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RDS Test 1 > B8-027 CBCL Menopause > Flashcards

B8-027 CBCL Menopause Flashcards

(73 cards)

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1
Q

menopause is confirmed after […] of no menstrual bleeding

A

1 year

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2
Q

premature menopause occurs before age […]

A

40

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3
Q

perimenopause begins with variation in cycle greater than […] days associated with increased […]

A

seven
FSH

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4
Q

which phase of menopause is the most symptomatic for women?

A

perimenopause

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5
Q

average age of onset of menopause

A

51

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6
Q

FSH consistently elevated over […] is considered diagnostic for menopause

A

30

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7
Q

menopause before age 40 suggests

A

primary ovarian failure

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8
Q

cause early induction of menopause

A

radiation
chemotherapy
bilateral oophorectomy

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9
Q

source of estrogen after menopause

A

peripheral conversion of androgens

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10
Q

what would you expect to see for FSH, LH, GnRH, and estrogen in a menopausal female?

A

FSH very high
LH high (no surge)
estrogen low
GnRH high

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11
Q

symptoms of menopause

A

Hot flashes
Atrophy of
Vagina
Osteoporosis
Coronary artery disease
Sleep disturbances

causes HAVOCS

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12
Q

how can early menopause result in shorter cycles?

A

as follicles decrease –> decreased inhibin –> less negative feedback on hypothalamus –> more FSH released

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13
Q

when the cycle length shortens, it is called

A

LOOP: luteal out of phase

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14
Q

what leads to the loss of LH surge in menopause?

A

GnRH pulses slow, but more GnRH is released
alterations of GnRH pulse cause this

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15
Q

is AMH useful in predicting when menopause will occur?

A

no

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16
Q

in premenopause […] is the dominate estrogen type
however, in post menopause it is […]

A

estradiol
estrone (formed via peripheral metabolism)

(ratio reverses after menopause)

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17
Q

most common cause of AUB

A

bleeding due to anovulation

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18
Q

in the workup of AUB endometrial biopsy is important to rule out [2]

A

endometrial hyperplasia
malignancy

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19
Q

most common symptom of menopause

A

sudomotor symptoms (hot flashes)

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20
Q

physiologic mechanism of hot flashes

A

estrogen narrows the thermoneutral zone

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21
Q

serum estrogen levels [are/are not] predictive of hot flash frequency

A

are not

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22
Q

treatment of hot flashes

A

lifestyle modifications
SSRI, gabapentin, clonidine

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23
Q

the sudomotor symptoms of menopause tend to […] over time, while the vulvo-vaginal symptoms […]

A

get better
progressively worsen

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24
Q

people with surgical menopause [are/are not] considered to have POI

A

are not

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25
diagnosis of POI requires a minimum of [...] bleeding abnormally and at least [...] FSH levels drawn at least 1 months apart
4 months 2
26
why should patients with POI not desiring pregnancy still be on contraception?
ovary can occasionally ovulate
27
HT used to protect women with a uterus from endometrial cancer
estrogen-progesterone therapy
28
HT consisting of hormones chemically identical or very similar to those made in the body
bioidentical hormone therapy (generally not recommended by ACOG unless dosing is not commercially available or there is an allergy)
29
HT useful for perimenopausal transition to treat symptoms and prevent bleeding and pregnancy
hormone contraception
30
primary estrogen during reproductive years
estradiol
31
primary estrogen circulating after menopause
estrone
32
estrogen produced primarily by the placenta during pregnancy
estriol
33
estrogen that comes from granulosa cells in dominant follicles
estradiol
34
estrogen that comes from aromatization in body fat
estrone
35
estrogen found in estrogen containing contraceptives
ethinyl estradiol
36
used to prevent endometrial cancer in women on estrogen therapy
progesterone
37
hormonal contraception is contraindicated in women over [...] who smoke
35
38
menopausal EPT will not suppress ovulation in perimenopausal women and can result in [...]
unpredictable bleeding
39
factors to consider in duration of HT use
severity of symptoms effectiveness of other treatments risk of osteoporosis risk of CAD risk of cerebrovascular event risk of DVT risk of breast cancer
40
does EPT or ET have a higher risk of breast cancer?
EPT
41
effect of oral estrogen on liver
increases fibrinogen, factors VII and X, triglycerides, and platelet aggregation decreases: antithrombin III
42
there is less risk of thromboembolism with [...] estrogen delivery
non-oral (transdermal)
43
women who initiate HT older than [...] are at a higher risk of cardiac event
60
44
there is some evidence that ET has antidepressant effects in what phase of menopause?
perimenopausal
45
mood changes are a side effect of [...] therapy that can worsen in patients with PMS or PMDD
progestin
46
in women with POI, it is recommended to continue HT until
average age of menopause
47
system of nomenclature for reproductive aging
STRAW staging system
48
evaluation of AUB after age 45 should include [3]
endometrial biopsy transvaginal US pregnancy test
49
3 major hormones synthesized in the ovary
estrogen progesterone testosterone
50
adverse effects of exogenous estrogen [4]
DVT stroke endometrial cancer postmenopausal bleeding
51
absolute contraindications for estrogen therapy
breast cancer thromboembolic event CVD
52
vasomotor symptoms typically occurs in [...] menopause
early
53
urogenital atrophy typically occurs in [...] menopause
late-post menopause
54
term used to describe menopausal transition and 12 months after FMP
perimenopause
55
menopause that occurs before age 40
premature menopause
56
does an ovarian sparing hysterectomy carry the risk of early menopause?
yes, hastens menopause by 2-3 years
57
major hormones secreted by the ovary during the follicular phase
estradiol inhibin B
58
predominant hormone secreted by the ovary in the luteal phase
progesterone
59
what can early follicular phase FSH tell you about a patient's ovarian reserve?
an ovary with a decreasing number of follicles will release lower levels of inhibin, so early follicular phase FSH will be **elevated**
60
risk factors of endometrial cancer [4]
age obesity infertility unopposed estrogen
61
risk factors for increased vasomotor symptoms [3]
obesity smoking decreased physical activity
62
caffeine, smoking, and spicy foods can worsen [...] symptoms
vasomotor
63
what would you expect to see on histologic examination of the vaginal epithelium during menopause?
loss of mature epithelial cells increase in parabasal cells
64
first line treatment for women with genitourinary syndrome
lubricants/moisturizers (then low dose estrogen if those don't work)
65
second line treatment for women with genitourinary syndrome
vaginal estrogen cream
66
levonorgestrel-releasing intrauterine system (Mirena) is FDA approved for contraception and [...]
abnormal uterine bleeding
67
often used in peri-menopause to regulate menses and help with vasomotor symptoms while providing contraception
oral contraceptive pills
68
[...] estrogen therapy is associated with a higher risk of DVT
oral
69
risk of DVT with estrogen therapy [is/is not] dose dependent
is
70
paroxetine is FDA approved to treat [...] symptoms without risk of thromboemolic event
vasomotor
71
unopposed estrogen increases risk for
endometrial cancer
72
if a patient has both vasomotor symptoms and GSM, what is the best treatment option?
systemic non-oral ET (patch) and progestin
73
start [...] estrogen therapy for GSM only symptoms
local (cream or vaginal ring)

RDS Test 1 (23 decks)

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