1.) Lori, a 27 year old patient with diagnosed endometriosis, is curious about what causes the majority of her symptoms. The best response would be:
A. Symptoms are mainly due to the degree of endometriosis.
B. The location of ectopic bleeding of endometrial tissue is the main cause of symptoms.
C. Pain is caused by the endometriosis response to progesterone exposure.
D. Patients with endometriosis experience increased levels of pain due to abnormal hormone fluctuations.
B. is the correct answer. Symptoms of endometriosis are usually associated with the location of ectopic bleeding.
A. is incorrect, the experience symptoms are not usually related to the degree of endometriosis.
C. is incorrect, endometriosis is resistant to progesterone.
D. is incorrect, the displaced endometrial tissue responds to normal hormonal fluctuations of the menstrual cycle.
2.) Which of the following is NOT a common result of endometriosis?
A. Pelvic Pain.
B. Dyspareunia.
C. Production of ovarian cysts.
D. Infertility.
C. is the correct answer. Ovarian Cysts are not a result of endometriosis. However, to issue a definitive diagnosis due to the symptom similarity, ovarian cysts can and will need to be ruled out by a pelvic exam or ultrasound.
A, B, and C are incorrect because Pelvic Pain, Dyspareunia, and Infertility are all commonly caused by endometriosis.
3.) Erin, a 27-year-old patient with newly diagnosed endometriosis, is curious about the connection between endometriosis and infertility. Which statement by the provider is the most accurate?
A. “There is no connection between endometriosis and infertility.”
B. “Patients with endometriosis should have no difficulties with infertility after treatment.”
C. “Though there is a strong connection between endometriosis and infertility, the cause is unknown.”
D. “Many patients who have endometriosis find sex painful. Because they don’t have as much sex, this affects their fertility.”
C. is the correct answer. Though there is a strong connection between endometriosis and infertility, the cause is unknown. Possibilities include the presence of adhesions and inflammation causing a mechanical interference with ovulation or an underlying autoimmune disorder. Additional possibilities include the increased macrophage phagocytosis of sperm or a under-active uterine response to progesterone.
A. Is incorrect, there is a strong link between infertility and endometriosis.
B. Is incorrect, though there are treatments that aim to increase the chances of conceiving there is no cure to endometriosis. Patients may continue to struggle with fertility.
D. is incorrect, though many patients with endometriosis do report painful intercourse, this is not the cause of infertility.
4.) Susan, a 17 year old, has just been diagnosed with endometriosis. Which of the following statements by the patient displays a lack of understanding about the condition?
A. “I have pain because the endometrial tissue located outside of my uterus breaks down and bleeds with my normal menstrual cycle leading to inflammation and scarring.”
B. “I will work with my provider to create a treatment plan that will aim to prevent the progression and spread of the disease and alleviate my pain.”
C. “Because I have endometriosis I am infertile and do not have to worry about unwanted pregnancy.”
D. “My family has a history of endometriosis so it is possible that I have a genetic predisposition for the condition.”
C. is the correct answer. Even though a common symptom of endometriosis is infertility, it is still possible to become pregnant with this condition. Endometriosis should not be counted on to prevent unwanted pregnancies.
A, B, and D are incorrect because they display accurate understanding of the condition.
5.) Which of the following is NOT a risk factor for Endometriosis?
A. History of UTIs.
B. Early Menarche.
C. Menstrual bleeding for more than 7 days.
D. Menstrual cycle less than 27 days in length.
A. is correct. UTIs are infections of the Urinary Tract and are not associated with the development of endometriosis.
B, C, and D are incorrect because they are associated risks factors for endometriosis. Risk factors for Endometriosis include early menarche, nulliparity, family history, and menstrual irregularities including menstrual cycle length of less than 27 days, menstrual bleeding for greater than 7 days, and heavy menses.