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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?

    <p>14 days</p> Signup and view all the answers

    Which hormone is primarily responsible for stimulating follicular development?

    <p>FSH</p> Signup and view all the answers

    What typically happens to the follicular phase during perimenopause?

    <p>It becomes shorter and more frequent</p> Signup and view all the answers

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

    <p>Secretory phase</p> Signup and view all the answers

    What defines a 'regular' menstrual cycle?

    <p>Cycle length variation ≤ 7‒9 days</p> Signup and view all the answers

    Which treatment is commonly used for rosacea?

    <p>Azelaic acid</p> Signup and view all the answers

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

    <p>Macule</p> Signup and view all the answers

    Which of the following is a characteristic feature of impetigo?

    <p>Honey-colored crust lesions</p> Signup and view all the answers

    Which of the following describes a nodule?

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

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

    <p>Pustule</p> Signup and view all the answers

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

    <p>Symmetrical lesions</p> Signup and view all the answers

    What is a defining characteristic of urticaria?

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

    What is the primary treatment for folliculitis?

    <p>Oral antibiotics</p> Signup and view all the answers

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

    <p>Comedone</p> Signup and view all the answers

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

    <p>Papule</p> Signup and view all the answers

    What type of skin lesion is a bulla?

    <p>Large, clear-fluid blister.</p> Signup and view all the answers

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

    <p>Seborrheic dermatitis</p> Signup and view all the answers

    Which example corresponds with the diagnosis of psoriasis?

    <p>Seborrheic dermatitis</p> Signup and view all the answers

    What triggers are known to exacerbate rosacea symptoms?

    <p>Sunlight, alcohol consumption, caffeine, spicy food</p> Signup and view all the answers

    What is the definition of a furuncle?

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

    What type of bacterium is responsible for causing furuncles?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Which of the following is true about carbuncles?

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

    What is the correct description of onychomycosis?

    <p>A fungal nail infection</p> Signup and view all the answers

    Which condition is characterized by a diffuse vesicular rash?

    <p>Varicella</p> Signup and view all the answers

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

    <p>Tertiary complications</p> Signup and view all the answers

    Which of the following conditions can lead to neurosyphilis?

    <p>Tertiary syphilis</p> Signup and view all the answers

    What describes a common consequence of varicella?

    <p>Pneumonia and neurologic impact</p> Signup and view all the answers

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

    <p>Chronic Plaque Psoriasis</p> Signup and view all the answers

    What triggers Guttate Psoriasis?

    <p>Strep infection</p> Signup and view all the answers

    Which option correctly describes a symptom of Pustular Psoriasis?

    <p>Painful plaques</p> Signup and view all the answers

    What does the Auspitz Sign indicate in relation to psoriasis?

    <p>Pinpoint bleeding</p> Signup and view all the answers

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

    <p>For clinically negative nodes with lesions having any ulceration</p> Signup and view all the answers

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

    <p>Cutibacteria acne</p> Signup and view all the answers

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

    <p>Isotretinoin</p> Signup and view all the answers

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

    <p>Accumulation of lipids and keratin in follicular units</p> Signup and view all the answers

    Which of the following treatments is inappropriate for managing rosacea?

    <p>Benzoyl peroxide</p> Signup and view all the answers

    What is the primary clinical feature distinguishing macules from patches?

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

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

    <p>Impetigo</p> Signup and view all the answers

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

    <p>Acyclovir</p> Signup and view all the answers

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

    <p>Patch</p> Signup and view all the answers

    Which characteristic is NOT typically associated with folliculitis?

    <p>Commonly treated with topical corticosteroids</p> Signup and view all the answers

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

    <p>Cold weather</p> Signup and view all the answers

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

    <p>Seborrheic dermatitis</p> Signup and view all the answers

    Which of the following characteristics is true for Guttate Psoriasis?

    <p>Small salmon colored papules with dew drop fine scales</p> Signup and view all the answers

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

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

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

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

    Which of the following best describes Pustular Psoriasis?

    <p>It includes painful plaques potentially leading to systemic symptoms</p> Signup and view all the answers

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

    <p>Accumulation of lipids and keratin in the follicular unit</p> Signup and view all the answers

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

    <p>It converts sebum into fatty acids, causing inflammation</p> Signup and view all the answers

    Which treatment is specifically indicated for severe nodulocystic scarring acne?

    <p>Isotretinoin</p> Signup and view all the answers

    Which characteristic feature is associated with Erythrodermic Psoriasis?

    <p>Widespread erythema covering large areas of the body</p> Signup and view all the answers

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

    <p>It signals the theca cells to produce testosterone.</p> Signup and view all the answers

    Which type of estrogen is primarily associated with pregnancy?

    <p>Estirol</p> Signup and view all the answers

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

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

    During what stage of development does puberty occur?

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

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

    <p>Negative feedback to inhibit FSH and LH production.</p> Signup and view all the answers

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

    <p>Follicle-stimulating hormone (FSH)</p> 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?

    <p>Gonadotropin-releasing hormone (GnRH)</p> 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?

    <p>Gonadotropin-releasing hormone (GnRH)</p> Signup and view all the answers

    What defines a carbuncle in relation to skin infections?

    <p>A cluster of interconnected boils caused by bacterial infection</p> Signup and view all the answers

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

    <p>Tertiary syphilis</p> Signup and view all the answers

    What is the primary microorganism responsible for furuncles?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Which statement accurately describes onychomycosis?

    <p>It is a fungal infection of the nails.</p> Signup and view all the answers

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

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

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

    <p>Vesicular rash</p> Signup and view all the answers

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

    <p>Varicella</p> Signup and view all the answers

    Which of the following conditions may lead to neurosyphilis?

    <p>Tertiary syphilis</p> Signup and view all the answers

    What is the first sign of puberty in females?

    <p>Breast development</p> Signup and view all the answers

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

    <p>Primary dysmenorrhea</p> Signup and view all the answers

    Which test is commonly used to confirm HIV infection?

    <p>4th-generation enzyme immunoassay</p> Signup and view all the answers

    What defines secondary amenorrhea?

    <p>Absence of periods for more than 3 cycles in previously menstruating individuals</p> 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?

    <p>Hypospadias</p> Signup and view all the answers

    Which of the following is a typical characteristic of osteoporosis?

    <p>Compromised bone strength</p> Signup and view all the answers

    What clinical sign is associated with testicular torsion?

    <p>Prehn's sign</p> Signup and view all the answers

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

    <p>Primary phase</p> Signup and view all the answers

    What is the likely presentation of a testicular cancer mass?

    <p>Often painless mass</p> Signup and view all the answers

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

    <p>Decrease in estrogen levels</p> 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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