Question 1 1. Samira is a 26-year-old female with a history of intense dysmenorrhea. She experience menarche at age 11. Her menstrual cycles average 25 days in length.

Question 1 1. Samira is a 26-year-old female with a history of intense dysmenorrhea. She experience menarche at age 11. Her menstrual cycles average 25 days in length. She has a BMI of 18. Her menstrual cycle pain had decreased over the last 3 years while she was consistently taking birth control pills. However, she is now planning her first pregnancy and has been off birth control for 6 months now. She has yet to conceive, even though she and her partner have been carefully timing intercourse and monitoring Samira’s fertility window each month. Her dysmenorrhea has returned and she has developed menometrorrhagia, along with other cyclical symptoms like diarrhea, bloating, and craving salty foods. Samira’s physician is concerned that she may have endometriosis. Briefly explain the pathophysiology of this condition. Question 2 1. Which of Samira’s symptoms is most likely NOT related to endometriosis? Craving salty food Diarrhea Dysmenorrhea Bloating Question 3 1. Why would Samira’s dysmenorrhea symptoms decrease when taking birth control pills? Question 4 1. List and briefly describe 3 risk factors Samira has for endometriosis. Question 5 1. Aside from the symptoms Samira has, which of the following symptoms is also likely for women who experience endometriosis? (Select all that apply.) Fatigue Pain with bowel movements Pain with intercourse Increased likelihood of gonorrhea Increased risk of genital warts Question 6 1. Samira’s physician wants to perform several tests to diagnose her condition. Which of the following procedures would NOT be helpful in diagnosing endometriosis? Pap smear Ultrasound Pelvic exam Laparoscopy Question 7 1. If Samira still wishes to become pregnant, which treatment option may decrease her symptoms while allowing fertilization and implantation of an ovum? Progestin therapy Depo-Provera Estrogen-Progesterone patch Conservative surgery Question 8 1. List and describe 3 lifestyle or at-home treatments that may help Samira reduce her symptoms. Question 9 1. Which of the following statements is true? Women with endometriosis always have symptoms of the disease, even if they are only mild symptoms. Patients under 25 years of age with endometriosis are often treated with surgical hysterectomy. In endometriosis, endometrial tissue only grows on reproductive organs and cannot affect other structures in the pelvic or abdominal cavity. About 1/3 of women with endometriosis struggle with infertility. Question 10 1. Which of the following statements is true? Genetics play no role in endometriosis. Women who have mothers, aunts, and sisters with endometriosis are more likely to develop the condition themselves. Endometriosis is typically diagnosed after menopause. Exposure to estrogen through foods, medications, and other environmental factors does not contribute to a woman’s risk of endometriosis. Question 11 1. Donald is a 62-year-old male who has been experiencing frequent urination and trouble starting to urinate for several weeks. He has a family history of benign prostatic hyperplasia. Donald’s BMI is 29, he occasionally drinks alcohol and coffee, and his diet consists mainly of red meat, starches, and dairy products. Just yesterday, he had an episode of incontinence and decided to seek care immediately. Donald was referred to an urologist who suspected that his prostate was the cause of his urinary issues. Which of the following conditions could be causing Donald’s urinary symptoms? (Select all that apply.) Erectile dysfunction Benign prostatic hyperplasia Prostate cancer Urinary tract infection Question 12 1. Briefly explain how Donald’s prostate could be related to his inability to urinate normally. Question 13 1. Which of the following statements is true? BPH increases the risk of prostate cancer. Prostate cancer is typically diagnosed in men under 40 years of age. Early prostate cancer may cause no symptoms at all. Both prostate cancer and BPH often cause radiating pain into the lower extremities, bilaterally. Question 14 1. Donald’s urologist performs a digital rectal exam and finds the surface of the prostate to be hard and many nodules are present. Based on these findings, which of the following is most likely? BPH Prostate cancer UTI Kidney stones Question 15 1. Explain what a prostate-specific antigen test is and how it could be helpful for Donald. Question 16 1. “Watchful waiting” is a treatment approach commonly used in cases involving the prostate. Explain what this means and why it is used. Question 17 1. Medications like alpha-blockers may help relieve Donald’s symptoms by: Relaxing the muscles at the base of the bladder. Increasing the amount of urine filtered through the kidneys. Increasing blood pressure Diluting the urine’s concentration Question 18 1. Donald’s physician recommends a surgery called “transurethral resection of the prostate”. Briefly describe how this procedure is performed. Be sure to use anatomical terms. Question 19 1. If Donald is diagnosed with prostate cancer, his treatment will depend on the stage of the cancer. Which of the following is true? Early stages of cancer are always metastatic. Cancer staging is measure by three factors- tumor size and location, lymph node involvement, and metastasis. Prostate cancer that involves lymph nodes is the earliest stage of cancer. Tumors that are classified as T1 always cause urinary symptoms. Question 20 1. Donald is experiencing urinary symptoms, but prostate conditions can also interfere with the male reproductive system. Which of the following statements is true? Donald should be worried about developing erectile dysfunction, as it is a common side effect of prostate enlargement. Prostate enlargement can impair a male’s ability to produce sperm. Some forms of prostate enlargement, such as prostate cancer, can occlude the ejaculatory duct and cause painful ejaculation. Early stages of prostate cancer often occlude the epididymis, blocking the transportation of sperm.

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