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Module 1 > Endocrine-2 (Female Reproductive) > Flashcards

Endocrine-2 (Female Reproductive) Flashcards

1
Q

Therapeutics

A

GnRH (pulse generator)
↓
FSH & LH
↓
Ovary

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2
Q

What does pulsatile release of GnRH from the hypothalamus stimulate?

A

Pituitary release in pulses of FSH/LH

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3
Q

What does FSH stimulate?

A

Ovarian follicle development

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4
Q

What do ovarian follicles release?

A

Estradiol

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5
Q

What does estradiol stimulate?

A

Growth of endothelial lining (“positive” feedback)

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6
Q

What do LH surges trigger?

A

Ovulation

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7
Q

In increase in estradiol/progesterone levels maintains what?

A

Uterine lining

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8
Q

Day 1 to ovulation is called the ________ phase.

A

follicular

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9
Q

Ovulation to menstruation is called the __________ phase.

A

luteal

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10
Q

Estrogen

A

Reproductive organs mature

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11
Q

What does estrogen decrease?

A

Reabsorption of bone

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12
Q

What does estrogen increase?

A

Coagulability of blood

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13
Q

What does continuous/unopposed estrogen for long periods of time lead to?

A

Abnormal hyperplasia

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14
Q

What does progesterone maintain?

A

Endometrial lining (in pregnancy)

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15
Q

What is androstenedione?

A

A weak androgen

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16
Q

What does testosterone have?

A

Significant androgen activity

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17
Q

What is the brand name for a copper-IUD?

A

Paragard

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18
Q

What is the duration of a copper-IUD’s use?

A

10 years

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19
Q

What is the mechanism of action in a copper-IUD?

A
  • Non-hormonal
  • Continual release of Cu++ into uterus
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20
Q

What are the side effects of a copper-IUD?

A

Heavier flow, abdominal cramps

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21
Q

What is the duration of a levonorgestrel IUD?

A

3-5 years

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22
Q

What is the mechanism of action in a levonorgestrel IUD?

A
  • Progestin ONLY
  • Local release of progestin into uterus
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23
Q

What are the side effects of a levonorgestrel IUD?

A

Changes in bleeding patterns, amenorrhea

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24
Q

What is the brand name for etonogestrel?

A

Nexplanon

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25
Q

What is the duration of the etonogestrel implant?

A

3 years

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26
Q

What is the mechanism of action in the etonogestrel implant?

A
  • Progestin ONLY
  • Controlled progestin release
  • Suppresses ovulation
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27
Q

What is a prominent side effect of the etonogestrel implant?

A

Unpredictable bleeding

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28
Q

What are some considerations when using long-acting reversible contraception?

A
  • Return to fertility in 1-2 cycles
  • Effectiveness is NOT decreased with weight
  • Efficacy
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29
Q

What are combination hormonal contraceptives?

A

Continuous administration of estrogen + progestin

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30
Q

What do combination hormonal contraceptives suppress?

A

GnRH release from hypothalamus

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31
Q

What does the estrogen component of combination hormonal contraceptives do?

A
  • Prevents ovulation
  • Provides cycle control
  • Prevents ADEs
32
Q

What enzymes are part of the elimination component of combination hormonal contraceptives?

A

CYP450 3A4 enzymes

33
Q

What doses do ethinyl estradiol come in?

A

50mcg, 35mcg, 30mcg, 20mcg, 10mcg

34
Q

What is a good starting dose of ethinyl estradiol for women?

34
Q

What dose of ethinyl estradiol is good to use for women with adherence issues?

A

30mcg/35mcg

35
Q

What does the progestin component of combination hormonal contraceptives do?

A

Provides most contraceptive effect

36
Q

What does the progestin component of combination hormonal contraceptives suppress?

37
Q

What does the progestin component of combination hormonal contraceptives decrease?

A

Ovary response to FSH

38
Q

What is drospirenone?

A

Analog of spironolactone, anti-aldosterone/mineralcorticoid

39
Q

What are some risks of estrogen?

A
  • Venous thromboembolism
  • CV disease
  • Hypertension
  • Breast cancer
  • Headaches
40
Q

What E/P ratio do you use for monophasic cycles?

A

Equal E/P dose

41
Q

What E/P ratio do you use for biphasic cycles?

A

Same E/ different P in 2 phases

42
Q

What E/P ratio do you use for triphasic cycles?

A

Vary the E/ or P/ or both

43
Q

What should you do if you miss 2 or more combination hormonal contraceptive pills?

A

Use a non-hormonal backup until hormonal pills have been taken for 7 days

43
Q

What is an example of a progestin-only contraceptive?

A

Norethidrone (Micronor)

44
Q

What is the mechanism of action in norethidrone?

A

Increases thickness of the cervical mucus

45
Q

Are there placebo pills in norethindrone packs?

46
Q

What dose of tablets do norethindrone come in?

47
Q

What is an over the county progestin only pill?

A

Norgestrel

48
Q

What strength do norgestrel pills come in?

49
Q

What is the brand name of norgestrel?

50
Q

What is the name for the depo-injection?

A

depo-MedroxyProgesterone Acetate (DMPA)

51
Q

What is the mechanism of action of DMPA?

A

Suppresses FSH/LH (no ovulation)

52
Q

What are the adverse effects of DMPA?

A
  • Unpredictable bleeding
  • Weight gain
  • Decreased bone mineral density
53
Q

What is a form of emergency contraception that comes in a prescription only?

A

Ulipristal acetate (Ella)

54
Q

What is the dose that ulipristal acetate comes in?

55
Q

What is the mechanism of action of ulipristal acetate?

A

Inhibits/delays ovulation

56
Q

What does ulipristal acetate block?

A

Progesterone from binding to its receptor

57
Q

When should ulipristal acetate be administered?

A

Up to 5 days after unprotected intercourse

58
Q

What is a form of emergency contraceptive that is available over the counter?

A

Levonorgestrel (Plan B)

59
Q

What dose does levonorgestrel come in?

60
Q

What is the common directions for levonorgestrel?

A

Take as soon as possible after unprotected sex
The sooner you take it the better it will work

61
Q

What are some adverse effects of levonorgestrel?

A

Mild headache, fatigue, dizziness, breast tenderness

62
Q

Menarche

A

1st period that occurs

63
Q

Menopause

A

When a woman has had no cycles for 12 months or longer

64
Q

What are characteristics of perimenopause?

A
  • Irregular cycles
  • Unpredictable fertility
  • Increases FSH levels
65
Q

How is perimenopause diagnosed?

A
  • Bleeding changes
  • Increased FSH levels
66
Q

What are examples of drug therapy for menopause symptoms?

A
  • OTC vaginal moisturizers
  • Vaginally inserted estrogen (local effect)
67
Q

What are some examples of vaginal estrogen products?

A
  • Creams
  • Tablets
  • Rings
68
Q

Is progestin needed in vaginal estrogen products?

69
Q

What are examples of estrogen products for systemic symptoms/hormone therapy?

A
  • Conjugated equine estrogens (Premarin)
  • Estradiol (Estrace)
70
Q

What are examples of progestin products for systemic symptoms/hormone therapy?

A
  • Medroxyprogesterone acetate (Provera)
  • Levonorgestrel IUD
71
Q

For women with a uterus, do they need estrogen therapy alone or estrogen + progestin?

A

Estrogen + progestin

72
Q

For women WITHOUT a uterus, do they need estrogen therapy alone or estrogen + progestin?

A

Estrogen therapy alone

73
Q

For women with “okay” FSH/LH levels and something “wrong” with their hormonal balance, what can they use to induce ovulation?

A

Clomiphene citrate (Clomid)

Module 1 (5 decks)

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