GYNE SE2 menopause

Question 1

absence of menstrual periods for at least 6 months in a woman over 40

Answer 1

menopause

Question 2

more rapid oocyte depletion and hypoestrogenism starting age 37

Answer 2

perimenopause

Question 3

time between onset of irregular AND permanent cessation of menses

Answer 3

perimenopause

Question 4

premature menopause before age 40

Answer 4

premature ovarian failure

Question 5

hormonal changes in perimenopause

Answer 5

decreased INHIBIN and increased FSH

Question 6

hormonal changes in established menopause

Answer 6

marked reduction in ESTRADIOL (plus dec inhibin and inc FSH too)

Question 7

first symptom of menopause

Answer 7

menstrual irregularities

Question 8

thin lola vs fat lola during menopause - anong difference

Answer 8

thin lola prone to DRYNESS; fat lola prone to hyperplasia and BLEEDING

Question 9

how to diagnose menopause

Answer 9

use signs and symptoms and physical exam

Question 10

treatment for asymptomatic women

Answer 10

NONE

Question 11

2 main indications of hormonal therapy

Answer 11

for symptomatic women AND to prevent osteoporosis and heart disease

Question 12

most effective treatment for vasomotor symptoms

Answer 12

LOW DOSE hormone therapy (ex. 0.3 mg CEE)

Question 13

route for those with liver problems

Answer 13

transdermal (0.25 mg transdermal estradiol)

Question 14

hormonal treatment for vulvovaginal symptoms

Answer 14

HRT including tibolone

Question 15

first line tx for mood disorders

Answer 15

not HRT but anti-depressants

Question 16

explain the “window of opportunity” concept

Answer 16

HT may be cardioprotective if started around the time of menopause and continued long-term

Question 17

risk for ________ (disease) is INCREASED in women on HRT

Answer 17

venous thromboembolism

Question 18

for women over 60 with rish of osteoporosis, must take ___

Answer 18

raloxifene, biphosphonates or strontium ranelate.. AND .8-1g calcium and 800 IU vitamin D

Question 19

differentiate advantages/disadvantages of two types of HRT regimens

Answer 19

CYCLIC has predicatble and controlled bleeding, CONTINUOUS has good compliance but irregular bleeding

Question 20

hormonal therapy for vasomotor sx, sexual well-bein, vulvovaginal symptoms

Answer 20

TIBOLONE 2.5 mg / day

Question 21

non-HT indicated for hot flushes with depression (SNRI class)

Answer 21

desvenlafaxine

Question 22

woman on HRT with persistent irregular BLEEDING –> how to evaluate

Answer 22

(+) ultrasound -> (+) hysteroscopy –> biopsy –> D&C