Reproductive

Question 1

Estradiol esters?

Answer 1

Estradiol valerate, Estradiol cyplonate, Quinestrol

Question 2

Conjugated estrogens?

Answer 2

Estrone sulfate, Equilin sulfate

Question 3

Alkyl estrogens?

Answer 3

Ethinyl estradiol, Mestranol

Question 4

Absorption of synthetic steroidal estrogens?

Answer 4

Skin, mucus membranes, GI

Question 5

Distribution of synthetic steroidal estrogens?

Answer 5

Body-wide, via SHBG

Question 6

Indications for synthetic steroidal estrogens?

Answer 6

Contraception, primary hypogonadism, postmenopausal hormone therapy

Question 7

Common side effects of synthetic steroidal estrogens?

Answer 7

Nausea, breast tension/pain, vaginal bleeding, headache, weight gain, HTN

Question 8

Less common side effects of synthetic steroidal estrogens?

Answer 8

Breast cancer (controversial), DVT, PE, MI, stroke, gallbladder disease, cervical & endometrial cancer

Question 9

Contraindications for synthetic steroidal estrogens?

Answer 9

W/ breast or endometrial cancer (or a family history), endometriosis, undiagnosed vaginal bleeding, pregnancy, thromboembolic disease, HTN, hepatic disease

Question 10

Diethylstilbesterol?

Answer 10

Non-steroidal synthetic estrogen

Question 11

Risks associated with DES?

Answer 11

Clear cell adenocarcinoma of vagina & cervix

Question 12

Tamoxifen citrate class?

Answer 12

Non-steroidal anti-estrogen; SERM

Question 13

Clomiphene citrate class and mxn?

Answer 13

Non-steroidal anti-estrogen; blocks estrogen binding, decreasing negative feedback, inducing GnRH, LH, FSH release, inducing ovulation

Question 14

Clomiphene citrate side effects?

Answer 14

Hot flashes, upset stomach/pain, vomiting, headache, multiple pregnancy

Question 15

Cis-isomer of clomiphene?

Answer 15

Zuclomiphene (weak agonist)

Question 16

Trans-isomer of clomiphene?

Answer 16

Enclomiphene (potent antagonist)

Question 17

Progesterone indications?

Answer 17

Contraception, hormone replacement therapy

Question 18

Natural progesterones?

Answer 18

Micronized, Transvaginal progesterone

Question 19

Natural progesterone side effects?

Answer 19

Minimal (fatigue, drowsiness)

Question 20

Synthetic progesterone/Progestins?

Answer 20

Medroxyprogesterone, Norethindrone, Norgestrel, Megestrol

Question 21

Progestin common side effects?

Answer 21

Anxiety/irritability, depression, muscular pain, edema, abdominal bloating, androgenic effects (acne, hirsutism)

Question 22

Less common side effects of progestins?

Answer 22

Thrombosis, PE

Question 23

Contraindications of progestins?

Answer 23

Thromboembolic disorders (or Hx of), liver disease, undiagnosed vaginal bleeding, pergnancy, HTN, risk of breast cancer

Question 24

Combination pills?

Answer 24

Mono-/Bi-/Triphasic Ortho-Novum

Question 25

Monophasic dosing?

Answer 25

Consistent, 21 days

Question 26

Biphasic dosing?

Answer 26

Fixed estrogen, Progestin increased days 11-21

Question 27

Triphasic dosing?

Answer 27

Fixed or variable estrogen, progestin increase in three phases (days 1-7, 3-14, 15-21)

Question 28

Mini-pill?

Answer 28

Progestin only

Question 29

Mini-pill benefit?

Answer 29

Suppress endometrial cancer

Question 30

Mini-pill side effect?

Answer 30

Irregular cycles

Question 31

Plan B?

Answer 31

Levonorgestrel

Question 32

Levonorgestrel mxn?

Answer 32

Unknown: interfere with implantation & inhibit/delay ovulation

Question 33

Levonorgestrel must be taken within?

Answer 33

72 hours of coitus

Question 34

"Abortion pill?"

Answer 34

Mifepristone (RU-486, Korylym)

Question 35

Mifepristone mxn?

Answer 35

Anti-progesterone, leading to detachment of the fetus; Glucocorticoid receptor antagonist

Question 36

Mifepristone must be taken within?

Answer 36

49 days

Question 37

AKA Viagra?

Answer 37

Sildenafil citrate

Question 38

AKA Levitra?

Answer 38

Vardenafil HCL

Question 39

AKA Cialis?

Answer 39

Tadalafil

Question 40

ED drugs mxn?

Answer 40

Inhibit PDE5, inhibit breakdown of cGP, decreased Ca, increased smooth muscle relaxation, erection

Question 41

PDE5 inhibitors with 4 hr half life?

Answer 41

Sildenafil citrate, Vardenafil HCL

Question 42

PDE5 inhibitors with 17.5 hr half life?

Answer 42

Tadalafil

Question 43

Peak plasma concenctration of PDE5 inhibitors within?

Answer 43

1-2 hours

Question 44

PDE5 inhibitors contraindicated?

Answer 44

Nitrates, alpha-blockers (unsafe drop in BP)

Question 45

PDE5 inhibitor side effects?

Answer 45

Change in vision, headaches, dizziness, flushing, upset stomach, stuffy/runny nose, UTI, diarrhea

Question 46

Unique contraindication of micronized progesterone?

Answer 46

Peanut allergy