GWSS/PSYCH 357
FINAL EXAM REVIEW
Contraception
Unwanted
Pregnancy
Pregnancy &
Childbirth
Menopause
Review
10
10
10
10
10
20
20
20
20
20
30
30
30
30
30
40
40
40
40
40
50
50
50
50
50
Contraception – 10 Points
QUESTION:
What are the contraceptive actions of copper in an IUD?
ANSWER:
•
•
•
•
increases inflammatory reaction to the IUD
decreases sperm viability
slows ovum transport
interferes with the actions of estrogen on the endometriumprevents build up.
Contraception – 20 Points
QUESTION:
What are the five actions of progestin in contraceptives?
ANSWER:
1. prevents ovulation by inhibiting LH and FSH production in
the anterior pituitary
2. stimulates the production of a thick, pasty cervical mucus.
3. inhibits capacitation of sperm
4. slows the rate of ovum transport through the oviduct
5. prevents adequate build-up of the endometrium such that
implantation is unlikely.
Contraception – 30 Points
QUESTION:
How does Plan B/Next Choice work? If a fertilized ovum has
already implanted, will Plan B/Next Choice work?
ANSWER:
Plan B/Next Choice works by:
• preventing ovulation
• slowing the rate of ovum or sperm transport
• reducing endometrial buildup, making the endometrium
unsuitable for implantation
NO. Plan B/Next Choice only works before implantation
Contraception – 40 Points
QUESTION:
What are the advantages and disadvantages of hormonal
contraceptives?
ANSWER:
Advantages
• may reduce the risk of ovarian cancer
during and after use
• decreased risk of endometrial and
colorectal cancer during use
• non-intrusive; it doesn’t interrupt sex
• easy to use
• highly effective
• reduction of menstrual blood loss
• reduced dysmenorrhea
Disadvantages
• no protection from STDs
• may cause irregular menses
or amenorrhea [particularly
progestin-only
contraceptives]
• reduced estrogen levels may
reduce bone density
Contraception – 50 Points
QUESTION:
What are the advantages and disadvantages of IUD’s?
ANSWER:
Advantages:
• 95-99% effective
• non-intrusive (in sex behavior)
• Long term effectiveness
• Reduced dysmenorrhea with
Mirena and Skylar
• Reduced menstrual blood loss
with Mirena and Skylar
Disadvantages:
• danger of uterine perforation on insertion
and removal
• increased menstrual blood loss with
ParaGard
• increased dysmenorrhea with ParaGard
• Increased risk of PID, which can lead to
infertility
• May increase risk of vaginal infections
• No protection from STDs
• May increase susceptibility to STDs
during first 3 months
• Inflammation may increase risk of
infertility
Unwanted Pregnancy – 10 Points
QUESTION:
How are psychological reactions different for abortions for
medical or eugenic reasons?
ANSWER:
• Medical (health of mother) - often followed by guilt
• Eugenic (health/ development problems with fetus) - often
followed by depression
Unwanted Pregnancy – 20 Points
QUESTION:
What happens during a medical abortion? What are the effects
of the medications administered?
ANSWER:
• Mefepristone (RU 486) & Misoprostol (prostaglandin) are
administered in pill form.
• Mefepristone results in the deterioration of the endometrium and
Misoprostol causes contractions of the uterus to expel contents.
• Patient must agree to have a surgical abortion if the medical
abortion is not effective (only 92-99% effective).
Unwanted Pregnancy – 30 Points
QUESTION:
What are the three types of surgical abortions and when are they
performed?
ANSWER:
1. Manual Vacuum aspiration (up to 10 weeks after start of last
menses)
2. Vacuum Aspiration (6 -14 weeks after start of last menses).
3. Dilation and Evacuation (used after 14 weeks).
• (Abortion is not used after 24 weeks except when there are serious
health risks for the woman)
Unwanted Pregnancy – 40 Points
QUESTION:
What factors have been found to be associated with increased
risk of negative outcomes after voluntary abortion?
ANSWER:
•
•
•
•
•
•
•
Previous psychiatric problems
mid-trimester abortion
low self-esteem
poor prior knowledge of contraception
ambivalence about decision
pregnancy highly meaningful to woman
not making own decision
Unwanted Pregnancy – 50 Points
QUESTION:
What are closed adoptions as opposed to open adoptions? What did Lauderdale and
Boyle’s study conclude about closed v. open adoptions?
ANSWER:
Definition: Open adoption is when the woman relinquishing helps
select the family and may receive news of the child after birth.
A closed adoption is done anonymously through an agency and the
woman usually has little contact with the child post birth and does
not know anything about the family she is relinquishing to.
Lauderdale & Boyle study:
• Both report avoiding developing attachment during pregnancy.
• Most relinquish their child due to pressure from others or financial problems.
• Women relinquishing in closed adoptions are more likely to have been
pressured by others, have less contact with the infant after birth, have poorer
pre-natal care and initiate the search for the child years later.
• Women relinquishing in open adoptions are more likely to admit pregnancy to
others and desire child to contact them but don’t initiate search.
Pregnancy & Childbirth – 10 Points
QUESTION:
What hormone is measured in pregnancy tests and why are
pregnancy tests uncertain in early pregnancy?
ANSWER:
HCG is measured and is similar to LH so the test is uncertain
until HCG levels are higher than LH levels would ever be in a
cycling woman.
Pregnancy & Childbirth – 20 Points
QUESTION:
What major hormones does the placenta produce? What is
unique about the way it produces one of these?
ANSWER:
• Estrogen (estrial)*
• Progesterone
• Human Placental Lactogen (and a number of other hormones similar to
those produced by the anterior pituitary)
*It can not make estrial from cholesterol so it makes it from androstenedione
provided by the fetal adrenal gland.
Pregnancy & Childbirth – 30 Points
QUESTION:
What comes from the ectoderm? Mesoderm? Endoderm?
ANSWER:
Ectoderm  Central nervous system, peripheral nervous system,
and epidermis
Mesoderm  Skeletal system, musculature, vasculature
Endoderm  Gut, lungs, liver
Pregnancy & Childbirth – 40 Points
QUESTION:
What are three common signs that labor has begun?
ANSWER:
• release of a small amount of blood with mucus from the vagina
(cervical plug)
• uterine contractions at intervals less than 10 minutes
• rupture of amniotic sac (water breaking)
Pregnancy & Childbirth – 50 Points
QUESTION:
What are the three phases of the first stage of labor? What
happens at each?
ANSWER:
Latent phase (contractions 5-20 min. apart, cervix 3-5 cm.)
Active phase (contractions 3-4 min. apart, cervix 4-7 cm.)
Transition (contractions every few minutes, cervix 8-10 cm.)
Menopause – 10 Points
QUESTION:
How can a woman tell whether she has gone through
menopause?
ANSWER:
Menopause has occurred if the woman has had no menses for 12
consecutive months.
Menopause – 20 Points
QUESTION:
How is body fat level related to a woman’s estrogen level after
menopause?
ANSWER:
High body fat is associated with higher post-menopause estrogen
levels since androstenedione from the adrenal cortex is converted
to estrogen (estrone) in fat.
Menopause – 30 Points
QUESTION:
What are the benefits and risks of Estrogen Replacement
Therapy (ERT)?
ANSWER:
Benefits: Can reduce estrogen-related symptoms of
menopause such as hot flashes, genital changes, loss of sex
drive, loss of calcium from bones, and risk of cardiovascular
disease
Risks: increases risk of endometrial cancer (so is rarely used
for women with an intact uterus)
Menopause – 40 Points
QUESTION:
What are some factors that a woman can control to reduce her risk of
osteoporosis? What are some factors a woman cannot control?
ANSWER:
Steps to Take:
• Have an active lifestyle (including
weight-bearing exercise).
• Avoid taking thyroid hormones.
• Don’t smoke.
• ERT/HRT stops calcium loss (but has
risks!).
• Non-estrogen treatments, such as
Fosomax and Boniva, increase bone
density.
• Consume adequate calcium.
Uncontrollable Factors:
• Being Caucasian or Asian.
• Being tall and thin (small-boned).
• Having early menopause (in your
20’s or 30’s) or surgical menopause
(removal of ovaries)
Menopause – 50 Points
QUESTION:
What happens to women’s levels of estrogen, progesterone,
GnRH, FSH and LH levels during menopause? What happens to
sex steroid production by the adrenal cortex?
ANSWER:
• Estrogen and progesterone production from the ovaries is
dramatically reduced.
• GnRH, FSH, and LH levels become very high.
• Hormone production by the adrenal cortex is unchanged.
Androstenedione from the adrenal cortex is converted to estrone in
fat.
Review – 10 Points
QUESTION:
What are the four things released at ovulation?
ANSWER:
•
•
•
•
Follicular fluid
corona radiate
sticky cumulus
the ovum
Review – 20 Points
QUESTION:
1. In recall studies, what symptoms do women report to be associated
with the menstrual cycle?
2. In concurrent studies, what relationships between mood and
behavior and the monthly cycle do women report?
ANSWER:
1. a) An increase in negative moods and behaviors premenstrually.
b) And sometimes an increase in positive moods during the follicular phase or
midcycle.
1. a) More positive moods and behaviors during the follicular phase or at mid-cycle.
b) They report no correlation between negative moods and behaviors and the
premenstrual phase of the cycle.
Review – 30 Points
QUESTION:
Male internal genitalia include what?
What is required for male internal genitalia to develop? Male
external genitalia?
ANSWER:
•Male internal genitalia include: seminal vesicles, epididymus, and
the ejaculatory ducts and tubes.
•Development of male internal genitalia requires: androgens,
Mullerian Inhibiting Factor, and inductor substance.
•Development of male external genitalia requires: Presence of
androgens and the ability to respond to androgens
Review – 40 Points
QUESTION:
Describe the estrogen and progesterone levels across the
monthly cycle:
ANSWER:
Estrogen
a) Levels increase on Day 1 and gradually
increase throughout the preovulatory phase
(because the follicles are growing)
b) Surge 24 hours prior to ovulation.
c) Levels decrease after surge (through
ovulation).
d)Levels rise during the postovulatory
phase as the corpus luteum develops.
Drop off just before menses when the
corpus luteum dies.
Progesterone
a) Levels low on Day 1
b)Stay very low throughout the
preovulatory phase
c) Increase during the postovulatory phase
with the development of the corpus
luteum
d) Drop off just before menses with the
death of the corpus luteum
Review – 50 Points
QUESTION:
What do CRH, TRH, Somatostatin, GHRH, GnRH, Dopamine
and PSH do? What does inhibin (not a releasing hormone)
do?
ANSWER:
•CRH - stimulates the production and release of ACTH
•TRH - stimulates the production and release of TSH
•Somatostatin - inhibits the production and release of GH
•GHRH - stimulates the production and release of GH
•GnRH - stimulates the production and release of both FSH and LH
•Dopamine - inhibits the production and release of prolactin
•PSH - stimulates the production and release of prolactin
•Inhibin - acts at the anterior pituitary to inhibit the production and release of FSH