Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Women's Health Exam 1 > Menopause & POP > Flashcards

Menopause & POP Flashcards

(77 cards)

Start Studying
1
Q

perimenopause (menopausal transition)

A

he preceding time period during the physiologic changes associated with menopause occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Menopause

A

permanent cessation of menses for 12 consecutive months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Postmenopause

A

The period following menopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

age of perimenopause

A

4 years before final menstrual period (FMP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

manifestations of perimenopause

A 
estrogen fluctuates unpredictably
IRREGULAR MENSES
vasomotor sx (hot flashes/night sweats)
Mood sx (anxiety/depression)
vaginal dryness
change in lipids and bone loss begin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Labs for perimenopause

A

FSH >25 suggestive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Median age of menopause

A

51.5 YO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Abnormal menopause

A

before 40 YO (primary ovarian insufficiency/premature ovarian failure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Labs for menopause

A

FSH >70 (post-meno women)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Sx of postmenopause

A

vasomotor- untreated, hot flashes stop spontaneously 4-5 years of onset
vaginal dryness
increased risk of osteoporosis, CVD, dementia
Mood sx (anxiety/depression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Women with worst hot flashes

A

african american

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

women w/ fewest vasomotor sx

A

Asian

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Length of hot flash

A

1-5 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tx for vasomotor sx

A
  • Lifestyle modification
  • Hormone Therapy (Estrogen vs Estrogen/Progestin)
  • SSRIs and SSNRIs
  • Clonidine
  • Gabapentin
  • Complementary Botanicals and Natural Products (Phytoestrogens, Herbal Remedies, Vitamins, Accupuncture)

• Not recommended: progestin‐only medications, testosterone, or compounded bioidentical hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Most effective therapy for menopause

A

Systemic hormone therapy (HT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cause of hotflashes

A

narrowing of thermoregulatory zones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Types of HT

A

estrogen only- women who have undergone hysterectomy

estrogen + progestin: intact uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Adverse effect of unopposed estrogen in woman w/ uterus

A

endometrial hyperplasia

increased risk of endometrial adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

SE of HT

A

breast tenderness
vaginal bleeding
bloating
h/a

low-dose estrogen has less SE but not as effective – treat w/ lowest effective dose for shortest duration to relieve vasomotor symtpoms (no more than 5 years or beyond age 50)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When to stop HT

A

5 years after start or beyond age 60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Risks of HT

A

thromboembolic disease
Breast CA

Combined HT: Breast CA, CHD, stroke, venous thromboembolic events; decreased fx and colon Ca

Estrogen only: only increased risk of thromboembolic (no CVD or breast CA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Benefit of transdermal estrogen

A

lower risk of venous thromboembolism compared to oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Contraindications of HT

A 
hx of:
• Breast cancer
• Coronary Heart Disease
• Previous venous thromboembolic event or stroke 
• Active liver disease
• unexplained vaginal bleeding
• high‐risk endometrial cancer
• transient ischemic attack
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

No risk of CVD or breast CA

A

estrogen only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Role of progestin
prevent endometrial hyperplasia and endometrial CA | may improve vasomotor sx somewhat
26
Why is progestin not used alone?
Risk of breast CA
27
Why is T not used?
``` no benefit for vasomotor sx clitoromegaly hirsuitism acne lipid effects ```
28
T good for
improves sexual function
29
what are bioidentical hormones?
Plant‐derived hormones that are similar to those produced by the body (micronized progesterone and estradiol)
30
Types of bioidentical hormones
micronized progesterone and estradiol
31
dosing for bioidentical hormones
salivary hormone level testing to customize dosing -- expensive and useless (hormones vary)
32
Nonhormonal meds for hot flashes
SSRI's SNRI's Antiepileptic/central-acting
33
SSRI's
Low-dose paroxetine Paroxetine (FDA) CItalopram Escitalopram
34
SNRI's
Venlaxafine | Desvenlafaxine
35
Antiepileptics/central-acting
Gabapentin Pregabalin Clonidine
36
Alternative therapies
Phytoestrogens (soy based, red clover) herbal (black cohosh, ginseng, St. john's worst, ginkgo biloba) Vit E Accupuncture
37
GU syndrome of menopause sx
vulvovaginal atrophy (dryness, itching, dyspareunia, sexual dysfunction) Urinary frequency Recurrent bladder infections
38
Tx for vulvovaginal atropy
water-soluble moisturizers/lubes HT - local estrogen (cream, ring, tablet) - estrogen agonists and antagonists (SERMs): stimulate or inhibit estrogen receptors (Ospemifene)
39
Caution w/ local estrogen for atrophy
h/o breast cancer (can still consider it)
40
Ospemifene
SERM: stimulate estrogen receptors in the vagina; unknown effect elsewhere
41
Osteoporosis risk factors
``` (ACCESS) alcohol corticosteroid calcium low estrogen low smoking sedentary lifestyle ```
42
Risk factors for osteoporosis
``` • Advanced age • Cigarette smoking • FH of osteoporosis • Vitamin D deficiency • Female sex • White or Asian ethnicity • Secondary osteoporosis - Endocrinologic disorders - Hormonal factors - Medical disorders (RA) • Long‐term glucocorticoid therapy • Low body weight • Excess alcohol intake ```
43
Ethnicity w/ lowest rate of osteoporosis
african american
44
Preventing osteoporosis
weight-bearing, resistance exercises walking and aerobics Vit D Calcium
45
Calcium levels recommended
9-18: 1300 19-50: 1000 51-70: 1200 >71: 1200
46
Vit D level recommended
9-70: 600 | >71: 800
47
Dx of osteoporosis
DXA (T-score and Z-score T- score used in post-menopausal women Fragility fx: spine, hip, wrist, humerus, rib and pelvis (fall or standing height or less)
48
T-score
BMD in sex-matched young normal controls
49
Z-score
BMD in same age
50
T-score values
normal: > -1.0 Osteopenia: -1 - -2.5 Osteoporsis: =< 2.5
51
Screening for osteoporosis
Normal healthy: 65 YO | Postmenopausal w/ risk factors: screen earlier
52
Risk factors to screen early for osteoporosis
* Medical history of a fragility fracture * Body weight less than 127 lb * Medical causes of bone loss (medications or diseases) * Parental medical history of hip fracture • Current smoker * Alcoholism * Rheumatoid arthritis * FRAX 10‐year risk of major osteoporotic fracture > 9.3%
53
Tx for osteoporosis types
Lifestyle mod | Pharm
54
Candidates for osteoporosis therapy
postmenopausal w/ hx of hip/vertebral fx T-score <= 2.5 High-risk postmenopausal w/ T-score between -1 and -2.6 (10-year risk >= 20% or risk of hip fx >3%)
55
Pharm tx for osteoporosis
BISPHOSPHONATES (1st line) SERMs Forteo (teriparatide (PTH-134)) Calcitonin (maicalcin)
56
Role of bisphosphonates
reduce bone resorption and turnover
57
Bisphosphonate drugs
Alednronate Risedronate Ibandronate Zoledronic Acid
58
SE of bisphosphonates
UGI | Osteonecrosis of jaw
59
SERM drug for osteoporosis
Raloxifene
60
Goal of raloxifene
inhibit bone resorption decrease risk of vertebral fx reduce risk of breast CA
61
Used in severe osteoporosis or those that can't take bisphosphonates, or refractory cases
Teriparatide (PTH-134)
62
Calcitonin
PTH antagonist Less preferred useful in short-term tx of acute pain relief (vertebral fx)
63
Monitoring for osteoporosis
* Normal BMD (T score 0 to ‐1.5): Repeat in 5‐15 years * Osteopenia (T‐score of –1.5 to –1.99): Repeat in 5 years * Osteopenia (T‐score of –2 to –2.49): Repeat in 1 years * Osteoporosis on treatment: Repeat in 1‐2 years, and 2 years thereafter
64
Types of POP
Atypical (uterovaginal, vaginal vault (enterocele) Anterio compartment (cystocele) Posterior compartment (rectocele) Procidentia
65
Sx of POP
only a problem if having sx: • Bulge/Something falling outside of vagina • Heaviness • Pressure • Discomfort • Urinary Symptoms (Incontinence vs retention) • Defecatory Symptoms (with posterior defects) • Splinting • Pain and irritation
66
Risk factors for POP
``` Parity (vaginal deliveries) Large BW babies Advancing age obesity CT disorders Menopausal status Chronic disease (Constipation, COPD) Iatrogenic (prior prolapse surgery at increased risk) Racial/genetic ```
67
Ethnicity w/ lowest risk of POP
African
68
Ethnicity w/ hight risk of POP
hispanic women
69
PE for POP
``` neuro (voluntary mm. control, pelvic floor reflex) GYN exam (valsalva, cough) ```
70
Tx for POP
Expectant Conservative (pessary, Kegels) Surgery (symptomatic who failed or decline conservative)
71
Advantages of pessaries
safe | effective
72
Disadvantages of pessaries
odor d/c vaginal ulcers most remove for coitus
73
Risk of pessaries
* Erosion into bladder * Fistula formation * Ureteral obstruction with urosepsis or uremia * Small bowel prolapse and incarceration
74
Surgery type for POP
``` Apical support (sacrospinous fixation, uterosacral ligament fixation) Sacrocolpopexy ```
75
Sacrocolpopexy
Attachement of vagina or cervix to the anterior longitudinal ligament of the sacrum (goal: correct all compartments)
76
when is POP urgent/emergent?
almost never urinary retention obstructive nephropathy
77
Tx of urinary retention/obstructive nephropathy
indwelling catheter | urogyn consult for pessary or surgery

Women's Health Exam 1 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions