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Flashcards in Menopause Deck (47):
1

The menopause is a point in time when permanent cessation of menstruation occurs following the loss of ovarian activity for at least:

A. 3 months
B. 6 months
C. 12 months
D. 24 months

C

2

Conclusive evidence of ovarian failure

A. High testosterone, Low FSH
B. Low estradiol, High FSH
C. High FSH, High inhibin
D. High FSH, High LH

D

3

A late consequence of estrogen deficiency

A. Vaginal atrophy
B. Incontinence
C. Coronary heart disease
D. Psychological symptoms

C

4

The following are indications for hormone replacement therapy except

A. Protection against osteoporosis
B. For genito-urinary atrophy
C. Primary cardiovascular protection
D. For premature ovarian failure

C

5

A 51 year-old G0, virgin, came to you complaining of severe hot flushes. Her last menses was 18 months ago. She is a non-smoker, of medium built, and is a housewife. Past medical history is unremarkable. Among the following, which diagnostic exam will you include in your work-up?

A. Dexa bone scan
B. Pap smear
C. Transvaginal ultrasound
D. TSH

D

6

What is the most effective treatment for her hot flushes?

A. Lifestyle modification
B. Estrogen – only HRT
C. Estrogen – Progesterone HRT
D. Progesteron

C

7

A 38 year-old G3P3(3003) underwent radical hysterectomy, bilateral salphingooophorectomy with lymph node dissection for early stage cervical cancer. She has been complaining of hot flushes, irritability and difficulty in sleeping. You are contemplating hormonal replacement therapy for her. What will be the most ideal medication for her case?

A. Sequential estrogen + progestin
B. Continuous estrogen + progestin
C. Estrogen only
D. Progestin only

C

8

A 66 year-old G5P5 (5005) patient consulted at the outpatient department. She underwent a total hysterectomy with bilateral salphingooophorectomy for myoma uteri at 45 years old. She complains of frequent low back pains which are temporarily relieved by intake of pain medications. You are requested a dual xray absorptiometry scan (DEXA). Results revealed a T-score of -2.7 at the spine and -2.5 at the hip. What is the next best step in the management of this patient?

A. Start hormone replacement therapy
B. Increase calcium intake
C. Start her on biphosphanates
D. Limit activities to avoid fracture

C

9

A 50 year woman old complains of moderate hot flushes, irritability and insomnia since she stopped having her menses 10 months ago. She tells you that her mother and aunt are breast cancer survivors. Otherwise, her past medical and family medical history are unremarkable. Her recent mammogram showed no suspicious lesions. You advise what medical management?

A. Fluoxetine
B. Oral estrogen – progesterone HRT
C. Tibolone
D. Raloxifene

B

10

A 57 year old woman, menopausal for 6 years, complains of dyspareunia and vaginal dryness. No other complaints. She is otherwise a healthy, sexually active woman. What would you advise her?

A. Tibolone
B. Estrogen progesterone vaginal tablet
C. Oral estrogen – progesterone HRT
D. Estrogen cream

D

11

An early consequence of early estrogen deficiency include the following except:

A. Dyspareunia
B. Insomnia
C. Hot flushes
D. Psychological symptoms

A

12

Which form of estrogen is predominant in menopausal women?

A. Estrone
B. Estradiol
C. Estriol
D. All forms of estrogen are secreted equally.

A

13

What is surgical menopause?

The cessation of menses due to the surgical removal of BOTH ovaries

14

What is perimenopause?

The years prior to menopause that encompass normal ovulatory cycles to cessation of menses

15

What is the median age of menopause in Filipinas?

48 years old

16

What three factors can cause menopause before the age of 45?

Current smoking, undernutrition and vegetarianism

17

The earlier menarche occurs in a woman, the earlier menopause occurs. T/F

F

There is no correlation between the age of menarche and the age of menopause.

18

Mothers and daughters tend to experience menopause at the same age. T/F

T

19

During menopause, the estrogen levels are low and derived mainly from peripheral conversion of which hormone?

Androstenedione

20

Which is the main hormone of the reproductive age group?

Estradiol

21

Which is the main hormone of the menopausal age group?

Estrone

22

Identify which stage of perimenopause is the following changes associated: Alzheimer's disease

Late

23

Identify which stage of perimenopause is the following: Hot flushes

Early

24

Identify which stage of perimenopause is the following: Sweating

Early

25

Identify which stage of perimenopause is the following: Skin atrophy

Intermediate

26

Identify which stage of perimenopause is the following: Menstrual irregularity

Early

27

Identify which stage of perimenopause is the following: Dyspareunia

Intermediate

28

Identify which stage of perimenopause is the following: Vaginal atrophy

Intermediate

29

Identify which stage of perimenopause is the following: Atherosclerosis

Late

30

Identify which stage of perimenopause is the following: Osteoporosis

Late

31

Identify which stage of perimenopause is the following: Urge-stress incompetence

Intermediate

32

Identify which stage of perimenopause is the following: Psychological symptoms

Early

33

Identify which stage of perimenopause is the following: Insomnia

Early

34

Filipino women don't experience severe hot flushes as compared to Caucasians. T/F

T

35

Estrogen (increases/decreases) vasodilation and NO levels.

Increases

36

Estrogen increases (LDL/HDL) and decreases (LDL/HDL).

HDL, LDL

37

Estrogen (improves/inhibits) carbohydrate metabolism/

Improves

38

Estrogen (inhibits/stimulates) vascular injuries.

Inhibits

39

Estrogen (improves/inhibits) vascular activity in the coronary artery.

Improves

40

HRT decreases heart disease in menopause women with existing heart disease. T/F

F

HRT should not be initiated for women with existing heart disease as secondary prevention.

41

HRT can be used for primary prevention of CVD. T/F

F

There is currently insufficient data to assert that HRT should be initiated for the sole purpose of primary prevention of CVD.

42

All menopause women need HRT. T/F

F

HRT may be given to women around the time of menopause if they are without history of CVD. But HRT is not an option for women 60 years and older.

43

What is osteopenia?

Bone density between that of a normal bone and that of an osteoporitic bone

44

What is the main indication for hormone therapy?

Severe hot flushes

45

Family history of breast cancer is a contraindication of HT. T/F

F

Personal history only and not family history of breast cancer is a contraindication for HT.

46

Known or suspected estrogen-dependent malignancy is indication for HT. T/F

F

It is a counterindication.

47

Dyspareunea is a contraindication for HT. T/F

F