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Reproductive and sexual health > Exam 7- post-menopausal health > Flashcards

Exam 7- post-menopausal health Flashcards

1
Q

Definition of menopause?

A

Retrospective diagnosis made after 12 months amenorrheoa

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2
Q

What constitutes a) early b) premature menopause?

A

a) before 45

b) before 40

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3
Q

Main symptoms of the climacteric

a) vasomotor
b) urogenital
c) sleep
d) mood/libido
e) nails/skin/hair

A 
Vasomotor- hot flushes, sweats
Urogenital- dryness, recurrent UTI, dyspareunia
Sleep disturbance
Mood changes
Loss of libido
Brittle nails, thin skin and hair
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4
Q

HRT is protective against….(2)

A

Osteoporosis

Possibly Alzheimers

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5
Q

Risks of HRT (3)

A

Increased risk of:
stroke/VTE
Breast cancer
Endometrial cancer

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6
Q

The risk of which adverse effects of HRT are a) increased and b) decreased by inclusion of a progestogen?

A

a) breast cancer, VTE

b) endometrial cancer

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7
Q

Most suitable HRT for women

a) without a uterus
b) with a uterus, still have a period
c) post-menopausal, with a uterus

A

a) oestrogen-only continuous
b) cyclical combined HRT
c) continuous combined

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8
Q

What schedules of combined HRT are available and who are they most suitable for? (2)

A

Monthly (oestrogen every day, progesterone for 12-14 days at end of cycle) [regular period]
Three-monthly (take oestrogen every day and progesterone for 12-14 days, every 13 weeks)[best for women who have irregular periods]

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9
Q

Contraceptive options for patients taking HRT (2)

A

Barrier methods

Mirena IUS with added oestrogen in tablet/gel/patch form

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10
Q

For how long after the last period can women still become pregnant?

A

up to 2 years if under 50

up to 1 year if over 50

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11
Q

Alternative drugs for vasomotor symptoms (2)

A

Gabapentin

SSRIs

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12
Q

Main types of endometrial cancer (4)

A

Endometrioid and mucinous- oestrogen-related

Serous and clear cell- not oestrogen related

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13
Q

Risk factors for endometrial ca (3)

A

Obesity
Late menopause and nulliparity
PCOS

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14
Q

Endometrial cancer management

a) surgical
b) adjuvant

A

a) total hysterectomy with bilateral salpingo-oophorectomy

b) radiotherapy, high dose progestogens, chemotherapy

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15
Q

Why does obesity lead to higher oestrogen?

A

Androgens are converted to oestrogens in adipose tissue.

Sex hormone binding globulin is lower in obese people

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16
Q

Why do fibrioids rarely progress following menopause?

A

oestrogen-dependent

17
Q

Management of fibroids

a) medical
b) surgical

A

a) COCP, GnRH analogues

b) Myomectomy, hysteroscopic ablation, hysterectomy

18
Q

Nerve responsible for voluntary control of urination, mechanism

A

Pudendal nerve innervates the external urethral sphincter, contracts it

19
Q

Treatment of overactive bladder

A

Oxybutynin (anti-muscarinic)

20
Q

Drug therapy for stress incontinence

A

Duloxetine (SNRI)

21
Q

What are the three degrees of uterine prolapse?

A

1st- in vagina
2nd- at interoitus
3rd- outside vagina

22
Q

Types of physiological ovarian cyst

A

Follicular and corpus luteum cyst

23
Q

Types of epithelial ovarian cysts

A

Serous and mucinous (rupture can cause pseudomyxoma peritonei)

24
Q

What are ovarian fibromas?

A

Benign sex cord stromal tumours

25
Q

What is Meigs syndrome?

A

Fibroma + ascites + pleural effusion

26
Q

In what age group are dermoid cysts (teratomas) most common?

A

Young women

27
Q

Investigations in suspected ovarian mass (5)

A 
Pregnancy test
TVUS
CA-125
FNA cytology
AFP and bHCG (for dermoid cysts)
28
Q

What is the risk of malignancy index?

A

US score x menopause score x CA-125 score. Assesses the risk of ovarian malignancy in post-menopausal women

29
Q

Complications of benign ovarian masses (4)

A

Torsion
Haemorrhage
Rupture
Infertility

30
Q

Serum tumour marker used to monitor efficacy of treatment and recurrence in ovarian cancer

A

CA-125

31
Q

Management of ovarian cancer (3)

A

Total hysterectomy with bilateral sapingo-oophorectomy
Peritoneal inspection and washings
Infracolic omentecomy

Reproductive and sexual health (65 decks)

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