menopause HRT

Question 1

signs and symptoms of hypoestrogenic state

Answer 1

menstrual cycle alterations (dysfunctional bleeding)

hot flashes
mood/sleep/acute cognitive changes

UG symptoms
CV disease
Osteoporosis

Question 2

indications for non hormonal

Answer 2

m

Question 3

cessation of menstruation for ______ year (s)= menopause

Answer 3

1

Question 4

menopause before 40 is

Answer 4

premature ovarian failure

Savage syndrome

Question 5

FSH goes up or down with menopause?

Answer 5

up up up because of lack of negative feedback

Question 6

maximum germ cells at what week?

Answer 6

20 weeks gestation

Question 7

why does estrogen, progesterone decline?

Answer 7

decrease in granulosa cells

Question 8

pure antagonists or partial antagonists take advantage of the fact that

Answer 8

Estrogen receptors can be fully activated, partially activated, not activated

Question 9

irregular bleeding

Answer 9

endometrial hyperplasia risk

put on low dose OCP

Question 10

hot flashes

Answer 10

most common symptom 3-5 years into menopause

25% beyond 5 years

Question 11

why do hot flashes occur?

Answer 11

increased core body, skin blood flow, heart rate

Question 12

who gets the most hot flashes?

Answer 12

african american

Question 13

ERT and HRT within 2-3 weeks help reduce severity of

Answer 13

hot flashes

Question 14

alternative approaches to hot flashes

Answer 14

lifestyle

clonidine

megestrol

SSRI/SNRI

Vitamin E, dong quai, black cohash

Phytoestrogens

Question 15

sleep quality affected by

Answer 15

hot flashes and sleep makes the mood worse

Question 16

cystocele, rectocele, prolapse increase as

Answer 16

vagina and vulvar epithelium thins

Question 17

when does vaginal dryness occur?

Answer 17

1-3 years post menopausal

Question 18

estriol is E

Answer 18

E1, formed with enzymes from adrenal of fetus

Question 19

estrone is E produced

Answer 19

E3 in adipose, MOST COMMON DURING MENOPAUSE peripherally

Question 20

estradiol is E and is the

Answer 20

E2 most common, from the dominant follicle/corpus luteum

Question 21

micronized 17beta estradiol forms?

Answer 21

tablet, cream, patch, ring

Question 22

micronized progesterone is

Answer 22

natural

Question 23

breaking down more bone than making it leading to less dense bone

Answer 23

osteoporosis

Question 24

why does calcium not work with Ca supplements

Answer 24

stromal structure that holds the calcium gets less dense. Existing bone is stronger but doesn’t reduce risk of breaking from stromal insufficiency

Question 25

what affects survivability of patients with osteoporosis

Answer 25

breaking a hip (50* mortality)

Question 26

osteopenia

Answer 26

loss of bone but no increase of fracture, not as raised T score (middle score)

Question 27

risk factors for osteoporosis

Answer 27

steroids smoking family hx

Question 28

reduce osteoporosis

Answer 28

``` high BMI current estrogen alcohol use former estrogen Regular estrogen ```

Question 29

osteoporosis management for normal, osteopenia, osteoporosis

Answer 29

osteopenia without fracture hx: no tx osteopenia with fracture hx: treat osteoporosis: treat

Question 30

SERM medication to reduce vertebral fractures and breast CA risk

Answer 30

Raloxifene

Question 31

primary tx for osteoporosis

Answer 31

Bisphosphonates

Question 32

med for severe osteoporosis or unable to use other

Answer 32

PTH

Question 33

supplements

Answer 33

Calcium and Vitamin D

Question 34

cohort study?

Answer 34

longitudinal of group with same characteristics

Question 35

ERT/HRT on lipids previous studies/previous thoughts on HRT and CAD

Answer 35

helps prevent CAD

Question 36

WHI study conversely proved though that estrogen tx and CAD relationship

Answer 36

increase CAD

Question 37

issues with the LDL plaque?

Answer 37

it necroses, and increases thrombosis and risk of MI

Question 38

basically what's the deal with estrogen replacement and CAD

Answer 38

estrogen started for those going through menopause earlier (younger age) may help prevent MI/CAD

Question 39

thromboembolism and estrogen administration route:

Answer 39

transdermal less risk than oral