general

Question 1

1st Gen Progesterones

Answer 1

Norethindrone
Norethindrone Acetate
Ethynodiol Diacetate

Question 2

2nd Gen Progesterones

Answer 2

Norgestrel
Levonorgestrel
More acne, hirsutism, DLD

Question 3

3rd Gen Progesterones

Answer 3

Desogestrel
Norgestimate

Decreased androgenicity, reduced carb/lipid metabolism SEs

Question 4

4th Gen Progesterones

Answer 4

Drospirenone

Dienogest

Question 5

Norethindrone

Answer 5

Mod Androgenic Activity

Question 6

SEs r/t BOTH estrogen and progesterone / suggest too high

Answer 6

Menstrual irregularities
Weight gain
Bloating

Breast tenderness
Headache
BP increase

Question 7

SEs r/t estrogen / suggest too high

Answer 7

N/V
Coagulation risk
Depression
Photosensitivity 
Skin spotting/darkening
Increased growth/worsening of fibroids/endometriosis

Question 8

SEs r/t progestin / suggest too high

Answer 8

Acne, hirsutism, increased appetite
Abdominal pain, cramping
Fatigue, mood changes, nervousness

Dizziness, drowsiness

Question 9

Progestins and androgenicity

Answer 9

Levonorgestrel, Norgestrel

Moderate: norethindrone

Little: desogestrel, norgestimate

Anti: Drospirenone, dienogest

Question 10

Progestins w/ increased VTE risk

Answer 10

Desogestrel

Drospirenone

Question 11

Podofilox

Answer 11

Prevents cell division (arrests mitotic spindle) and blood vessels in wart

Max applied area: 10 sq cm, 0.5mL/day
BID x3 days, then off x4 days, clear or max 4 weeks

No pregnancy, vagina, anus

Question 12

Imiquimod 5%

Answer 12

Cell mediated immune response modifier

TIW HS X 16 weeks
Wash 6-10 hours after app

Question 13

Sinecatechins 15%

Answer 13

Green tea extract

Thin layer TID until clear or max 16 weeks
Do not wash
Avoid sexual contact, avoid open wounds

Question 14

Sinecatechins 15%

Answer 14

Green tea extract

Thin layer TID until clear or max 16 weeks
Do not wash
Avoid sexual contact, avoid open wounds

Question 15

Steroidal AI

Answer 15

Exemestane (Aromasin)

Question 16

DDIs avoid in AI use

Answer 16

tamoxifen
estrogens
DHEA
Aprepitant

Question 17

Only approved LHRH agonist for metastatic BCA and DDIs

Answer 17

Goserelin

QT prolongation w/ drugs: Dronedarone, amitriptylline, citalopram, clarithromycin

Question 18

Contradindicated w/ peanut allergy

Answer 18

Micronixed progesterone (Prometrium) - PCOS alternative cyclic progestin

Cyclic progestin: Q4 weeks x 10-14days

Question 19

Alternative herbal Tx for menopause

Answer 19

Black cohosh: 7 small short-term RCTs. Remifemin. Not recommended to take longer than 6mo

Question 20

Breast cancer risk

Answer 20

5 years measure
Low: less than 1.67%, MHT ok
Intermediate: 1.67-5% - caution
High: 5% or more - AVOID

Question 21

Duavee

Answer 21

Estrogen plus bazedoxifene (SERM)

Question 22

Absolute contraindications for menopausal hormone therapy

Answer 22

Liver dz
Undiagnosed vaginal bleeding
10 year ASCVD > 7.5

known breast/endometrial cancer 
Known clotting d/o
Known ASCVD, CAD, PAD
Known VTE, PE
Known stroke, TIA, MI

Question 23

Relative contraindications for menopausal hormone therapy

Answer 23

10 year ASCVD 5-7.4

DM, DLD, gallbladder dz, smoking, uncontrolled HTN
Migraine w/ aura
Obese, sedentery, limtied mobility

Question 24

Age/timing for menopause therapy

Answer 24

Age less than 60 or less than 10 years since menopause