Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OU Module Endo Fall 2018 > Women's Health Issues Exam 3 > Flashcards

Women's Health Issues Exam 3 Flashcards

1
Q

What population is affected for dysmenorrhea?

A

women 17-24 y/o

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

Pathogenesis of dysmenorrhea

A

shedding of the uterine lining releases arachidonic acid and stimulates prostaglandin synthesis that causes uterine and GI smooth muscle contraction and ischemia

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

Non-Pharmacologic Treatment for Dysmenorrhea

A
  • Regular exercise
  • Smoking cessation
  • Low-fat, vegetarian diet
  • Local application of heat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pharmacologic Treatment for Dysmenorrhea

A
  • NSAIDS
  • COX-2 inhibitors
  • Combinational hormonal contraceptives (CHC)
  • Other contraceptives
  • try each therapy for 3 months; can switch or combine methods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Dysmenorrhea: NSAIDs

A
  • pain relief in 72%
  • NSAIDs are equally effective
  • Ibuprofen
  • Naproxen sodium
  • Diclofenac potassium (Cataflam®)
  • Mefenamic acid (Ponstel ®)
  • Ketoprofen
  • use up to 3 days; scheduled, NOT prn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Dysmenorrhea: NSAID contraindications

A
  • Hypersensitivity to aspirin or NSAIDs
  • Renal disease
  • History of GI bleeding or ulceration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dysmenorrhea: NSAID place in therapy

A

first line

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

Dysmenorrhea: COX-2 Selective Inhibitors

A
  • Celecoxib (Celebrex®)

- similar efficacy to NSAIDs

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

Dysmenorrhea: COX-2 Selective Inhibitors place in therapy

A

limited to patients who have significant risk for GI ulceration or who have failed traditional NSAIDs

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

Dysmenorrhea: Combinational hormonal contraceptives (CHC) MOA

A

Suppresses ovulation, decreases menstrual fluid volume, and thereby decreases prostaglandin production and uterine cramping

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

Dysmenorrhea: Combinational hormonal contraceptives (CHC) place in therapy

A
  • Generally second line.
  • May be first-line if contraception is also desired.
  • relieve dysmenorrhea in 50-80% of women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dysmenorrhea: Other Contraceptives

A
  • can be considered if other therapies ineffective
  • Extended or continuous cycle CHC
  • Levonorgestrel IUD
  • Depo-medroxyprogesterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pharmacologic Treatment for Menorrhagia

A
  • NSAIDS
  • Hormonal contraception
  • Medroxyprogesterone
  • Tranexamic acid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Menorrhagia: NSAIDs

A
  • 20-50% reduction in blood loss in 75% of women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Menorrhagia: NSAIDs place in therapy

A

first line

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

Menorrhagia: Hormonal contraception

A
  • 40-50% reduction in blood loss with cyclic combined oral contraceptives
  • 79-97% reduction in blood loss with levonorgestrel IUD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Menorrhagia: Hormonal contraception place in therapy

A

First line option in those desiring contraception

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

Menorrhagia: Medroxyprogesterone (MPA, Provera®) MOA

A

Suppresses FSH and LH and ultimately estrogen and progesterone

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

Menorrhagia: Medroxyprogesterone (MPA, Provera®)

A

32-50% reduction in menstrual blood loss

20
Q

Menorrhagia: Tranexamic acid MOA

A

Antifibrinolytic

21
Q

Menorrhagia: Tranexamic acid

A

26-60% reduction in menstrual blood loss

22
Q

Pathogenesis of PMS

A

results from the interaction of cyclic changes in ovarian steroids and central neurotransmitters

23
Q

Population affected by PMS

A

occurs in late 20s through early 40s

24
Q

Diagnostic Criteria for PMS

A

Physical

  • abdominal bloating
  • acne
  • backache
  • breast tenderness
  • fatigue
  • headache
  • weight gain

Psycholoigcal

  • irritability
  • depressed mood
  • forgetfulness and difficulty concentrating
  • increased appetite
  • labile mood
  • tension

Must have one of each for 3 cycles

25
Q

Treatments for PMS and PMDD

A
  • First line: Nonpharmacologic therapies for mild to moderate PMS
  • First line: Pharmacologic therapies for severe PMS (i.e. PMDD)
26
Q

Nonpharmacologic Therapies for PMS

A
  • Decrease salt, caffeine, and refined sugars
  • eat smaller
  • more frequent meals
  • aerobic exercise > 3x/week with an increase in exercise during the premenstrual week
27
Q

Pharmacologic Therapies for PMS

A
  • Antidepressants
  • Anxiolytics
  • Non-prescriptions therapies (calcium, NSAIDS, combination products)
  • Ovulation suppression
28
Q

Pharmacologic Therapies for PMS: Antidepressants: SSRIs

A
  • Fluoxetine (Sarafem®)
  • Paroxetine (Paxil CR®)
  • Sertraline (Zoloft®)
  • Improves both psychological and physical symptoms.
29
Q

Pharmacologic Therapies for PMS: Antidepressants: SSRIs timing and duration

A
  • Onset of efficacy: within first treatment cycle
  • Initially, use only during the luteal phase (14 days premenstrual)
  • If response is inadequate, increase to continuous daily regimen
  • If response remains inadequate, may try switching to another SSRI
30
Q

Pharmacologic Therapies for PMS: Antidepressants: SSRIs place in therapy

A

considered first-line

31
Q

Pharmacologic Therapies for PMS: Alternative Antidepressants

A
  • clomipramine
  • duloxetine
  • nefazodone
  • venlafaxine
32
Q

Pharmacologic Therapies for PMS: Alternative Antidepressants place in therapy

A

secondline in patients who fail, cannot tolerate, or have contraindications to SSRI therapy

33
Q

Pharmacologic Therapies for PMS: Anxiolytics: Benzodiazepines

A
  • Alprazolam

- also useful for acute anxiety and intermittent insomnia

34
Q

Pharmacologic Therapies for PMS: Anxiolytics: Benzodiazepines timing and duration

A

TID days 1428 of cycle

35
Q

Pharmacologic Therapies for PMS: Anxiolytics: Benzodiazepines place in therapy

A

agent of choice if intent is for short-term use

36
Q

Pharmacologic Therapies for PMS: Anxiolytics: 5HT1A-Agonist

A
  • Buspirone (BuSpar ®)
  • does not improve physical symptoms
  • also useful for anxiety and insomnia
37
Q

Pharmacologic Therapies for PMS: Anxiolytics: 5HT1A-Agonist place in therapy

A

can be used in pts with anxiety esp if drug dependence is a concern

38
Q

Pharmacologic Therapies for PMS: Anxiolytics: 5HT1A-Agonist timing and duration

A

take days 14-28 of cycle

39
Q

Pharmacologic Therapies for PMS: Calcium

A
  • Improves mood, bloating, food cravings, and pain.

- May take a few months to see improvement

40
Q

Pharmacologic Therapies for PMS: Calcium place in therapy

A

all women with symptoms of PMS

41
Q

Pharmacologic Therapies for PMS: NSAIDS

A

improves physical symptoms but not psychosocial

42
Q

Pharmacologic Therapies for PMS: Ovulation Suppression: Hormonal Contraception (CHC)

A
  • does not work for everyone

- CHC containing drospirenonemay be more beneficial because they reduce fluid retention (i.e. Yaz®, Yasmin®)

43
Q

Pharmacologic Therapies for PMS: Ovulation Suppression: GnRH Agonists

A
  • downregulates pituitary gonadotropin secretion and suppresses gonadal function
  • Leuprolide (Lupron Depot®) (IM)
  • works for both physical and psychological symptoms
  • can give adjunct estrogen and progestin to counter hypo-hormone
44
Q

Pharmacologic Therapies for PMS: Ovulation Suppression: GnRH Agonists place in therapy

A

reserve for those with severe PMDD who do not respond to more conservative measures due to adverse effects

45
Q

Pharmacologic Therapies for PMS: Surgery

A
  • oophorectomy

OU Module Endo Fall 2018 (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions