BC Menopause Flashcards
Premature ovarian failure is associated with a persistently elevated FSH level
And is further defined as cessation of menses before what age?
A- 40 years B- 45 years C- 52 years D- 35 years E- 50 years
40y
During menopausal transition, erractic fluctuation in female reproductive
Hormones lead to an array of physical and psychological symptoms.
These symptoms include all of the following except
A- Poor memory G)fatigue
B- Headache H)decrease libido
C- urinary incontinence I)skin thinning
D- vision changes J)dyspareunia
E- Hot flashes K)Sleep disturbance
F- decrease breast size L)formication
M-back /joint pain
Vision changes
Age and race are nonmodifiable risk factors for osteoporosis.
Menopausal Osteoporosis is most common in which race group?
A- White B- Asian C- Aboriginal D- African Canadian E- Pacific Islander
White
What T- score value is associated with osteopenia?
A- T- score greater -1 B- T -score between -1 to -2.5 C- T-score = -2.5 D- T- score between + 1.0 and -1.0 E- T-score between + 1.0 and – 2.5
T score betewen -1 to - 2.5
CONTENT Normal BMD; +2.5 to -1.0 Osteopenia -1.0 and -2.5 Osteoporosis -2.5 Severe or established osteoporosis at or below -2.5 with fractures
What are secondary causes of osteoporosis?
Primary hyperparathyroidism, secondary hyperparathyroidism from chronic renal failure, hyperthyroidism or excess thyroid hormone, increased calcium excretion, hypercortisolism, alcohol abuse, and metastatic cancer, osteomalacia.
A 57 years old woman has been amenorrheic for 4 years and asks whether hormone therapy will lead to heart attack. You explain that results from Women’s Health Initiative (WHI ) suggest which of the following regarding coronary heart disease risk?
It is decreased among older users (70-79 years)
It is increased among younger users (50-59 years)
It is increased among all postmenopausal users of combined estrogen and progestin hormone therapy.
It is likely decreased among women who initiate combined hormone therapy within 10 years of the menopause.
All of the above statements are true
D.It is likely decreased among women who initiate combined hormone therapy within 10 years of the menopause.
What drugs are used to tx osteoporosis?
Bisphosphonates (alendronate, risendfronate,etc), Denosumab (RankL inhibitor), Parathyroid hormone, Hormone Medications (estrogen/progesterone therapy), SERMS (estrogen like medicines (
What is a SE of bisphosphonates
Jaw pain (osteonecrosis of the jaw)
What are hormones good for (tx)?
Vulvovaginal and vasomotor sx)
What is Denosumab and when do you use it?
RankL inhibitor to help prevent bone loss in prostate ca and breast ca
What is the MOA of Denosumab?
Binds to RankL, blocks interaction between RANKL and RANK and prevents osteoclast
Formation, leading to decreased bone resportion and increased bone mass in
Osteoporosis.
Estrogen replacement therapy is contraindicated in women with all of the
following except:
Vasomotor symptoms
Active liver disease
Known or suspected breast carcinoma
Abnormal genital bleeding of unknown etiology
Known cardiovascular disease
Known or suspected uterine cancer
Acute or history of thromboembolic disease
Vasomotor Sx
For treatment of vasomotor symptoms, currently suggested alternatives to hormones includes all of the following EXCEPT:
Bellergal Clonidine Gabapentin Selective serotonin-reuptake inhibitors Venlafaxine (SNRI)
Bellergal
Which of the following does NOT have an indication for osteoporosis treatment?
Denosumab Calcitonin Bisphosphonates Estrogen replacement Parathyroid hormone
estrogen replacement
Which of the following is true of raloxifene (SERM)?
It is a potent bisphosphonate.
It increases breast cancer risk
It increases thromboembolism risk.
It significantly decreases nonvertebral fracture rick.
Decreases stroke mortality and hot flashes
Increases thromboembolism risk
