Menopause Flashcards Preview

Q4 Women's Health > Menopause > Flashcards

Flashcards in Menopause Deck (16):
1

Climacteric is?

Phase of ovarian fxn decline resulting in ↓ sex steroid prdxn

2

Menopausal Transition is?

∆ in cycle length/↑ FSH -> FMP

3

Perimenopause is?

Signs?

∆ in cycle length/↑ FSH -> 12 mo post FMP

Irreg cycles
Heavy flow/endom hyperplasia
Mood/emotional ∆s
Hot flashes, etc
Last 3-5yrs

4

Menopause is?

amenorrhea for 12 mo post FMP
(U) 50-55yo
Before 40yo = premature ovarian fail

5

Postmeno / early stage?

Late stage?

1st 5 yrs post FMP

> 5yrs

6

Menopause hormonal ∆s? (4)

↓E2 (↓ovarian estradiol)

↓Androgens (P ↑ sensitivity to androgens = facial hair, ↓breast tissue)

↓Progesterone (↓ when ovulation ↓) = irreg bleed, endo hyperpasia, ↑endo CA

↑FSH/LH (LH -> hot flashes)

7

Menop affects on bladder?

↓ elastic capacity = freq, urgent, incont, nocturia

8

Menop DDX?

Hyperthyroid (mens ∆, sweats, moods)
Pregnancy
Hyperprolactinemia (mens ∆)
Meds
Pheochromocytoma (hot flash/night sweat)
CA

9

Menop-caused vag atrophy/dryness tx?

1st line: Non-horm lube
2nd/Most effective: vag E2 (insert)
Other: SERM, Ospemifene

10

Menop-causes vasomotor sxs tx?

HRT: (short-term/low-dose)
E2 if sans uterus
E2/Prog if uterus

Effexor, Paxil, Neurontin
Soy, St John, Black cohosh

11

HRT contraindicated for?

Heart dz
Breast CA
VTE/Stroke Hx
Liver dz
High Riskers for the above

12

Osteoporosis characteristics?

Low bone mass
Microarchitectural disruption
Skeletal fragility

13

Osteoporosis clinical findings?

Spine and Femoral neck most C,
Loss of height > 1.5"

14

Osteoporosis imaging?

DXA: >50yo w/ risks, o/w >65
T-score < -2.5 = osteoporosis
T-score b/w -1 and -2.5 = osteopenia

15

Osteoporosis management: Meds

Use when?

Med types? (3)

Repeat DXA when?

If T-score < -2.5 and no risks or
T-score b/w -1 and -2.5 w/ risks

SERMs
Bisphosphonates
PTH/Calcitonin

Q 2yrs if on meds

16

Osteoporosis management: Meds

SERMs?

Bisphos?

PTH?

SERMs: Evista
Prevents and treats
↓ vert fx but not hip
↓breast Ca

Bisphosphonates: Actonel, Fosamax, Boniva
Prevent and treat
Few s/e

PTH/Calcitonin: Forteo, Miacalcin
Refractory