Sex hormone responsive conditions + Thyroid hormones Flashcards
(34 cards)
What are the natural oestrogens?
Estradiol, estrone, estriol
Natural oestrogens are hormones that play a key role in the female reproductive system.
Name two synthetic oestrogens.
Ethinylestradiol, mestranol
Synthetic oestrogens are commonly used in hormonal contraceptives.
What is tibolone?
Oestrogenic, progestogenic, and weakly androgenic
Tibolone is a medication used in hormone replacement therapy.
What menopausal symptoms can oestrogens alleviate?
Vaginal atrophy, vasomotor instability, postmenopausal osteoporosis
Hormone replacement therapy is often used to manage these symptoms.
True or False: Clonidine can be used for vasomotor symptoms.
True
However, clonidine has a large side-effect profile.
What is the risk of breast cancer associated with HRT?
Increased risk after 1 year; higher risk with combined HRT
excess risk persists for more than 10yrs
The risk persists for more than 10 years after stopping HRT.
What is the risk of endometrial cancer in women with a uterus using HRT?
Lower with combined HRT than oestrogen only
tibolone can increase risk
Tibolone also increases the risk of endometrial cancer.
What is the risk associated with ovarian cancer and HRT?
Small increase which disappears a few years after stopping
This highlights the importance of careful monitoring.
What is venous thromboembolism and its relation to HRT?
Increased risk of DVT with both oestrogen only and combined HRT
- Increased risk with prolonged bed rest, obesity, trauma, family history
Risk factors include prolonged bed rest, obesity, and family history.
What is the effect of tibolone on stroke risk?
Increases risk by 2.2 times in the first year of treatment
This emphasizes the need for careful patient selection.
What should be done before elective surgery for patients on HRT?
Stop HRT 4-6 weeks before surgery
HRT can be reinitiated when the patient is fully mobile.
List some reasons to stop HRT.
- Sudden severe chest pain/breathlessness
- Unexplained swelling or severe calf pain
- Severe stomach pain
- Serious neurological effects
- Hepatitis/jaundice
- BP > 160 mmHg systolic or 95 mmHg diastolic
- Prolonged immobility
These symptoms may indicate serious complications.
What characterizes hyperthyroidism?
High T3 and T4, low TSH
Patients may exhibit symptoms such as hyperactivity and weight loss.
What is the first-line treatment for hyperthyroidism?
Carbimazole
Monitoring for adverse effects like neutropenia is essential.
What is the recommended treatment for Grave’s Disease?
Radioactive Iodine
Carbimazole can be considered if remission is likely.
What are the symptoms of hypothyroidism?
- Fatigue
- Weight gain
- Constipation
- Depression
- Dry skin
- Intolerance to cold
- Menstrual irregularities
These symptoms can significantly impact quality of life.
What is the first-line treatment for hypothyroidism?
Levothyroxine
Patients should monitor TSH levels every 3 months until stable.
What are 3 examples of progestogens?
norethisterone, levonorgestrel, desogestrel
What are the 3 MHRA guidance points on carbimazole?
report sore throat, malaise, fever - neutropenia and agranulocytosis
women should use contraception during treatment - congenital malformations
report persistent abdo pain - acute pancreatitis
Does oestrogen only and combined HRT lower or increase stroke risk
increase
How does combined HRT affect coronary heart disease risk
increased risk when combined HRT started more than 10yrs after menopause
When long before elective surgery should HRT be stopped?
4-6 weeks before surgery
reinitiate when fully mobile
What is the HRT option for women without uterus and what should they do if endometriosis occurs?
continuous oestrogen use
if endometriosis occurs consider addition of progesterone
What should be given to a pt on HRT who undergoes non-elective surgery?
prophylactic heparin
graduated compression stockings
