Contraception/Menopause √

Question 1

2 forms of emergency contraceptive

Answer 1

Pill
IUD if within 5 days

Question 2

Can estrogen suppress ovulation

Answer 2

No just helps the bleeding

Question 3

Estrogen side effects (ACHES)

Answer 3

A - abdominal pain (severe)
C - chest pain, SOB, coughing blood
H - headaches (severe)
E - eye problems, vision loss/blurry
S - Severe leg/calf pain

STOP and contact PPO

Question 4

Estrogen dose and smoking

Answer 4

Answer 5

Question 6

how many generations and what are the meds

Answer 6

1st Ethynodiol diacetate
2nd Norgestrel
3rd Norgestimate
anti-androgen Drospirenone

Question 7

Monophasic

Answer 7

21/7 or 24/4 fixed E + P

Question 8

multiphasic

Answer 8

21/7 varrying levels of E + P

Question 9

Nuraring

Answer 9

insert 3wks/1wks

Question 10

Xulane

Answer 10

patch 3wks/1wks higher risk of VTE

Question 11

Annovera

Answer 11

reusable ring 21/7 up to 13 cycles

Question 12

patient educations for initiation of COC

Answer 12

need use backup for 7 days unless period was <5 days ago

Question 13

DDI of COC

Answer 13

Question 14

estrogen excess and deficiency

Answer 14

Question 15

progesterone excess and deficiency

Answer 15

Question 16

Opill

Answer 16

progesterone only pill
3hr window need to be taken

Question 17

injection progesterone

Answer 17

Depot medroxyprogesterone acetate
No need to dose for body weight
q3 months

Question 18

Progesterone implant

Answer 18

Nexplanon
every 3 years
but ammenohhera (loss of period)

Question 19

what is the weight cut off for EC

Answer 19

BMI > 25 and must give ella (uliprostal acetate)

Question 20

Biggest issue with EC

Answer 20

nausea

Question 21

IUD pros

Answer 21

10 year replacement
Can be used if obese, SLE and APS

Question 22

IUD cons/risks

Answer 22

Heavier flow
X low platelet counts
X in Wilson disease
Insertion pain
Delay if PID/current or STI

Question 23

When do you need to use back up method when starting new BC

Answer 23

<5 days after menstruation okay to not use back up
> 5 days need to use back up for 7 days

Question 24

Which are the category 4

Answer 24

focus on the greens

Question 25

perimenopause

Answer 25

40-50

Question 26

menopause

Answer 26

(40-58)

Question 27

Postmenopause

Answer 27

1 year after menopause

Question 28

vasomotor symptoms of menopause

Answer 28

1.hot flashes 2. night 3. sweats 4. warmth 5.chills

Question 29

Gastrointestinal symptoms of menopause

Answer 29

1. vaginal dryness 2. burning 3. irritation 4. sexual dysfunction 5. dysuria 6. dyspareunia 7. urinary urgency 8.recurrent UTIs

Question 30

psychological symptoms of menopause

Answer 30

1. Mood swings 2. Depression 3. Anxiety 4. Insomnia 5. Fatigue 6. Poor concentration 7. Forgetfulness

Question 31

What are the triggers of menopause symptoms

Answer 31

alcohol caffeine spicy food smoking

Question 32

treatment overview

Answer 32

Question 33

lifestyle modification for menopause

Answer 33

Avoid triggers (caffeine, alcohol, other) Layered clothing, lower room temperature Exercises Weight-bearing exercise Calcium and vitamin D supplementation Smoking cessation

Question 34

Premarin dosing

Answer 34

estrogen 0.3 mg or 0.45 mg

Question 35

Menest

Answer 35

Estrogen 0.3 mg

Question 36

Estrace

Answer 36

estrogen 1 mg or 2 mg

Question 37

when would i use vaginal estrogens

Answer 37

when they mainly have vagianal symtpoms

Question 38

What are the vaginal estrogens

Answer 38

Vagifem most common

Question 39

most common side effect for progestrone

Answer 39

weight gain, acne and vaginal bleeding

Question 40

most common side effect for estrogen

Answer 40

nausea, headache, VTE, Gallbladder diease

Question 41

when would i use sequential or cyclic combo for menopause

Answer 41

Preferred in late menopausal transition and early postmenopause (premphase)

Question 42

when would i use continuous combo for menopause

Answer 42

Best for patients at least 2 years postmenopausal and less cancer risk (Prempro)

Question 43

Duavee dosing

Answer 43

SERMS (0.45/20 mg PO QD)

Question 44

when would i use Duavee

Answer 44

bone, breast and endometrial issues

Question 45

When would i use OSPEMIFENE

Answer 45

more for vaginal tissue issues

Question 46

OSPEMIFENE dosing

Answer 46

60 mg po qd

Question 47

OSPEMIFENE AD

Answer 47

hot flashes, muscle spams and a lot of the same as menopause so not well liked

Question 48

Why would we use Duavee over ospenifene

Answer 48

bc of the side effect profile. less side effects that are like menopause

Question 49

Duavee side effects

Answer 49

muscle spams, nausea, diarrhea and sometimes mouth pain

Question 50

Duavee w/ or w/o food

Answer 50

w/ food

Question 51

Absolute MHT contraindication

Answer 51

1.Undiagnosed abnormal genital bleeding 2. History of breast cancer 3. Estrogen- or progesterone-dependent neoplasia 4. Active DVT, PE, or history of VTE 5. Active or recent (in past vear) arterial thromboembolic disease (stroke, MI) 6. Liver dysfunction/disease

Question 52

Condition to consider against for MHT

Answer 52

Question 53

what are SSRI used for

Answer 53

decrease hot flashes

Question 54

what 4 SSRI can we use

Answer 54

Question 55

What do we watch out for if patients want to take citalopram

Answer 55

QTC

Question 56

what do we use gabapentin or pregabalin for

Answer 56

hot flashes but also takes 4 weeks

Question 57

what non hormonal medication is last line

Answer 57

clonidine

Question 58

What medication do I give if the patient complains of sexual dysfunction as their main concern

Answer 58

Androgen therapy intrarosa or Covaryx

Question 59

Biggest side effect with Androgen therapy

Answer 59

virilization (becoming more male), hirsutism,