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Gynaecology and Obstetrics > Hormones > Flashcards

Hormones Flashcards

1
Q

Mixed agonists with estrogenic effects are called ___________

A

Selective Estrogen receptor modulator

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2
Q

Long-acting esters of estradiol _______________ is administered __________

A

Estradiol cypionate
IV

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3
Q

Biologic source of estrogen

A

Premarin

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4
Q

Effects of estrogen on the body

A
  1. Modifies protein levels
  2. Reduces LDL and Increases HDL
  3. Reduces bone resorption
    4.Enhances the coagulability of blood
    5.Inhibits the secretion of gonadotropins from the anterior pituitary
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5
Q

Estrogen is used for

A

Hypogonadism
Estrogen deficiency (POF, menopause or surgical removal of varies)
Osteoporosis

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6
Q

Estrogen increases the risk for _____________ and ______________ CA

A

Breast
Endometrial

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7
Q

Endometrial cancer risk can be reduced by adding ____________ to estrogen

A

Progestin

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8
Q

Dosage of estrogen must be reduced in hypogonadal girls. Why?

A

To prevent premature closure of epiphyses of long bones and short stature

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9
Q

What are dose-dependent toxicities of estrogen?

A

Nausea
Breast tenderness
Migraine headache
Thromboembolic events
Gall bladder disease
Hypertriglyceridemia
Hypertension
Increased clotting factors

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10
Q

The side effect of increased clotting factors by estrogen can be decreased by ______________

A

avoiding oral route

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11
Q

Diethylstilbestrol use is associated with ____________, ______________, and ______________ in the daughters of women who were treated for spontaneous abortion

A

Infertility
Ectopic pregnancy
Vaginal adenocarcinoma

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12
Q

Progesterone ___________________ have improved oral bioavailability

A

Medroxyprogesterone

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13
Q

Fx of progesterone

A

Maintenance of pregnancy
Affect carb metabolism
Suppress ovulation in high doses

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14
Q

Uses of progesterone

A

COntraceptive with estrogen
Maintain pregnancy

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15
Q

Toxicities of progesterone

A

Decrease HDL
Weight gain
Decrease in bone density
Delayed resumption of ovulation after termination of therapy
Increases the risk of breast CA

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16
Q

Postcoital contraceptive

A

L-norgestrel alone
Estrogen alone
COCP

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17
Q

Abortifacient

A

Mifepristone
Misoprostol

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18
Q

Endometriosis

A

OCP
Depot inj of medroxyprogesterone acetate
GnRH agonist
Danazol

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19
Q

Breast cancer

A

Tamoxifen
Aromatase inhibitors (e.g. anastrozole)

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20
Q

Osteoporosis

A

Estrogen
Raloxifene

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21
Q

Infertility

A

Clomiphene
hMG
hCG
GnRH analogs
Progesterone
Bromocriptine

22
Q

Hirsutism

A

COCP
Spironolactone
Flutamide
GnRH agonists

23
Q

Prostate hyperplasia

A

Finasteride

24
Q

Norethindrone is AKA ___________

A

minipill

25
Q

What is norethindrone?

A

Progesterone
For breastfeeding women

26
Q

COCPs are available in

A

monophasic
biphasic
triphasic
quadriphasic

27
Q

Postcoital contraceptives should be used within _______ hours after unprotected intercourse

A

72 hours

28
Q

What is the action of COCP?

A

Inhibition of ovulation
Thickening of the cervical mucus
Affects the tubal function and endometrial lining

29
Q

Using COCPs has reduced the risk of many diseases.

A

Ovarian cyst
Ovarian CA
Endometrial CA
PID
Ectopic pregnancy
Iron deficiency anemia
Benign breast disease
Rheumatoid arthritis

30
Q

What are the toxicities of COCPs?

A

Thromboembolic events
Breast CA
Nausea
Breast tenderness
Headache
Skin pigmentation
Depression
Weight gain
Acne
Hirsutism

31
Q

Why SERMs have agonist and antagonist effects at different sites?

A

Different ER dimers
ERa-ERa
ERa-ERb
ERb-ERb

32
Q

Name some SERMS

A

Tamoxifen
Raloxifene
Clomiphene
Toremifene
Bazedoxifine

33
Q

_______________ is a pure estrogen receptor antagonist

A

Fulvestrant

34
Q

Tamoxifen is used for the tx of ______________

A

Hormone responsive breast cancer

35
Q

What is the action of tamoxifen?

A

Antagonist in breast tissue
Agonist at endometrial tissue

36
Q

What are the pros of tamoxifen?

A

Reduces risk of breast CA
Prevents osteoporosis

37
Q

What are the cons of tamoxifen?

A

Endometrial CA (agonist)
Venous thromboembolism (agonist)
Hot flushes (antagonist)

38
Q

Raloxifene is used for __________________
Clomiphene is used for __________________

A

Osteoporosis
Induction of ovulation

39
Q

_______________ is a newer SERM for the treatment of menopausal symptoms and prophylaxis of osteoporosis

A

Bazedoxifene

40
Q

Raloxifene reduces the risk of ______________ cancer

A

breast

41
Q

Side effects of raloxifene

A

Hot flushes
Venous thromboembolism

42
Q

How does clomiphene induce ovulation?

A

It is a partial agonist at the estrogen receptor so it increases FSH and LH output (by reducing the negative feedback)

43
Q

______________ is used in tx of breast cancer resistant to tamoxifen

A

Fulvestrant

44
Q

Name the aromatase inhibitors and their use.

A

Anastrozole
Letrozole
Exemestane

Used for Breast cancer

45
Q

What is the mechanism of action of Danazol?

A

It inhibits the P450 enzyme involved in gonadal steroid synthesis
Weak partial agonist at progestin, androgen, and glucocorticoid receptors

46
Q

Danazol is used for _________________ and ____________________

A

Endometriosis
Fibrocystic disease of the breast

47
Q

GnRH analog _____________ is used for _________________ (4)

A

Leuprolide
Controlled ovarian hyperstimulation
Precocious puberty
Endometriosis
Fibroids

48
Q

Side effect of leuprolide

A

Decreased bone density if used for more than 6 months

49
Q

GnRH antagonist _______________ and _____________ are used for ___________________

A

Ganirelix
Cetrorelix
Controlled ovarian hyperstimualtion

50
Q

Antiprogestins (Mifepristone) is used as an abortifacient in ____________ pregnancy

A

early (up to 49 days after LMP)

51
Q

Most common complication of mifepristone is ______________

A

failure to induce abortion

52
Q

Side effects of Mifepristone

A

N/V/D and cramping and bleeding associated with passing the pregnancy

Gynaecology and Obstetrics (13 decks)

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