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PSIO 469 Exam 04 > Lecture 24: Hormone Replacement Therapy > Flashcards

Lecture 24: Hormone Replacement Therapy Flashcards

1
Q

Estrogen Actions: Desirable Effects
The Brain:
(3)

A
  • Regulates area that prepares body for reproduction
  • Helps maintain stable temperature and avoid hot flashes
  • May help protect memory
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2
Q

Estrogen Actions: Desirable Effects

The Breasts:

A

Programs glands to produce milk

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3
Q

Estrogen Actions: Desirable Effects
The Liver and Heart:
(2)

A
  • Helps regulate production of cholesterol in the liver

- helps avoid atherosclerosis and heart attacks

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4
Q

Estrogen Actions: Desirable Effects

The Uterus:

A
  • Programs the uterus to nourish a fetus
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5
Q

Estrogen Actions: Desirable Effects

The Bones:

A
  • Maintains density
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6
Q

Estrogen Actions: Undesirable Effects

The Breasts:

A

-Promotes breast cancer

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7
Q

Estrogen Actions: Undesirable Effects

The Uterus:

A
  • Promotes cancer of the uterine lining
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8
Q

Pre-Menopause

Before menopause, ovaries produce:

A
  • Estrogen

- Progesterone

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9
Q

Pre-Menopause
During years of ovarian estrogen production, women benefit from these activities:
(3)

A
  • Protection against cardiovascular disease
  • Estrogen prevents atherosclerotic lesion formation
  • Prevents or reversal of bone loss (osteoporosis)
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10
Q

Menopause

Average age of menopause in US is:

A

51

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11
Q

Menopause

Common symptoms associated with estrogen deficiency are:

A
  • Hot flashes
  • Vaginal Atrophy
  • Sleep Disturbance
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12
Q

Conjugated Equine Estrogen (CEE)
Premarin is a commercial name for a compound drug consisting primarily of conjugated estrogens for hormone therapy. It consists of

A
  • Estrone (> 50%)
  • Equilin (15-25%)
  • Equilienin
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13
Q

Conjugated Equine Estrogen (CEE)

Estrogen are conjugated because:

A
  • of it being hydrophilic side-groups attached
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14
Q

Conjugated Equine Estrogen (CEE)

Estrone sulfate is easily absorbed and converted to ______ by body

A

Estradiol

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15
Q

Conjugated Equine Estrogen (CEE)

Premarin is isolated from

A

Mare’s urine

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16
Q

Conjugated Equine Estrogen (CEE)

Prempro is CEE plus this; a synthetic Progesterone.

A

Medroxyprogesterone acetate (MPA)

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17
Q

Progestin helps reduce the risk of endometrial cancer by:

A

maintaining endometrial atrophy in women with uterus

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18
Q

CEE + MPA study was stopped in July 2002

This was because women taking CEE + MPA demonstrated health problems such as:

A
  • increased risk of stroke
  • increased risk of venous thromboembolic events
  • increased risk of invasive breast cancer
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19
Q

Estrogen alone study was stopped in Feb 2004

When women were taking CEE alone, they demonstrated health problems with:

A
  • increased risk of stroke
20
Q

Studies dound the CEE + MPA conferred the following health benefits:
(2)

A
  • Decreased risk of colorectal cancer

- Decreased risk of hip fractures

21
Q

Estrogen also:

A
  • decreases risk of hip fractures
22
Q

The USPTF recommends against routine use of ____ and _____ for the prevention of chronic conditions in ___-_______ women

A

estrogen; progesterone

post-menopausal

23
Q

Hazard Ratio

The hazard ratio is

A

explanatory variable on the hazard of an event

24
Q

Hazard Ratio

Hazard ratio is the estimate of:

A

relative risk (RR)

25
Q

Hazard Ratio

Relative Risk is

A

Risk of events relative to exposure

26
Q

Hazard Ratio

Relative Risk is calculated by:

A

Probability of the event occurring in exposed group

Probability of the event occurring in non-exposed group

27
Q

Hazard Ratio

If Relative Risk is 1, then it means:

A

there is no difference in risk between two groups

28
Q

Hazard Ratio

If Relative Risk is > 1, then it means:

A

Event is more likely to occur in experimental group than control group

29
Q

Hazard Ratio

If Relative Risk is < 1, then it means:

A

Even is less likely to occur in the experimental group than control group

30
Q

Global Index Hazard Ratio

These 8 represent first event for each participant among the following:

A
  1. CV Disease
  2. Stroke
  3. PE
  4. Breast Cancer
  5. Endometrial Cancer
  6. Colorectal Cancer
  7. Hip Fracture
  8. Death due to other causes
31
Q

Therapeutic Window of Opportunity Hypothesis

Estrogen have _____ effects prior to menopause

A

beneficial

32
Q

Therapeutic Window of Opportunity Hypothesis

Estrogen have adverse affects when started well beyond the:

A

menopausal transition

33
Q

Therapeutic Window of Opportunity Hypothesis

Perhaps estrogens may have beneficial effects if initiated around entry to

A

menopause

34
Q

Atherosclerosis is:

A

buildup of plaque in blood vessels

35
Q

Plaque consists of:

A

fat, cholesterol, calcium and other molecules

36
Q

Estrogen and Atherosclerosis

Endogenous estrogens are thought to be _____ against coronary artery atherosclerosis

A

protective

37
Q

Estrogen and Atherosclerosis

Atherosclerosis begins in ____ and progress with increasing ___.

A

youth; age

38
Q

Estrogen and Atherosclerosis

Coronary Hear Disease is extremely rare in ____ age women compare to men of the ___ age

A

fertile; same

39
Q

Estrogen and Atherosclerosis
Women experiencing early menopause or surgically-induced menopause are more likely to develop ___ than premenopausal women of the same age

A

Coronary Heart Disease (CAD)

40
Q

Thrombus is:

A

blood clot that is formed in blood vessels when plaque erupts

41
Q

Thromboembolus is:

A

a piece of thrombus that breaks loose and travels through bloodstream where it can become stuck in a narrow vessels

42
Q 
Estrogen and Atherosclerosis
Exogenous estrogens  (ET/HT) administered well beyond menopausal transition can have \_\_\_\_\_\_ effects.
A

harmful

43
Q

Effects of exogenous estrogen on complicated plaque can:

2

A
  • Increase inflammatory response
    • which promotes growth of atherosclerotic plaque
  • Increases MMP
    • destabilizes and promotes rupture of the plaque
44
Q

MMP is

A

Matrix Metalloproteinase

45
Q

Current Recommendations

Hormone Therapy should be initiated around:

A

onset of menopause

46
Q

Current Recommendations
Treating menopausal related symptoms such as:
(3)

A
  • Hot flashes
  • Vaginal Atrophy
  • Sleep disturbances
47
Q

Current Recommendations

To treat or reduce risk of disorders such as:

A
  • Osteoporosis and/or fractures

- CAD

PSIO 469 Exam 04 (5 decks)

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