Chapter 35 Flashcards
What are the differential diagnosis for a patient with menopausal symptoms?
Hyperthyroidism, pregnancy, hyperprolactinemia, Menopause
What is the possible physical examination findings for a menopausal patient? How is menopause diagnosed?
Vaginal dryness; clinical diagnosis
What is the criteria for menopause that Precludes necessary Lab investigations?
Women over 45 with 12 months of amenorrhea
What confirms menopause diagnosis in a patient that is uncertain?
High FSH levels
What test should be ordered in a patient who is clinically diagnosed for menopause?
Diagnostic test are not needed there for age-appropriate screening test should be administered ( Colonoscopy, Mammography, Pap smear and fasting lipid profile)
What should be ordered in patients who are younger than 45 ( with irregular menses and Sxs) or have symptoms that suggest hyperthyroidism?
TSH, FSH, HCG, prolactin
What menopausal symptoms are to be treated and with what?
Vasomotor symptoms, and vaginal dryness should be treated with Estrogen replacement therapy which should be paired with progestin if patient is still has a uterus. May also be useful for osteoporosis prevention
How long should hormone replacement therapy be instituted?
2 to 3 years but no more than five years
What are HRT contraindications? What can be used for hot flashes therapy instead?
Breast cancer cardiovascular disease, stroke, DVT; gabapentin, SSRIs, SNRIs
Patient presents with severe vasomotor symptoms, how may rebound symptoms be avoided?
Gradually tapering HRT for 6 to 12 months
What is the necessary counseling for this patient?
Regular exercise, high calcium diet, Low salt diet, medication compliance, medication side effects for HRT
What’s the follow up duration for this patient
3 to 6 weeks
