GWSS/PSYCH 357FINAL EXAM REVIEW

ReviewContraception Unwanted Pregnancy

Pregnancy & Childbirth

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Menopause

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 endometrium-

prevents build up.

Contraception – 20 PointsQUESTION:

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 oviduct5. prevents adequate build-up of the endometrium such that

implantation is unlikely.

Contraception – 30 PointsQUESTION:

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 implantationNO. 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 PointsQUESTION:

What are the advantages and disadvantages of IUD’s?

ANSWER: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

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

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 PointsQUESTION:

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 PointsQUESTION:

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 PointsQUESTION: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 epidermisMesoderm Skeletal system, musculature, vasculatureEndoderm 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 PointsQUESTION:

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 PointsQUESTION:

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 PointsQUESTION: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:3. a) An increase in negative moods and behaviors premenstrually.

b) And sometimes an increase in positive moods during the follicular phase or midcycle.

4. 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 PointsQUESTION:

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.

Progesteronea) Levels low on Day 1b)Stay very low throughout the preovulatory phasec) Increase during the postovulatory phase with the development of the corpus luteumd) Drop off just before menses with the death of the corpus luteum

Review – 50 PointsQUESTION:

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