I. Instructions : For each of the following questions choose: A. If only 1,2 and 3 are correct. B.

If only 1 and 3 are correct. C. If only 2 and 4 are correct. D. If only 4 is correct. E. If all are correct. 1, The heaviest bleeding is secondary to high sustained levels of estrogen associated with : 1. polycystic ovaries. 2. obesity. 3. immaturity of the hypotrhalamuc-pituitary-ovarian axis. 4. late annovulation. E. 2. Well tested treatment regimen fpr control of anovulatory bleeding include : 1. spironolactone. 2. medroxyprogesterone acetate 10 mg QD for 10 days each month. 3. danocrine. 4. oral contraceptives twice a day for 5-7 days followed by daily use in subsequent months beginning day 5. C. 3. Women who are ovulating but have menorrhagia can be treated with : 1. prostaglandin inhibition. 2. progestin. 3. oral contraceptives. 4. danocrine. A. 4. Workup for dysfunctional uterine bleeding includes : 1. a physical exam with attention to the appearance of acne, hirsutism,galactorrhea. 2. laboratory tests such as coagulation studies,HCG,thyroid function tests,prolactin. 3. endometrial biopsy. 4. MRI A. 5. Estrogen therapy is useful in clinical situations associated with : 1. bleeding associated with polycystic ovarian disease. 2. breakthrogh bleeding occuring with use of oral contraceptives. 3. bleeding associated with residual polyps. 4. breakthrough bleeding associated with depo-progestional agents. C