Advanced Pathophysiology Across The Lifespan
A 13-year-old female is undergoing rapid development of her breasts after experiencing menarche several months ago. Which of the following hormones are NOT active in the development of her breasts?
A 51-year-old woman who has been receiving estrogen and progesterone therapy (EPT) for the last 5 years has visited her care provider because her peers have told her about the risks of heart disease, stroke, and breast cancer that could accompany hormone therapy (HT). How should her care provider respond to her concerns?
“There is a demonstrable increase in breast cancer risk with HT, but the risk of stroke or heart disease actually goes down slightly.”
“All things considered, the benefits of HT outweigh the slightly increased risks of heart disease, stroke, or breast cancer.”
“HT is actually associated with a decrease in heart disease risk, but there is an increase in stroke risk; the breast cancer connection is still unclear.”
“There’s in fact a slight protective effect against stroke associated with HT, but this is partially offset by increased rates of heart disease and breast cancer.”
After a long and frustrating course of constant vaginal pain, a 38-year-old woman has been diagnosed with generalized vulvodynia by her nurse practitioner. What treatment plan is her nurse practitioner most likely to propose?
Alternative herbal therapies coupled with antifungal medications
Antidepressant and antiepileptic medications
Lifestyle modifications aimed at accommodating and managing neuropathic pain
Narcotic analgesia and nonsteroidal anti-inflammatory medications
Which of the following situations would be considered pathologic in an otherwise healthy 30-year-old female?
The woman’s ovaries are not producing new ova.
The woman’s ovaries do not synthesize or secrete luteinizing hormone (LH).
The epithelium covering the woman’s ovaries is broken during the time of ovulation.
The woman’s ovaries are not producing progesterone
A 24-year-old woman has presented to an inner-city free clinic because of the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginalis. What is the woman’s most likely treatment and prognosis?
Abstinence will be required until the infection resolves, since treatments do not yet have proven efficacy.
Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease.
Antifungal medications are effective against the anovulation and risk of HIV that accompany the infection.
Vaginal suppositories and topical ointments can provide symptom relief but cannot eradicate the microorganism.
A 71-year-old man has visited his nurse practitioner for a check-up, during which the nurse practitioner has initiated a discussion about the patient’s sexual function. Which of the following phenomena would the nurse practitioner most likely consider a pathological rather than an age-related change?
The presence of relative or absolute hypogonadism
A decrease in the size and firmness of the patient’s testes
Cessation of FSH production
A decrease in the force of the man’s ejaculation
A 57-year-old woman who has been diagnosed with atrophic vaginitis has expressed her surprise to her care provider, citing a lifetime largely free of gynecological health problems. She has asked what may have contributed to her problem. How can the care provider best respond?
“The lower levels of estrogen since you’ve begun menopause make your vagina prone to infection.”
“Vaginitis is not usually the direct result of any single problem, but rather an inevitability of the vaginal dryness that accompanies menopause.”
“This type of vaginitis is most commonly a symptom of a latent sexually transmitted infection that you may have contracted in the distant past.”
“The exact cause of this problem isn’t known, but it can usually be resolved with a diet high in probiotic bacteria.”
A 29-year-old woman has been trying for many months to become pregnant, and fertilization has just occurred following her most recent ovulation. What process will now occur that will differentiate this ovulatory cycle from those prior?
Human chorionic gonadotropin will be produced, preventing luteal regression.
The remaining primary follicles will provide hormonal support for the first 3 months of pregnancy.
The corpus luteum will atrophy and be replaced by corpus albicans.
The basal layer of the endometrium will be sloughed in preparation for implantation.
A 20-year-old male has been diagnosed with a chlamydial infection, and his primary care provider is performing teaching in an effort to prevent the patient from infecting others in the future. Which of the following statements by the patient demonstrates the best understanding of his health problem?
“Either me or a partner could end up with an eye infection from chlamydia that could make us blind.”
“Even though I couldn’t end up sterile, a woman that I give it to certainly could.”
“Each of the three stages of the disease seems to be worse than the previous one.”
“Even if I spread it to someone else, there’s a good chance she won’t have any symptoms or know she has it.”
A 40-year-old male patient with multiple health problems has been diagnosed with a testosterone deficiency. Which of the following assessment findings would his care provider attribute to an etiology other than this deficiency?
The patient has a voice that is unusually high in pitch.
The patient has long-standing anemia and low red cell counts.
The patient has a history of susceptibility to upper respiratory infections.
The patient has a low muscle mass as a proportion of total body weight.
A 66-year-old man has presented to a nurse practitioner to get a refill for his antiplatelet medication. The patient has a history of ischemic heart disease and suffered a myocardial infarction 5 years ago and has unstable angina; he uses a transdermal nitroglycerin patch to control his angina. The patient has a 40-pack-year smoking history and uses nebulized bronchodilators at home for the treatment of transient shortness of breath. He has long-standing hypertension that is treated with a potassium-sparing diuretic and a ß-adrenergic blocking medication. During the nurse’s assessment, the man notes that he has been unable to maintain his erection in recent months. Which of the following aspects of the man’s health problems and treatments would the nurse identify as NOT being contributing to his erectile dysfunction (ED)?
His antihypertensive medications
His use of bronchodilators
His ischemic heart disease
His smoking history
Which of the following statements best captures an aspect of normal spermatogenesis?
Testosterone chemically lyses each primary spermatocyte into two secondary spermatocytes with 23 chromosomes each.
Sertoli cells differentiate into spermatids, each of which can contribute half of the chromosomes necessary for reproduction.
Spermatogonia adjacent to the tubular wall undergo meiotic division and provide a continuous source of new germinal cells.
Each primary spermatocyte undergoes two nuclear divisions, yielding four cells with 23 chromosomes each.
A 39-year-old male patient has been recently diagnosed with primary hypogonadism. Which of the following lab results would be most indicative of this diagnosis?
Normal levels of free testosterone; low levels of total testosterone
Low free testosterone, LH, and FSH levels
Low levels of GnRH
Low testosterone levels; normal levels of LH and FSH