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OBGYN 2 > Menopause > Flashcards

Menopause Flashcards

1
Q

What is Menopause? Perimenopause?

A

Cease in Estrogen production of ovaries. Evid. by 12 consecutive months with no period.
Peri: Estro fluctuates unpredictably before Meno.

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2
Q

What is climacteric

A

Period of time during transition into menopause.

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3
Q

WHat happens to FSH during menopause?

A

FSH increases to try and stimulate Estrogen production

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4
Q

What happens to Progesterone in menopause? Effects?

A

Decreases => PMS symptoms dissappear

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5
Q

What are the signs and symptoms of menopause?

A 
Alterations in menstrual flow
Changes in mood and behavior
-Depression
-Anxiety and irritability
-Loss of Libido
Vasomotor Instability
-Hot flashes and Night Sweats
Dec in REM sleep
Change in serotonin
Change in ST memory
Urogenital Atrophy -Dec Estrogen, loss of collagen, normal pH, Lubrication
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6
Q

What are the long term effects of Menopause?

A

OSTEOPOROSIS (#1 Morb)

Card Vasc Dis (#1 Mort)

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7
Q

What test is noe to assess for bone density?

A

DEXA Scan

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8
Q

When should you screen for bone density before the age of 65?

A

Hx of fragility fractures (or FHx)

BW

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9
Q

What are the Tx options for Menopause?

A

Estrogen therapy (no Uterus)
Estrogen + Progest (w/ Uterus)
Alt to Hormone therapy

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10
Q

What are the risks of Standard HRT?

A 
Endometrial Hyperplasia
Breast Cancer
HTN
Stroke and MI
Venous Thrombosis
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11
Q

What are the benefits of Hormone Therapy?

A 
Relief ot vasomotor symptoms
Impr. of mood and Well being
Imp of urogenital atrophy
Imp of Osteoporosis/Hip Frac
Dec in Colon cancer
Imp in dental health
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12
Q

What are the contraindications of HT?

A 
Br CA in last 5 yrs
Est dependent neoplasm
UVB
Thrombo disease
Active liver disease
Preggo
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13
Q

What are ACOG recc for HT?

A

Short term relief of menopausal symptoms

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14
Q

What are the routes of HT?

A

Estrogen: Oral, TransD, IM, TV
Combined: Oral, TD, Combo

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15
Q

What are the SE of Estrogen?

A

Bleeding
Br Tenderness
Mood Changes
Wt Gain/Water retension

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16
Q

What are the SE of Progestin?

A

Depression

Wt gain

17
Q

What are strategies for coping with symptoms?

A 
Good diet with Ca++
Wt Loss 
Avoid Ca++, EtOH, tobacco
Wt bearing exercise (30 min 3x per week)
Stress reduction
18
Q

What are the benefits of SERMs?

A

Est effects on lipids and bone
Est Blocking on Breast
Tamoxifen- Prolif effect on uterus
Raltoxifen- No prolif on uterus

19
Q

What are the non-estrogen Alternatives?

A 
Steroids: Progestins
Non-steroidal:
Clonidine- Dec adr activity (HF)
Vit E
SSRI
Acupuncture: HF
Natural Remedies:
-Phytoestrogens have same benefits and risks as estrogen
20
Q

What is Premature ovarian failure?

A

Menopause occurs spontaneously before 40 years of age

OBGYN 2 (15 decks)

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