Exam 5 - Random Info Flashcards
what are the 3 PCOS diagnosis criteria?
-hyperandrogenism
-chronic anovulation
-polycystic ovaries
(need 2 of the 3 to confirm diagnosis)
what is the first line treatment for hyperandrogenism and menstrual irregularity?
combined oral contraceptive (COC)
(usually ethinyl estradiol/norgestimate or norethindrone)
first line treatment in PCOS with type 2 diabetes mellitus and failed lifestyle modifications
metformin
true or false: you should consider discontinuing metformin if pregnant
true
which statement is FALSE regarding the use of metformin in PCOS?
a. Dose is 500 mg po QD (titrated to maximum of 2000 mg/day)
b. Offers reliable endometrial protection
c. Results may take up to 6 months to be seen
d. Gastrointestinal side effects will decrease after 2-3 weeks
b. Offers reliable endometrial protection
true or false: topical Vaniqa (eflornithine) is 2nd line treatment for hyperandrogenism
false
(3rd line; it is for facial hair only)
letrozole is FDA approved for treatment of what disease?
breast cancer
letrozole is in what drug class?
aromatase inhibitors
first line treatment for anovulation
letrozole
true or false: spironolactone is teratogenic
true
true or false: aromatase inhibitors are contraindicated in pregnancy
true
what do we have to monitor when taking spironolactone?
K+ levels
(can cause inc in potassium levels)
what do we have to monitor when taking spironolactone?
K+ levels
(spironolactone can cause inc in potassium levels)
progestins prevent ___ surge
LH
ovulatory factors for female infertility (3)
-hypothalamic pituitary failure
-dysfunc. of hypothalamic-pituitary ovarian axis
-ovarian failure
dysmenorrhea first line
NSAID
NSAID mech of action
inhibits COX, leading to decrease in prostaglandin production
oral contraceptive therapy mech of action
inhibition of endometrial tissue proliferation, leading to decreased endometrial production and leukotrienes
levonorgestrel IUD and DMPA mechanism of action
related to amenorrhea side effect
treatment for amenorrhea, dopamine agonists (2 drugs)
-bromocriptine
-cabergoline
(if amenorrhea is caused by medications that increase prolactin levels)
bromocriptine half life
3 hours
cabergoline half life
65 hours
oligomenorrhea is menstrual cycle interval > ___ days (but less than 90 days)
35 days
polymenorrhea is menstrual cycle interval < ___ days
21 days
is tranexamic acid hormonal or non-hormonal?
non-hormonal
(usually reserved for those unable to take CHCs or wanting to conceive)
tranexamic acid mechanism of action
antifibrinolytic - prevents the degradation of blood clots
metrorrhagia in irregular menstrual bleeding _____ cycles
between
danazol is second line for what condition?
endometriosis
danazol mechanism of action
androgen that suppresses FSH and LH production
(danazol has a lot of side effects)
black box warning for danazol
thromboembolism
true or false: danazol is CI in pregnancy and breastfeeding
true
what is the most common pelvic tumor?
uterine fibroids
smoking is a protective factor for preventing what?
uterine fibroids
true or false: GnRH agonists and SPRM’s are used to treat uterine fibroids
true
(ex. mifepristone and ulipristal are SPRMs)
supplements for PMS/PMDD (3)
-calcium (elemental of 1200 mg/day)
-magnesium (200-400 mg/day)
-vitamin B, D, E
first line for PMS/PMDD (3)
SSRI’s, NSAIDs, spironolactone
(examples of SSRI’s: fluoxetine, sertraline, paroxetine CR)
second line for PMS/PMDD (5)
venlafaxine
duloxetine
clomipramine
alprazolam
COC’s
