249.The answer is d.(Young, p 358. Junqueira, p 451. Strauss and Barbieri,
pp 262–270.)The patient described in this question is probably pregnant. The
delay in menstruation coupled with the presence of basophilic cells in a vagi-
nal smear are clues. Ovulation is the midpoint of the cycle and should be
more than a few days away (answers a and b).She is relatively young for the
onset of menopause and there are no other symptoms (answer e).The vagi-
nal epithelium varies little with the normal menstrual cycle. Exfoliative cytol-
ogy can be used to diagnose cancer and to determine if the epithelium is
under stimulation of estrogen and progesterone. The presence of basophilic
cells in the smear with the Pap-staining method would indicate the presence
of both estrogen and progesterone (answer c).The data suggest the mainte-
nance of the corpus luteum (i.e., pregnancy).
250.The answer is e.(Ross and pawlina, pp 781–782. Young, pp 347, 352.
Junqueira, pp 439–440. Kierszenbaum, p 572.)The structure in the photomi-
crograph is a corpus luteum. In the absence of the hormones necessary for
maintenance of the corpus luteum [luteinizing hormone (LH) or human
chorionic gonadotropin (hCG)], the corpus luteum regresses to form a cor-
pus albicans, which consists primarily of fibrous connective tissue. Without
LH or hCG, the uterine epithelium, which has undergone glandular prolifer-
ation in preparation for implantation, collapses and degenerates as part of
menstruation. The corpus luteum forms from the granulosa and theca layers
of the follicle following ovulation. The luteal phase is the second half of the
menstrual period and follows the follicular phase during which follicles
mature. The corpus luteum synthesizes progesterone in response to high LH
levels. In each reproductive cycle, the production of LH stimulates develop-
ment and maintenance of the corpus luteum, which is well formed by 12 to
14 days following ovulation. In the case of fertilization and subsequent
implantation, the corpus luteum of pregnancy is maintained by human
chorionic gonadotropin (hCG) produced by the embryo.
251.The answer is a.(Young, pp 349–352. Ross and Pawlina, p 791. Junqueira,
pp 444–446.)The spiral arteries of the endometrium (labeled Ain the dia-
gram accompanying the question) depend on specific estrogen/progesterone
ratios for their development. They pass through the basalis layer of the
endometrium into the functional zone, and their distal ends are subject to
degeneration with each menses. The straight arteries (B)are not subject to
these hormonal changes. In the proliferative phase, the endometrium is only
Reproductive Systems Answers 381