Womens Health Drugs

Question 1

What is the first phase of the ovarian cycle?

Answer 1

Follicular phase

Question 2

What are the first 2 phases of the uterine cycle?

Answer 2

Menses

Proliferation phase

Question 3

What is the 2nd phase of the ovarian cycle?

Answer 3

Luteal phase

Question 4

What is the 3rd phase of the uterine cycle?

Answer 4

Secretory phase

Question 5

What phase contains the highest levels of progesterone levels?

Answer 5

Luteal/secretory phase

Question 6

What phase is estrogen increasing?

Answer 6

Follicular/Proliferation phase

Question 7

What causes LH and FSH to increase at the beginning of follicular phase?

Answer 7

Slow rise in estrogen

Question 8

What is the MOA of BC how does it effect ovulation?

Answer 8

Large dose of estrogen and progesterone cause a negative feedback to LH and FSH…causing no ovulation

Question 9

What are the 6 major effects of estrogen on the body?

Answer 9

Increase risk for VTE
Increase bone retention
Increase in female body contours
Cervical mucus thinning
Increase risk for endometrial cancer
Increase risk for breast cancer

Question 10

What are the 5 major effects of progesterone on the body?

Answer 10

Increase risk for VTE
Increase bone retention
Thickening of cervical mucus
Increase in alveolar growth
Inhibition of uterine contractions

Question 11

What is RU 486? what is it used for?

Answer 11

Progesterone agonist

Used to abort fetus

Question 12

What is the major estrogen that comes from the body?

Answer 12

Estradiol

Question 13

What does the body use to make estrogen and progesterone? What is the basically chemical structure of the sex hormones considered? How does it cross the cell membrane?

Answer 13

Cholesterol

Steroid

Simple diffusion

Question 14

What are the good factors from taking exogenous estrogen? Bad factors?

Answer 14

Decreases hot flashes
Increases bone retention

Increases cancer risk
Increases VTE risk

Question 15

What are the indications for Estrogen(7)?

Answer 15

Atrophic vaginitis
Hypogonadism
BC
uterine bleeding
Hot flashes
Osteoporosis
Ovary removal

Question 16

What is dyspareunia?

Answer 16

Pain during intercourse

Question 17

What is atrophic vaginitis?

Answer 17

Shrinkage of vagina

Question 18

What is hypogonadism?

Answer 18

Decrease in the production of estrogen

Question 19

What are the contraindications for estrogen(5)?

Answer 19

Allergy
Estrogen dependent cancer
Abnormal vaginal bleed
Pregnant
VTE risk

Question 20

What are ADR of estrogens?

Answer 20

VTE
N/V
chloasma 
Amenorrhea 
HA
Fluid retention
Tender breasts

Question 21

Which pts are not recommended for estrogen HRT?

Answer 21

Pts with endometrial cancer or breast cancer

Question 22

What must be assessed in pts who have had several years use of estrogen HRT?

Answer 22

Bone mineral density

Question 23

What do progestin drugs have in their name?

Answer 23

-gest- or nor-

Question 24

What are the indications for progestins?

Answer 24

Uterine bleeding
Amenorrhea
Uterine cancer
BC
prevention of threatened miscarriage
PMS Sx

Question 25

What can uterine bleeds be caused by?

Answer 25

Hormone imbalance Fibroids Uterine cancer

Question 26

What are fibroids?

Answer 26

Non cancerous growth in uterus

Question 27

What are the ADRs of Progestins?

Answer 27

``` Cholesterol jaundice VTE N/V Amenorrhea Edema ```

Question 28

What is cholestatic jaundice? What Sx does it cause?

Answer 28

Bile duct gets blocked which increases bilirubin deposited in skin Causes severe itching

Question 29

What effect does hypocalcemia cause on nerves?

Answer 29

Increases the frequency of AP

Question 30

How does Calcitonin effect Ca2+ in the blood?

Answer 30

Decreases Ca2+ in the blood

Question 31

How does PTH effect Ca2+ in the blood?

Answer 31

Increases Ca2+ in the blood

Question 32

What effect do osteoclasts have on Ca2+ in the blood?

Answer 32

Increase Ca2+ in blood

Question 33

What I needed for Ca2+ to be reabsorbed in the kidneys and be absorbed in the intestines?

Answer 33

Vitamin D

Question 34

What conditions can cause hypocalcemia(6)?

Answer 34

``` Vit D deficiency Calcitonin secreting thyroid tumors Dialysis Diarrhea Pregnancy Hypoparathyroidism ```

Question 35

Why does dialysis and diarrhea cause hypocalcemia?

Answer 35

Because you poop and pee out Ca2+

Question 36

Why does pregnancy cause hypocalcemia?

Answer 36

Because creating a skeleton inside of you requires increased demand for Ca2+

Question 37

Why does hypoparathyroidism cause hypocalcemia?

Answer 37

Because of the decreased production of PTH which increases Ca2+ in the blood

Question 38

What are the 2 Tx options for hypocalcemia? What are their ADR?

Answer 38

Calcium supplements Vit D Lead to kidney stones

Question 39

What syndrome can be caused by hypocalcemia? How can you Tx this condition?

Answer 39

Carpopedal syndrome Ca2+ IV

Question 40

What causes hypercalcemia?

Answer 40

Renal dysnfunction Multiple myeloma Parathyroid tumor

Question 41

How does renal dysfunction cause hypercalcemia?

Answer 41

Causes too much reabsorption of Ca2+

Question 42

How does multiple myeloma cause hypercalcemia?

Answer 42

Multi myeloma causes cytokines to be released to increase osteoclasts activity

Question 43

Why does parathyroid tumor cause hypercalcemia?

Answer 43

Because the tumor secretes increased amounts of PTH

Question 44

What does a RANKL and RANK interaction cause?

Answer 44

Increase in osteoclasts activity

Question 45

What holds RANKL? What holds RANK? What does it activate and turn it into?

Answer 45

Osteochondral progenitor/osteoblast Osteoclasts precursor RANKL and RANK interaction activate NFKB in precursor cell and turn it into a osteoclast

Question 46

What prevents RANKL and RANK interactions?

Answer 46

OPG binds to RANKL to prevent RANK from binding

Question 47

What increases OPG production? Decreases?

Answer 47

Increases - mechanical strain - sex hormones Decreases - PTH - Glucocorticoids

Question 48

What increases RANKL expression? Decreases?

Answer 48

Increases - PTH - glucocorticoids Decreases -sex hormones

Question 49

What is osteoporosis? How many SD away <30yo? What comes before osteoporosis? How many SD away <30yo?

Answer 49

Decreased BMD -1 SD Osteopenia -2.5 SD

Question 50

What is the female athlete triad?

Answer 50

1. decreased food intake 2. Increased number calories being burned 3. decreased body weight which decreases Estrogen levels

Question 51

Pain in osteoporosis is associated with what?

Answer 51

Pain is associated with fractures

Question 52

What are common fractures for pt with osteoporosis(5)?

Answer 52

``` Hip Vertebrae Pelvis Humerus Distal radius ```

Question 53

What are personal characteristics that can lead to osteoporosis(5)?

Answer 53

``` Increased age Female White or Asian Low body weight Postmenopausal ```

Question 54

What are lifestyles that can increase risk for osteoporosis?

Answer 54

Sendentary | Ca2+/vit D deficiency

Question 55

What drugs/diseases can cause osteoporosis?

Answer 55

Corticosteroids/cushings disease Celiac disease Anorexia nervosa

Question 56

How does celiac disease cause osteoporosis?

Answer 56

Because it decreases the bodies ability to absorb Ca2+

Question 57

Before giving a uterine stimulant, what should be assessed? How can this effect the fetus

Answer 57

Mother and fetus vitals Can increase fetal HR

Question 58

What are uterine stimulants called?

Answer 58

Oxytocics

Question 59

What are uterine relaxants called?

Answer 59

Tocolytics

Question 60

What are Sx of hypercalcemia?

Answer 60

N/V constipation Lethargy Muscle weakness

Question 61

What is the #1 drug to Tx osteoporosis?

Answer 61

Bisphosphonate

Question 62

What is the synthetic version of oxytocin?

Answer 62

Pitocin

Question 63

What is a common ADR of OCPs?

Answer 63

N/V