GA Care GAH-induced emotional lability √

Question 1

Male puberty blockers

Answer 1

slows growth of facial/body hair, prevent voice deepening, and limit growth of the penis, scrotum and testicles

Question 2

female puberty blockers

Answer 2

limits or stops breast development and stops menstruation

Question 3

Why would we used puberty blockers

Answer 3

Prevents the adverse mental toll and gives them the option without irreversible changes

Question 4

Feminizing hormone general approach

Answer 4

Androgen blocker + estradiol but at way higher doses

Question 5

drug of choice for Anti-Androgen

Answer 5

Spironolactone 100-400mg

Question 6

what drug do we use if intolerant to spirono/want partial transition

Answer 6

Dutasteride preferred over finasteride

Question 7

Estradiol formulation for feminizing

Answer 7

DOC: 17β-estradiol (“estradiol”) products
Conjugated estrogens
Ethinyl estradiol

Question 8

Conjugated estrogens cons

Answer 8

Inability to accurately measure blood levels
Potential of increased thrombotic and CV risk

Question 9

Ethinyl estradiol cons

Answer 9

Associated with increased thrombotic risk

Question 10

what are the routes of admin of estradiol

Answer 10

Question 11

what are the irreversible effects of feminizing hormones

Answer 11

Breast growth
Decreased spermatogenesis

Question 12

Expected onset of feminizing hormones

Answer 12

Question 13

Side effects or Estrogen

Answer 13

Sexual dysfunction
Decreased libido
Migraines
Weight gain
Venous thromboembolism
Elevated liver enzymes
Hypertriglyceridemia
Gallstones
Hot flashes
Moodswings

Question 14

Estrogen 3 contraindications

Answer 14

1. VTE related to underlying hypercoagulable state
2. Estrogen-sensitive neoplasm (higher risk of breast cancer)
3. End-stage liver disease

Question 15

hormone levels for trans females goals

Answer 15

Estradiol: 200 pg/ml
Testosterone: <55 ng/dl

Question 16

labs to monitor

Answer 16

potassium, renal function, prolactin, BUN

Question 17

Masculinizing hormone general approach

Answer 17

Testosterone monotherapy, Same dosing

Question 18

DOC for Masculinizing hormones

Answer 18

Cypionate (DOC) 50-100mg Q2wk or 25-50mg SQ/IM Q1wk (1 week better bc keeps peaks at better levels)

Question 19

what do pt perfer weekly over biweekly treatment

Answer 19

keeps the peaks better and less mood swings

Question 20

Masculinizing irreversible effects

Answer 20

Facial/body hair growth
Deepened voice
Clitoral enlargement

Question 21

Expected onset of Masculinizing hormones

Answer 21

Question 22

Testosterone side effects

Answer 22

Polycythemia/Erythrocytosis (less with patch)
Weight gain
Mood lability
Increased sex drive
infertility
Lower HDL cholesterol

Question 23

What is the DDI with testosterone

Answer 23

Warfarin increases the risk of bleeding
(not X might need to lower dosing of warfarin)

Question 24

hormone levels for trans males goals

Answer 24

Testosterone: 500-700 ng/dl
Estradiol: <50 pg/ml

Question 25

Labs monitoring for Masculinizing

Answer 25

CBC (Hemoglobin/hematocrit)

Question 26

What screening should we do for Transfeminine

Answer 26

Prostate cancer Breast cancer

Question 27

What screening should we do for Transmales

Answer 27

Chest screening Cervical cancer

Question 28

how to calc renal function for Transitioning genders

Answer 28

first 6 month sex assigned at birth then use the gender they transitions to

Question 29

What are 2 patient educations for transitioning care

Answer 29

It's slow and takes time your emotions may not be stable

Question 30

Which pts are at risk for HIV

Answer 30

black and male

Question 31

NEED TO ADD MEDS

Question 32

LAB CHECKING