reproductive 1

Question 1

What type of hormone are the sex hormones

Answer 1

Steroid based fat soluble so they pass through cell membranes easily

Question 2

Three types of estrogen

Answer 2

Estradiol E2 - the most powerful, Estriol E3, Estrone E1

Question 3

How do the estrogens compare

Answer 3

Estradiol E2 is 10 times more potent than Estriol and Estrone

Question 4

are naturally occurying or synthetic estrogens more bioavailable?

Answer 4

Synthetic estrogens are more bioavailable because they are less subject to first pass hepatic metabolism

Question 5

Why what HRT originally used

Answer 5

Postmenopausal: Reduce vasoactive response, tissue atrophy, improvesleep, blunts osteoporosis

Question 6

concerns with exogenous estrogen replacement (without progestin)

Answer 6

increases risk of stroke, clots, ovarian endometrial and breast cancer

Question 7

why is progestin added to those with uterus

Answer 7

because unopposed estrogen can increase risk of endometrial cancer

Question 8

Differences between estrogen and estrogen with progestin trials

Answer 8

both had reduced risk of fracture, and increased risk of stroke, but in addition the progestin plus estrogen had increase risk of MI, DVT and breast cancer

Question 9

bioidentical hormone options

Answer 9

BiEst: E3:E2 or TriEst: E3:E2:E1 both oral or topical

Question 10

Compare Bi and Triest

Answer 10

E3:E2 80:20 / E3:E2:E1 - 80:10:10

Question 11

what is the conjugated estrogens

Answer 11

Premarin ; estrone with equillin so it undergoes less hepatic metabolism

Question 12

what is premarin used for

Answer 12

prevent and treat osteoporosis and post menopausal sx

Question 13

how does premarin and all the hormones work?

Answer 13

MOA is altering gene transcripton

Question 14

what is importain to know when using premari

Answer 14

you must add progesteron if you still have your uterus

Question 15

category of premarin

Answer 15

Cat X, they also are contraindicated with hx of DVT, breast, ovarian or uterine cancer

Question 16

what is synthetic progestogen

Answer 16

progestin, similar effect of progesterone

Question 17

why are progestins used?

Answer 17

Hormonal contraception and prevention of endometrial hyperplasia in HRT

Question 18

name a synthetic progesterone/progestogen

Answer 18

Medroxyprogesterone/Provera

Question 19

indication for medroxyprogesterone/provera

Answer 19

contraceptive, HRT, dysfunctional uterine bleeding, endometriosis

Question 20

how is medroxyprogestrone administered

Answer 20

PO or DEPO iv

Question 21

side effects of medroxyprogestrone/provera

Answer 21

increase LDL/HDL ratio, facial hair, weight gain,

Question 22

when is medroxyprogesterone contraindicated

Answer 22

Hx of female cancers, or DVT hx, and will cause birth defects if taken while pregnant

Question 23

the pill

Answer 23

combo of estrogen and progestin

Question 24

what does the estrogen of birth control doo

Answer 24

supresses ovulation

Question 25

what does the progestin of birth control do

Answer 25

prevents implantation and makes mucus impenetrable to sperm

Question 26

how effective are BCPs

Answer 26

97-98%

Question 27

most commonly used estrogen fir BCP

Answer 27

ethinyl estradiol

Question 28

combination pills

Answer 28

contstant estrogen with changeingamount of progestin

Question 29

what are benefits of the OCP

Answer 29

reduce risk of colorectal cancer, improves PID, dysmeorrrhea, PMA and acne, PCOS sx and anemia

Question 30

side effects of OCP

Answer 30

increase CVD, DVT, HTN, Stroke,

Question 31

what should you not do while on the pill

Answer 31

Smoke, or be over 35

Question 32

what is mini pill

Answer 32

consistent progestin with no estrogen for 21 days

Question 33

why would someone want mini pill

Answer 33

it cant tolerate estrogenic, but its not as effective

Question 34

what can reduce the efficacy of the pill

Answer 34

antibiotics, sulfa drugs and st johns wart

Question 35

how much does pill reduce ovarian and endometrial cancer risk

Answer 35

about 50% in 5 and 80% in 10 years

Question 36

Drospirenone

Answer 36

yaz, it has a way higher risk of thromboembolism

Question 37

how often for Medroxyprogesteron acetate /depo proveria IM

Answer 37

four times each year, immediate protection

Question 38

how does depo provera work

Answer 38

inhibit folicular development to revent ovulation

Question 39

what does medroxyprogesteron acetate/provera also prevent

Answer 39

reduce risk of endometrial cancer by upt to 80%

Question 40

how long to get pregnant after depo

Answer 40

9-10 months after last injection

Question 41

risks of depo/medroxyprogesterone acetat

Answer 41

increase osteoporosis, has a black box warning, it shouldn't be used for more than 2 years

Question 42

what are the current implantable contraceptives

Answer 42

Implanon - can last 3 years

Question 43

transtermal patches

Answer 43

Ortho evara - applied withing first 5 days of cycle , never apply over breasts

Question 44

what happens if patch falls off

Answer 44

if you replace it in 48 hours no backup contraception is needed

Question 45

concerns with patch ortho evara

Answer 45

higher estrogen than pills, twice the risk of clotting

Question 46

what is in nuva ring

Answer 46

combined progestin and estrogen, 3 weeks, per ring, increased risk of blood clots

Question 47

if ring falls out what then

Answer 47

if out more than 3 hours back up method for 7 days

Question 48

IUD brand names

Answer 48

Copper: ParaGard, Hormone: mirena, liletta and skyla

Question 49

whats in homonal iud

Answer 49

levonorgestrel and progestin

Question 50

how does hormonal IUD work

Answer 50

Levonorgestrel : deminish ovulation, mucus consistency, make implation less likely, inflammatory response

Question 51

Mirena duration

Answer 51

levonorgestrel : 5 years / 20 mcg day

Question 52

liletta

Answer 52

levonorgestrel: 5 years / 20mcg day

Question 53

Skyla

Answer 53

levonorgestrel: 3 years/14mcg day

Question 54

Progestin only contraceptives

Answer 54

Levonorgestrel: Plan B, Next choide: 750 ug 12 hours apart

Question 55

what is Ulipristal acetate/Ella

Answer 55

SERM, selective progesterone receptor modulator for emergency contracepton given within 5 days.

Question 56

moa of ulipristal acetate /ella

Answer 56

delay or inhibit ovulation and inhibit folicular rupture

Question 57

what are combo mornin after pills?

Answer 57

estrogen and progestin, 2 doses, same effect as stacking reglular pills

Question 58

what are the 4 types of emergency contraceptive

Answer 58

progestin only, SPRM, combo, abortifacient

Question 59

First 2 months of pregnancy abortifacient

Answer 59

Mifepristone: synthetic steroid,

Question 60

moa of Mifepristone:

Answer 60

progenstin antagonist partial agonist so off and part on. 85% effective in first trimester

Question 61

side effects of mifepristone

Answer 61

crampin, bleeding 9-16 days., emergency if incomplete

Question 62

contraindications of mifepristone

Answer 62

in presence of IUD, ectopic pregnancy, hemorrhagic disorders, prednisone

Question 63

SERMs

Answer 63

Clomiphene/Clomid

Question 64

MOA of clomiphene/clomid

Answer 64

bind estrogen receptor sites in brain interfering with negative feedback on GnRH to resuld in increase secretion of GnRH, increasing LH and FSH stimulationg ovulation.

Question 65

what are these SERMS clomphine/Clomid used for

Answer 65

infertility or amenorrhea.