Part I — Hormonal Regulation

• The HPO axis (hypothalamus → pituitary → ovary → uterus)
• Hypothalamic anatomy and nuclei (arcuate, supraoptic, paraventricular)
• GnRH: decapeptide structure, pulsatile secretion rules, downregulation vs. upregulation, feedback loops (long/short/ultrashort)
• Anterior pituitary: FSH, LH, prolactin, GH, ACTH roles
• Posterior pituitary: oxytocin (parturition, milk letdown) and vasopressin

Part II — Menstrual Cycle

• Normal parameters (21–35 days, 2–6 days flow, 20–60 mL blood loss)
• 8-step sequential hormonal events from follicular through luteal phase
• Endometrial changes (proliferative vs. secretory phases)
• Folliculogenesis table: 5 stages with sizes, features, and gonadotropin dependence
• Two-cell theory of estrogen synthesis
• Corpus luteum lifespan and luteolysis

Part III — Gynecologic Examination

• Patient-centered approach: communication, confidentiality, cultural sensitivity
• Complete history components (menstrual, obstetric, medical, surgical, social)
• Abdominal exam: systematic palpation, rebound tenderness
• Speculum exam: technique, vaginal and cervical inspection checklist
• Bimanual exam: uterus, cervix (CMT), adnexa assessment
• Rectovaginal exam and rectal exam technique
• Special considerations for adolescents and patients with intact hymen