Female Reproductive Anatomy and Physiology Practice Questions

25 multiple-choice questions on Female reproductive anatomy and physiology for paramedic and EMT students, from Chapter 23 (Gynecologic Emergencies). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. Combined hormonal birth control pills prevent pregnancy mainly by:

   1. A. Killing sperm in the vagina
   2. B. Suppressing ovulation
   3. C. Blocking the fallopian tubes for good
   4. D. Causing the uterus to contract
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   Answer: B. Suppressing ovulation

   Estrogen-progestin pills suppress the hormone surge that triggers ovulation and thicken cervical mucus. They do not kill sperm (spermicides do) and do not permanently block the tubes (tubal ligation does).

2. After it is released at ovulation, an egg can be fertilized for only about:

   1. A. 5 to 10 minutes
   2. B. 7 to 10 days
   3. C. The whole next cycle
   4. D. 12 to 24 hours
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   Answer: D. 12 to 24 hours

   The egg survives roughly 12 to 24 hours after ovulation, while sperm can survive several days. That is why the fertile window includes the days before ovulation.

3. Endometrial (uterine) cancer is more common in women with:

   1. A. Obesity and unopposed estrogen
   2. B. A history of strep throat
   3. C. Regular exercise and normal weight
   4. D. Several pregnancies in their 20s
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   Answer: A. Obesity and unopposed estrogen

   Fat tissue makes estrogen, and estrogen without progesterone stimulates the uterine lining, raising the risk of endometrial cancer, which often presents as postmenopausal bleeding. Pregnancy and a normal weight lower the risk.

4. The normally acidic environment of the vagina helps to:

   1. A. Help sperm survive longer
   2. B. Keep the tissue lubricated
   3. C. Prevent infection
   4. D. Control the menstrual flow
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   Answer: C. Prevent infection

   Lactobacilli keep the vaginal pH acidic, which discourages overgrowth of harmful organisms. When this balance is disturbed, as with antibiotics or douching, yeast infections and bacterial vaginosis become more likely. The acidity is actually hostile to sperm, lubrication comes from glandular secretions, and pH does not control menstrual flow.

5. A woman breastfeeding a 3-week-old has a fever and a red, hot, tender wedge-shaped area on one breast. This is most likely:

   1. A. Mastitis
   2. B. Breast cancer
   3. C. A normal milk let-down
   4. D. Shingles
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   Answer: A. Mastitis

   Mastitis is inflammation, often with infection, of the breast during lactation and causes fever, malaise, and a red, tender area. A fluctuant mass suggests an abscess that needs drainage. Breastfeeding usually continues.

6. Sperm can survive in the female reproductive tract for up to about:

   1. A. 2 hours
   2. B. 1 month
   3. C. 6 months
   4. D. 5 days
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   Answer: D. 5 days

   Sperm can remain viable for up to about 5 days, so intercourse several days before ovulation can lead to pregnancy. This is one reason a woman may be unsure when she conceived.

7. A common functional ovarian cyst forms when:

   1. A. The uterus sheds its lining too early
   2. B. A follicle does not release its egg
   3. C. Sperm travel into the ovary itself
   4. D. An IUD moves up into the ovary
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   Answer: B. A follicle does not release its egg

   Follicular cysts develop when a maturing follicle does not rupture at ovulation and keeps growing; corpus luteum cysts form after ovulation. Most resolve on their own but can rupture, bleed, or lead to torsion.

8. Menarche is:

   1. A. The final end of menstruation
   2. B. Painful menstruation
   3. C. The first menstrual period
   4. D. Absence of menstruation
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   Answer: C. The first menstrual period

   Menarche usually occurs between ages 10 and 15. Menopause is the permanent end of periods.

9. After menopause, the drop in estrogen most increases a woman's risk of:

   1. A. Acute appendicitis
   2. B. Osteoporosis and fractures
   3. C. Kidney stones
   4. D. Tension headaches and migraines
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   Answer: B. Osteoporosis and fractures

   Estrogen helps maintain bone density, so bone loss speeds up after menopause, making low-energy fractures of the hip, wrist, and spine more likely. Consider fractures after minor falls in older women.

10. Why is postmenopausal vaginal bleeding concerning?

    1. A. It is normal after age 50
    2. B. It means pregnancy
    3. C. It only occurs with infection
    4. D. It may signal uterine cancer
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    Answer: D. It may signal uterine cancer

    Bleeding after menopause needs evaluation because endometrial cancer is a key cause.

11. Menstrual cramps are caused mainly by:

    1. A. Prostaglandins contracting the uterus
    2. B. Blood clots blocking the fallopian tubes
    3. C. Infection of the uterine lining
    4. D. Low blood sugar during the period
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    Answer: A. Prostaglandins contracting the uterus

    The shedding endometrium releases prostaglandins that make the uterus contract and reduce its blood flow, causing cramping pain. This is why NSAIDs relieve primary dysmenorrhea. Infection is not the cause.

12. A woman who is exclusively breastfeeding her 2-month-old has not had a period. This is usually because:

    1. A. She must have a pituitary tumor
    2. B. Her uterus has been injured
    3. C. Breastfeeding suppresses ovulation
    4. D. She has entered menopause unusually early
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    Answer: C. Breastfeeding suppresses ovulation

    Frequent breastfeeding raises prolactin, which suppresses ovulation (lactational amenorrhea). Protection is not complete, so pregnancy is still possible, especially as feeding becomes less frequent.

13. Normal blood loss over an entire menstrual period is about:

    1. A. 2 to 3 mL
    2. B. 500 mL
    3. C. 1 to 2 liters
    4. D. 30 to 40 mL
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    Answer: D. 30 to 40 mL

    Typical menstrual loss is about 30 to 40 mL; more than 80 mL is considered heavy and can cause iron-deficiency anemia over time. Losses of 500 mL or more in a period suggest hemorrhage.

14. In girls, the first sign of puberty, usually 2 to 3 years before the first period, is typically:

    1. A. Breast development
    2. B. A growth of facial hair
    3. C. A deepening voice
    4. D. The first menstrual period itself
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    Answer: A. Breast development

    Breast budding (thelarche) is usually the first sign of female puberty, followed by pubic hair, a growth spurt, and menarche about 2 to 3 years later.

15. A woman over 35 who smokes and takes an estrogen-containing pill is at higher risk of:

    1. A. Ovarian and uterine cancer
    2. B. Stroke and heart attack
    3. C. Iron-deficiency anemia
    4. D. Low blood pressure
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    Answer: B. Stroke and heart attack

    Estrogen plus smoking increases the risk of arterial clotting events such as stroke and MI, especially after age 35, which is why combined pills are avoided in this group. Estrogen also raises venous clot risk. Combined pills lower the risk of ovarian and uterine cancer and of anemia, and estrogen tends to raise rather than lower blood pressure.

16. Which organ lies directly in front of the uterus and is easily injured in pelvic trauma?

    1. A. Kidney
    2. B. Spleen
    3. C. Bladder
    4. D. Large bowel
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    Answer: C. Bladder

    The bladder sits anterior to the uterus. The rectum is posterior.

17. The external female genitalia are collectively called the:

    1. A. Vulva
    2. B. Cervix
    3. C. Perineum only
    4. D. Fundus
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    Answer: A. Vulva

    The vulva includes the labia, clitoris, and vaginal and urethral openings.

18. Bartholin glands are located:

    1. A. Inside the uterus
    2. B. On the ovaries
    3. C. Along the fallopian tubes
    4. D. Near the vaginal opening
    Show answer

    Answer: D. Near the vaginal opening

    These glands secrete lubrication and can become blocked or infected, forming a painful abscess.

19. The uterus is supported in the pelvis by:

    1. A. The pelvic diaphragm alone
    2. B. The lower ribs and spine
    3. C. Ligaments and pelvic muscles
    4. D. The bladder, ureters, and rectum
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    Answer: C. Ligaments and pelvic muscles

    Weakening of these supports with age and childbirth can cause prolapse.

20. Premenstrual dysphoric disorder (PMDD) differs from ordinary PMS because it:

    1. A. Begins after menopause
    2. B. Severely impairs mood and function
    3. C. Is caused by an infection
    4. D. Causes no emotional or mood symptoms
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    Answer: B. Severely impairs mood and function

    PMDD causes severe depression, irritability, or anxiety in the week before menses that disrupts work and relationships and can include suicidal thoughts. Ask about safety when a patient describes severe cyclic mood symptoms.

21. A woman of childbearing age with abdominal pain should be asked about:

    1. A. Her blood type
    2. B. Her last period
    3. C. Her last tetanus shot
    4. D. Her family cancer history
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    Answer: B. Her last period

    LMP helps assess pregnancy risk. Ectopic pregnancy must be considered.

22. A home urine pregnancy test usually turns positive around the time of:

    1. A. Fertilization itself
    2. B. The first fetal kick
    3. C. The first missed period
    4. D. The end of the first trimester
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    Answer: C. The first missed period

    Urine tests detect hCG, which rises enough to be detected around the time of the missed period, about 2 weeks after conception. A test taken earlier may be falsely negative.

23. Menstruation begins each month when no pregnancy occurs because:

    1. A. Estrogen suddenly doubles
    2. B. The LH surge peaks
    3. C. hCG levels rise
    4. D. Progesterone levels fall
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    Answer: D. Progesterone levels fall

    Without pregnancy, the corpus luteum breaks down and progesterone falls, and the lining it was supporting sheds as menstrual flow. If pregnancy occurs, hCG keeps the corpus luteum making progesterone. The LH surge triggers ovulation at mid-cycle, and rising hCG is a sign of pregnancy.

24. The vaginal canal is lined with:

    1. A. Mucous membrane
    2. B. Serous membrane
    3. C. Keratinized skin
    4. D. Skeletal muscle
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    Answer: A. Mucous membrane

    The vagina is a muscular canal lined with mucous membrane, which can tear and bleed. Serous membranes line closed body cavities, the vaginal surface is not keratinized like skin, and its wall muscle is smooth, not skeletal.

25. Why are many reproductive organs vulnerable to severe bleeding?

    1. A. They have no blood vessels
    2. B. They are protected by bone
    3. C. They have rich blood supply
    4. D. They clot faster than other organs
    Show answer

    Answer: C. They have rich blood supply

    The uterus and ovaries are highly vascular, especially during pregnancy, so injury can cause significant hemorrhage.