Menopause

Question 1

cessation of menses for 12 consecutive months…

Answer 1

menopause

Question 2

patient presents with

• irregular menses
• hot flashes/night sweats
• vaginal dryness
• change to lipids, bone density

Answer 2

perimenopause

Question 3

FSH > 25 is suggestive of…

Answer 3

perimenopause

Question 4

perimenopause onset is ___ years before final menstrual period

Answer 4

4

Question 5

Menopause before ___yo is abnormal

Answer 5

40

Question 6

FSH > ____ is found in most post-menopausal women

Answer 6

70

Question 7

Pt. presents with:

• vaginal dryness
• osteoporosis
• CV dz
• Dementia
• Mood sxs

Answer 7

postmenopause

Question 8

untreated, hotflashes/vasomotor sxs end within how many years of onset?

Answer 8

4-5

Question 9

straw staging is used for…

Answer 9

menopause tracking

Question 10

The below can help with what sxs of menopause?

HRT (Most effective)
SSRIs/SNRIs
clonidine
Gabapentin

Answer 10

vasomotor sxs

Question 11

Estrogen only HRT can be sued for…

Answer 11

hysterectomy

Question 12

women with an intact uterus can have what HRT

Answer 12

combo estrogen/progestin

Question 13

women with intact uterus should not use ____ because of the below

endometrial hyperplasia
risk of adenocarcinoma

Answer 13

estrogen only HRT

Question 14

describe the dosing of HRT

Answer 14

lowest effective dose, shortest duration

Question 15

Combined HRT confers increased risk for…

Answer 15

VTE and Breast CA

Question 16

estrogen only HRT confers increased risk of ___ only

Answer 16

VTE

Question 17

combined HRT decreases risk of…

Answer 17

fracture, colon Ca

Question 18

the below are C/I for:

• Breast cancer
• Coronary Heart Disease
• Previous venous thromboembolic event or stroke
• Active liver disease
• unexplained vaginal bleeding
• high-risk endometrial cancer
• transient ischemic attack

Answer 18

HRT

Question 19

is progestin only therapy recommended? why?

Answer 19

no, risk of CA

Question 20

Testosterone can help with what for post-menopausal women

Answer 20

sexual function

Question 21

This is the term to describe atrophic sxs from estrogen loss during menopause

Answer 21

genitourinary syndrome of menopause

Question 22

Patient presents with:

• vaginal drying
• vaginal pruritis
• dyspareunia
• sexual dysfunction

Answer 22

vulvovaginal atrophy

Question 23

genitourinary syndrome of menopause can present with what two GU sxs?

Answer 23

frequency, recurrent bladder infx

Question 24

what is local estrogen therapy useful in treating?

Answer 24

vulvovaginal atrophy

Question 25

The below are risk factors for? ``` "ACCESS" Alcohol use CS use Calcium low Estrogen low Smoking Sedentary lifestyle ```

Answer 25

osteoporosis

Question 26

Two methods of dx for osteoporosis...

Answer 26

DXA scan Fragility fx

Question 27

Fx at spine, hip, wrist, humerus, rib or pelvis from standing height or less is suggestive of...

Answer 27

osteoporosis

Question 28

DEXA scan gives you a ____ score which is the number of SD above or below the mean BMD for sex-matched young normal controls

Answer 28

T score

Question 29

T score of ____ indicates osteoporosis

Answer 29

-2.5 or less

Question 30

t score of ______ indicates osteopenia

Answer 30

-1 to -2.5

Question 31

when should osteoporosis screening occur for normally healthy women?

Answer 31

65

Question 32

Post menopausal women with the below are considered for____ • Postmenopausal women with a history of hip or vertebral fracture • Women with a T score ≤ -2.5 • High-risk postmenopausal women with T scores between -1.0 and - 2.5 (based off of FRAX score)

Answer 32

Bisphosphonate tx

Question 33

2nd line tx for osteoporosis

Answer 33

SERMs (raloxifene)

Question 34

normal BMD can have repeat scan on what time frame?

Answer 34

5-15 years

Question 35

T score -1.5 to -1.99 should be re-screened when?

Answer 35

5 years

Question 36

T score -2 to -2.49 should be rescreened when?

Answer 36

1 year

Question 37

if on osteoporosis tx, how often should screening occur?

Answer 37

repeat 1-2 years, and every 2 years after

Question 38

uterovaginal and vaginal vault are what type of pelvic organ prolapse?

Answer 38

apical

Question 39

cystocele is what type of pelvic organ prolapse?

Answer 39

anterior compartment

Question 40

rectocele is what type of pelvic organ prolapse?

Answer 40

posterior compartment

Question 41

A patient presents with: * Heaviness * Pressure * Discomfort * Urinary Symptoms (Incontinence vs retention) * Defecatory Symptoms (with posterior defects) * Splinting * Pain and irritation

Answer 41

pelvic organ prolapse

Question 42

two methods of conservative management of pelvic organ prolapse

Answer 42

pessary devices | kegel exercises

Question 43

a patient who is symptomatic or failed conservative tx

Answer 43

surgery

Question 44

The below are disadvantages of: * Odor * Discharge * Vaginal ulcerations * Must remove for coitus

Answer 44

pessaries

Question 45

Surgical tx of pelvic organ prolapse that provides apical support

Answer 45

sacrospinous fixation

Question 46

this is the attachment of the vagina/cervix to the anterior longitudinal ligament of the sacrum

Answer 46

sacrocolpopexy

Question 47

plication to vaginal tissue to the midline to reduce bulging bladder

Answer 47

anterior repair

Question 48

plication to vaginal tissue to midline to reduce bulging rectum

Answer 48

posterio repair

Question 49

most POP is not urgent, unless... (2)

Answer 49

urinary retention | obstructive neuropathy