormalities

Torsion: Medical emergency; indicated by an elevated testis and horizontal position.
Hydrocele: Fluid accumulation, identifiable with penlight transillumination.
Spermatocele: Cysts at the epididymis head.
Varicocele: Enlarged veins resembling a "bag of worms."
Cancer: Often presents as a painless mass; negative transillumination.

Male GU Cancers

Testicular cancer typically presents as a painless mass.
Prostate cancer largely asymptomatic until advanced, indicated by PSA levels > 4.

Phimosis vs. Paraphimosis

Phimosis: Inability to retract the foreskin over the glans.
Paraphimosis: Retracted foreskin cannot return to its normal position, requiring urgent treatment.

Stages of Syphilis

Primary: Chancre - painless ulcer at infection site.
Secondary: Systemic symptoms like fever, rash, swollen lymph nodes.
Latent: Aperiodic phase between secondary and tertiary stages.
Tertiary: Complications can include neurosyphilis and cardiovascular issues, occurring years later.

Dermatological Considerations

Sequela of varicella includes risk of pneumonia and neurological impacts.
Onychomycosis is a fungal infection of the nails.

Skin Infections

Furuncle: Painful bump (boil) due to Staphylococcus aureus infection of hair follicles.
Carbuncle: Cluster of boils resulting from multiple infected follicles; may require systemic antibiotics or surgery.
Acne: Often results from hormonal changes in adolescence; treated with topical or systemic antibiotics.

Knowledge of Common Skin Lesions

Macule: Flat lesion ≤ 1cm, differing in skin color.
Patch: Flat lesion > 1cm, differing in color.
Papule: Raised lesion ≤ 1cm, can vary in color and indicate disease processes.

Mastery of ABCDE for Skin Examination

A: Asymmetry
B: Border irregularity
C: Color variation
D: Diameter > 6mm
E: Evolving changes.

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