Hormone replacement treatment for lactation, pregnancy and delivery TEST #3

Question 1

T/F Natural estrogens are not considered steroid hormones because they are natural

Answer 1

False

-They are steroid hormones

Question 2

T/F Synthesized estrogens may be non-steroidal or steroidal

Answer 2

True

Question 3

What are the stages of the menstrual cycle?

Answer 3

• Menstrual stage
• Follicular stage
• Luteal stage

Question 4

T/F As populations age, they spend more time in menopause and andropause

Answer 4

True

Question 5

What are three natural estrogens?

Answer 5

• Estrone E1
• Estradiol E2
• Estratriol E3

Question 6

What natural estrogen is predominant during menopause?

Answer 6

E1 Estrone

Question 7

What natural estrogen is predominant during productive years?

Answer 7

E2 Estradiol

Question 8

What natural estrogen is predominant during pregnancy?

Answer 8

-E3 Estratriol

Question 9

What are Synthetic estrogens?

Answer 9

• Ethinyl estradiol

- Diethylstilbesterol

Question 10

Which synthetic estrogen is non-steroidal?

Answer 10

-Diethylstilbesterol

Question 11

Which synthetic estrogen is steroidal?

Answer 11

-Ethinyl estradiol

Question 12

What are the physiological functions of Estrogen?

Answer 12

• Sexual maturity
• Increased CNS excitability
• Increased endometrial and uterine growth
• Maintain skin elasticity
• Reduce bone adsorption
• Increase blood coagulability
• Alters plasma lipids-increases HDL and TGC and reduces LDL

Question 13

What are the main clinical uses for estrogen?

Answer 13

• Treat primary hypogonadism

- Postmenopausal problems

Question 14

What are the guidelines for use with estrogen?

Answer 14

• Always use the smallest dose for the shortest period of time possible
• Sometimes local creams are preferred to minimize exposure

Question 15

What are the adverse effects of estrogens?

Answer 15

• Postmenopausal bleeding
• Nausea
• Breast tenderness
• Migraines
• Hypertension
• Hyperpigmentation
• Increase some cancers

Question 16

When is the use of estrogens contraindicated?

Answer 16

• Liver disease (slows metabolism)
• Breast/endometrial cancers
• Thrombolytic disorders

Question 17

What are progestins mad from?

Answer 17

-Cholesterol

Question 18

T/F Progestins are found in both males and females

Answer 18

True

Question 19

What is the most important progestin in humans?

Answer 19

-Progesterone

Question 20

What is progesterone a precurosr to?

Answer 20

• Estrogen
• Androgen
• Adrenocortical steroids such as Cortisol
• Testosterone
• Estradiol

Question 21

What is the predominant hormone during the luteal phase?

Answer 21

-Progesterone

Question 22

What are synthetic progestins?

Answer 22

• Medroxyprogesterone

- Norgestimate

Question 23

What is the half life of progestins?

Answer 23

-5 minutes

Question 24

What are the effects of progestins?

Answer 24

• Increase fat deposition
• Decrease CNS excitability
• Increased aldosterone which increases Na+ retention
• Increase BP
• Increase body temperature

Question 25

Which hormone decreases CNS excitability?

Answer 25

-Progestins

Question 26

What are the clinical uses for progestins?

Answer 26

- Replacement therapy - Oral contraception - Long-term ovarian suppression

Question 27

What are the contraindications of using a progestin?

Answer 27

- Breast cancer is a risk | - Sever hypertension or heart disease is a risk

Question 28

What combination therapy do you use for contraception?

Answer 28

-Progesterone + estrogen

Question 29

When using a combination contraceptive what does that do to ovulation and conception and implantation?

Answer 29

-Decrease

Question 30

THe combination contraceptive decrease ovulation at what percent?

Answer 30

-Nearly 100%

Question 31

If using progestin only as a contraceptive what does it decrease ovulation to?

Answer 31

50-80%

Question 32

What does progestin do as a contraceptive?

Answer 32

- Thickens mucus and reduces sperm penetration | - Impairs implantation

Question 33

What is the minipill?

Answer 33

Progestin only contraceptive

Question 34

What are some combination delivery forms of a contraceptive?

Answer 34

- Monophasics (constant doses of both estrogen and progesterone) - Biphasic - Triphasic

Question 35

What are the side effects of combination contraceptives?

Answer 35

- Reduced ovarian functions and size - Increased breast size and tenderness - Increased breast size ad tenderness - Increased thrombolytic events - Increased HR and BP - Hyperpigmentation - Mild nausea - May interact with antibiotics that disrupt GI normal flora (amoxicilin)

Question 36

T/F Normal absorption of contraceptives from GI system is dependent on normal GI flora

Answer 36

True

Question 37

What can contraceptives be used for?

Answer 37

- Contraception - Menstrual disorders, irregularity, and heavy discharge - Acne

Question 38

What blocks actions of estrogen in breast and is used to treat breast cancers?

Answer 38

-Tamoxifen

Question 39

What blocks progesterone and glucocorticoid receptors?

Answer 39

-Mifepristone

Question 40

What suppresses ovarian function and has a masculinizing effect?

Answer 40

-Danazol

Question 41

What is Clomiphene (Clomid)?

Answer 41

-An ovulation inducing agent that is used for promoting fertilization and pregnancy

Question 42

What does testosterone cause?

Answer 42

-Male puberty

Question 43

What can testosterone be converted into?

Answer 43

-Estradiol

Question 44

Testosterone is used in gynecological disorders to do what?

Answer 44

-Reduce breast size (gynecomastia)

Question 45

What can help replace muscle loss because it has protein anabolic effects?

Answer 45

-Testosterone

Question 46

What can testosterone do for growth?

Answer 46

-Can prematurely close growth plates in growing adolescents

Question 47

What are side effects of testosterone?

Answer 47

- Acne - Aggressiveness - Roid Rage - Masculinizing effects - Hepatic dysfunction - Prostatic hyperplasia

Question 48

What is the predominant hormone of the follicular stage?

Answer 48

-Estrogen

Question 49

T/F THe last 5 days of the follicular stage plus during ovulation are the fertile window

Answer 49

True

Question 50

What is a steroid synthesis inhibitor drug?

Answer 50

-Ketoconazole that is used to treat prostate carcinoma in men

Question 51

What is oxytocin used for?

Answer 51

-Induce/augment labor

Question 52

What is Metoclopramide?

Answer 52

-Dopamine D2 receptor antagonist that stimulates prolactin and lactation