573 exam2

Question 1

1st non-hormone therapy for vasomotor symptoms (how flashes) associated with menopause.___

Answer 1

Paroxetine mesylate/brisdelle

Question 2

4. TEST Q: Give ____ for: menopause + osteoporosis

Answer 2

Duavee / CE + bazedoxifene

Question 3

(1st line = SERM, vaginal insert); dyspareunia DHEA: ___

Answer 3

Ospemifene / intrarosa

Question 4

___ class: good for white/elderly/HTN + osteoporosis

Answer 4

thiazides

Question 5

Adverse effects of HRT: ___

Answer 5

bloating, mstodynia, vaginal bleeding, headaches + estrogen,

rx of thromboembolic events (strokes), increased risk of pancreatitis

Question 6

HRT does NOT increase rx of CV disease when started in women under age__ and does not affect the rx of dying from CV disease.

Answer 6

60

Question 7

ARB is THE drug for the type __diabetic

Answer 7

2

Question 8

sideroblastic anemia
Iron
Ferritin
TIBI

Answer 8

Iron- increased
Ferritin- increased
TIBI- decreased

• Immature RBCs in bone marrow, cannot utilize iron, builds up in mitochondria and blood, binds to transferrin

Question 9

_____ sideroblasts within bone marrow (biopsy)= diagnostic

Answer 9

Ringed

Question 10

Vulvovaginal atrophy: mild ___, mod/severe ____

Answer 10

mild- lube

mod/severe (vag estrogen / HT)

Question 11

Menopause:
______: menopause + osteoporosis (SERM + CE)

Answer 11

Duavee / CE + bazedoxifene

Question 12

____spine/low impact hip fx/osteoporosis;
osteopenia + FRAX scores = hip >3%; major fx >20% can tx with
biphos.; full glass of H2O, upright 40 min after; 5 yr cont à half-life
bone is 10 year; follow-up BMD

Answer 12

Bisphosphonates (Fosomax):

Question 13

Osteoporosis:

Side effects of SERMS Raloxifene/Evista:

Answer 13

HF, vag dry, dec breast cx, NOT for preg/dvts

Question 14

Osteoporosis: tx

______ new bone matrix; need Ca+VitD, biphos 2 yr post tx

Answer 14

Teripartide/Forteo:

Question 15

Osteoporosis: tx

_____ SubQ q6mo; if dc – start biphos r/t inc fx risk

Answer 15

Denosumab/Prolia/Xgeva:

Question 16

Osteoporosis: tx

____ every other day nasal spray; incr risk cx; not tolerated well

Answer 16

Calcitonin:

Question 17

Osteoporosis: tx

___surgery; vertebral comp fx; relief of pain immediately

Answer 17

Kyphoplasty

Question 18

Early menopause

The vaginal epithelium is ____due to thinning/capillaries showing through

Answer 18

brighter red

Question 19

Mid to late menopause

Vaginal walls are ____

Answer 19

pale

Question 20

HRT:
Use HRT sooner rather than later (before age 60 or within 10 years of menopause onset when symptoms are worse and benefit is greatest).
Using later indicates an increased risk for:
1
2
3

Answer 20

Colorectal cancer
CAD* and myocardial infarction
Total mortality

Question 21

Estrogens are best option to relieve hot flushes and most symptoms menopausal women complain about.
But, if the woman has a uterus, unopposed estrogen can cause ______1.

So, add a progesterone to prevent the hyperplasia.
But adding progesterones increases 2.____ risk.

So, reduce the risk by, adding the progesterone just during the last half of the cycle.
But, then due to ‘withdrawal’ of the progesterone, DUB 3.____ may occur.
(Women do not like that if they are supposed to be menopausal).

In patients without a uterus, estrogen can be given, unopposed.
But, estrogens can increase the risk of 4._____
But, the risk is dose-related and determined by the vehicle used for administration.
So, use low dose, transdermal, or vaginal (topical) estrogen.

Answer 21

1- endometrial hyperplasia.

2-breast cancer

3- (BLEEDING)

4- thromboembolic events, including strokes.

Question 22

1-____ may be given to patients on acid blockers
Calcium carbonate should be given with food to enhance absorption
Calcium (in general) may be given with food to decrease risk for 2.____

Answer 22

1- Calcium citrate

2-kidney stones