MCN 538 sg 3 Questions and Verified Answers, 100% Guarantee Pass (Latest 2025) when should the diagnosis of primary amenorrhea be made and a diagnostic workup started? - Correct Answers ✅When there has been no adrenarche or thelarche by age 13.● When there has been no menses by age 15.● When adrenarche or thelarche started on time, but menses have not started within 5 years of that event.The differential diagnosis includes anatomical, genetic, hormonal, enzymatic, and psychologic causes. - Correct Answers ✅● Anatomical - imperforate hymen or a transverse vaginal septum may mask onset of menses.● Uterus, no breasts - a lack of ovarian estrogen production due to chromosomal abnormalities (Turner syndrome); ovarian enzyme deficiency; ovarian damage (radiation, chemotherapy); pituitary or hypothalamic dysfunction (congenital hypogonadotropic hypogonadism) ● Breasts, no uterus - congenital absence of a uterus (complete uterine Mullerian agenesis) is found in 10% of cases of primary amenorrhea and is associated with other urogenital malformations, especially in the urinary tract.The menstrual cycle is often irregular early in puberty. The average for this time is 21-45 days with up to 7 bleeding days, much longer periods without bleeding may occur. ACOG recommends evaluation for menstrual abnormalities if any of 1 / 3
MCN 538 sg 3 Questions and Verified Answers, 100% Guarantee Pass (Latest 2025)
the following occur: - Correct Answers ✅Menstrual periods
that ● have not started within 3 years of thelarche ● have not started by 14 years of age with signs of hirsutism ● have not started by 14 years of age with a history of examination suggestive of excessive exercise or eating disorder ● have not started by 15 years of age ● occur more frequently than every 21 days or less frequently than every 45 days ● occur 90 days apart even for one cycle ● last more than 7 days ● require frequent pad or tampon changes (soaking more than on every 1-2 hours) ● are heavy and are associated with a history of excessive bruising or bleeding or a family history of a bleeding disorder Actions Within the Reproductive Cycle - Correct Answers ✅Ovarian cycle Follicular phase
Luteal phase:
Uterine (Endometrial) cycle:
Proliferative phase:
Secretory phase 2 / 3
MCN 538 sg 3 Questions and Verified Answers, 100% Guarantee Pass (Latest 2025) Ovarian cycle - Correct Answers ✅- Development of a dominant follicle that results in ovulation and corpus luteum formation.
Follicular phase: - Correct Answers ✅pulsatile GnRH is
released by the hypothalamus and results in pulses of FSH and LH from the anterior pituitary. The pulsatile stimulus recruits a number of follicles to begin developing, which increases estrogen levels. One follicle becomes the dominant follicle producing the most estrogen and the rest of the follicles stimulated in that cycle undergo atresia. Estrogen level reaches peak, about 24 hours before ovulation. LH levels surge, and ovulation occurs 24-36 hours later.
Luteal phase: - Correct Answers ✅ovulation indicates
transition to luteal phase. A shift from estrogen dominance to progesterone dominance occurs. Following the rupture of the follicle, the corpus luteum develops and produces large amounts of progesterone. Progesterone suppresses further follicular growth and causes secretory changes in the endometrium. Length of luteal phase tends to be more constant than follicular phase, approximately 14 days.Progesterone causes elevation of basal body temperature. If pregnancy does not occur, corpus luteum rapidly deteriorates approximately 9-11 days after ovulation. A sharp decline in serum progesterone and estrogen levels occur, triggering menstruation.
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