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OB/GYN > Menopause > Flashcards

Menopause Flashcards

1
Q

What is the technical definition of menopause?

A

12 consecutive months with no menstrual bleeding

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2
Q

What is perimenopause?

A

The period before menopause that is the transition from the reproductive to nonreproductive years, when ovarian estrogen fluctuate unpredictably

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3
Q

What is climacteric?

A

The time at which the changes of menopause occur

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4
Q

What happens to the menstrual cycle during the 4 years prior to menopause?

A

Irregularities

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5
Q

What is the average age of menopause?

A

51

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6
Q

What is the relationship between menopause and age of menarche? Race? Parity?

A

No relation to any of these

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7
Q

True or false: tobacco use causes earlier menopause

A

True

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8
Q

True or false: EtOH use causes earlier menopause

A

False–longer

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9
Q

What happens to the follicles with menopause?

A

Become resistant to FSH stimulation, causing the estrogen to fall

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10
Q

Why is it that estrogen levels do not fall completely once menopause hits?

A

Peripheral conversion and fat

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11
Q

What happens to progesterone production with menopause? What indicates this?

A

Stops production, causing PMS s/sx to disappear

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12
Q

Why is there an increased risk for endometrial hyperplasia with menopause?

A

Loss of progesterone together with a lack of estrogen loss

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13
Q

What happens to androgen production with menopause? SHBG? What is the significance of this?

A

Decreases

Increased testosterone could be causing hirsutism in some women

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14
Q

What happens to FSH and LH levels with menopause?

A

Increased drastically d/t lack of estrogen production

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15
Q

What are the s/sx of menopause?

A
  • Oligomenorrhea

- Somatic and psych changes

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16
Q

What are the psych s/sx of menopause?

A
  • Depression
  • Anxiety and irritability
  • Loss of libido
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17
Q

What are the “vasomotor instability” s/sx of menopause?

A

Changes in neurotransmittersr and prostaglandins cause SNS activation

“hot flashes”

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18
Q

What is the cardinal symptom of menopause? How often does this occur?

A

Hot flashes–75% of women

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19
Q

What neurotransmitter concentration changes with menopause?

A

5HT

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20
Q

What happens to sleep with menopause?

A

Decreased REM

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21
Q

What happens to short term memory with menopause?

A

Changes

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22
Q

What are the urologic s/sx of menopause?

A

Urinary frequency
Urgency
Nocturia

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23
Q

Urogenital atrophy with menopause causes what s/sx?

A

Pruritis
Dryness
Dyspareunia

24
Q

What is the #1 morbidity in menopausal women?

A

Osteoporosis

25
Q

What is the RANKL receptor?

A

Receptor on osteoblasts that activates osteoclasts. Is upregulated with the presence of PTH

26
Q

What bones are assessed with a DEXA scan?

A

Spine and the hip

27
Q

What defines osteoporosis with a DEXA scan?

A

Less than 2.5 SDs from normal

28
Q

True or false: bone marker correlate well with bone density

29
Q

What are the meds that can be used to decrease bone loss?

A

Estrogen

SERMS

30
Q

Below what weight would you want to screen for bone loss earlier than age 65?

A

Under 127 lbs

31
Q

What causes the increased risk of CVD in menopausal patients?

A

Lack of estrogen causes:

  • Decrease HDL
  • Increase TG
  • Ratio of TC:HDL increases
32
Q

HDL less than what is a risk factor for heart disease?

A

Less than 50

33
Q

An increase in TG levels above what level is a risk factor for CVD?

A

More than 400 mg/dL

34
Q

A ratio of TC:HDL to more than what is a risk factor for CVD?

A

More than 4

35
Q

What causes the blood tinged discharge with menopause?

A

thinning of the vaginal canal

36
Q

In whom can estrogen alone be used to treat the s/sx of menopause? What about E + P?

A

E alone if no uterus

Need E+P for uterus

37
Q

What are the risk factors for HRT?

A
  • Endometrial hyperplasia

- Slight increase in breast cancer

38
Q

True or false: there is an increase in HTN with HRT

39
Q

True or false: there is a large increase in CVA/MIs with HRT

A

False–only slight increase

40
Q

When should HRT begin?

A

Close to menopause–if menopause for a long time, then there is a risk for VTEs

41
Q

True or false: exogenous estrogen increases the risk for colon cancer

A

False–decreases

42
Q

True or false: exogenous estrogen improves dental health

43
Q

Breast cancer within how many years is a contraindication to HRT

A

within the last 5 years

44
Q

True or false: VTEs at any age is a contraindication for exogenous estrogen at menopause

45
Q

How long should HRT be used to treat menopause?

A

Absolutely less than 5 years, but really only for the duration of s/sx

46
Q

What are the side effects of estrogen/progesterone replacement therapy?

A

Similar to the s/sx of menstruation

47
Q

BMI should be below what value to help with menopause

48
Q

How often should weight bearing exercise be performed to prevent complications from menopause?

A

30 mins, 3x/wk

49
Q

What are SERMS?

A

Estrogen-like agonists and antagonistic effects on specific target tissue

50
Q

What is the major side effect of tamoxifen?

A

Proliferative effect on the uterus

51
Q

What is the effect of Raloxifene on the uterus?

A

No proliferation

52
Q

What are the non-steroidal options for menopause?

A
  • SSRIs

- Clonidine for hot flashes

53
Q

True or false: acupuncture has been proven to alleviate vasomotor s/sx of menopause?

54
Q

What are bioidentical hormones?

A

Plant hormones that carry the same risk as HRT

55
Q

What is premature ovarian failure? What is the treatment?

A

Menopause the occurs spontaneously before 40 yo. May be 2/2 chemo or surgery

-HRT immediately

OB/GYN (33 decks)

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