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COMAT - OBGYN > Development/Menopause/Contraception > Flashcards

Development/Menopause/Contraception Flashcards

1
Q

Between what ages should females begin puberty?

A

8 - 13

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2
Q

What is the order of puberty for females?

A

Thelarche
Pubarche
Growth spurt
Menarche

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3
Q

Between what ages should females begin menses?

A

10 - 16

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4
Q

Stage 1 puberty

A

Pre-puberty adolescence

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5
Q

Stage 2 puberty

A

Breast buds + pubic hair

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6
Q

Stage 3 puberty

A

Breast mounds + coarsening of pubic hair

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7
Q

Stage 4 puberty

A

Breast enlarges with raised areola

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8
Q

Stage 5 puberty

A

Adult breast contour with flat areola + pubic hair on the medial thighs

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9
Q

What occurs in the Follicular phase of the menstrual cycle?

A

Increased GnRH –> Increased FSH –> Estrogen production and growth of follicles

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10
Q

Day 14 is Ovulation. What occurs?

A

Estradiol reaches its peak –> LH surge –> rupture of a follicle which releases an ovum and then becomes the corpus luteum

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11
Q

After Ovulation, what is the next stage of the menstrual cycle?

A

Luteal phase

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12
Q

During the follicular phase, estradiol dominates. During the luteal phase, progesterone dominates. Why?

A

Corpus luteum produces progesterone to prepare endometrium for implantation

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13
Q

If pregnancy does occur, how long will the corpus luteum produce progesterone? What takes over?

A

8 weeks
–> Placenta takes over

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14
Q

If pregnancy does not occur, the corpus lutuem dies and what happens to the hormone levels?

A

DROP –> sloughing of the endometrial lining (menses) and the cycle starts over again

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15
Q

What defines Precocious Puberty?

A

Onset of secondary sex characteristics BEFORE 8 years of age

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16
Q

What should be done to evaluate Precocious Puberty?

A

Wrist X-ray to assess bone age

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17
Q

If bone age is > 2 years ahead of chronological age, what diagnostics should be pursued?

A

FSH
LH
Estrogen
Brain/Ovarian studies

18
Q

If DHEAS is high, the etiology is likely where?

A

Adrenal glands

19
Q

What medication class can be used to treat Precocious Puberty that is not due to another cause?

A

GnRH Analogs

20
Q

What defines Menopause? When is it considered Premature?

A

No menses for 12 monthes
– Premature if this occurs before age 40

21
Q

List symptoms of Menopause

A
  • Hot flashes
  • Insomnia
  • Mood changes and poor concentration
  • Vaginal atrophy and dryness
  • Low libido
22
Q

What will the levels of FSH and LH be with Menopause?

A

HIGH

23
Q

When is Hormone Replacement Therapy likely indicated for Menopause?

A

Vasomotor symptoms

24
Q

With HRT, what is important to know about your patient?

A

Do they have a Uterus?

25
Q

With HRT, if your patient DOES have a uterus, what should be given?

A

Estrogen + Progestin

26
Q

With HRT, if your patient does NOT have a uterus, what should be given?

A

Estrogen only

27
Q

HRT increases risk for what complications? (4)

A
  • Breast cancer
  • Endometrial cancer
  • DVT
  • Cardiovascular mortality
28
Q

List 3 drug/classes that can be used for Menopause?

A
  1. SSRIs/SNRIs
  2. Clonidine
  3. Gabapentin
29
Q

What can be used for vaginal atrophy, dryness or dyspareunia with Menopause?

A

Estrogen cream

30
Q

With Menopause, women are at an increased risk for _____ due to low estrogen. What supplements should they be given?

A

Osteoporosis
– Calcium + Vitamin D

31
Q

If you start Bisphosphonates for Osteoporosis, what are 2 possible complications?

A

Esophagitis
Jaw osteonecrosis

32
Q

When should women be screened with a DEXA scan?

A

65

33
Q

Nexplanon is a progestin implant in the upper arm. How long does it last? Side effects?

A

3 years – irregular periods

34
Q

Progestin IUDs last for how long?

A

5 years

35
Q

What is the benefit of Progestin only contraceptive methods?

A

Safe with breastfeeding

36
Q

How long does a Copper IUD last? Side effect?

A

10 years
– HEAVY bleeding

37
Q

Medroxyprogesterone injections are given how often? What is a complication that is reversible?

A

q3 months
– Decreases bone mineral density but this is reversible

38
Q

OCPs protect against what cancers?

A

Endometrial and Ovarian

39
Q

What are contraindications for beginning OCPs?

A
  • Age > 35 + smoker
  • History of DVT
  • Migraines with aura
  • Hypertension
  • GERD
40
Q

What are contraindications for beginning OCPs?

A
  • Age > 35 + smoker
  • History of DVT
  • Migraines with aura
  • Hypertension
  • GERD

COMAT - OBGYN (12 decks)

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