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Human Development PBL > PBL 5 > Flashcards

PBL 5 Flashcards

1
Q

what is the definition of menopause

A

No menstrual periods for 12 consecutive months and no other biological or physiological cause can be identified

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2
Q

what is the average age of menopause

A

51-52yrs

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3
Q

what is early menopause

A

Early’ menopause = 40-45yrs (20% of women)

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4
Q

what is premature menopause

A

Premature’ menopause = <40yrs (1% of women)

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5
Q

what other things can cause periods to stop

A

Sudden weight loss, contraception (progesterone pill, mirena coil), pregnancy, stress, being overweight/obese, extreme overexercising, PCOS

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6
Q

what is perimenopause

A

The time leading up to and around the menopause, can last for several years.
This is when reproductive function starts to decline

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7
Q

what are the symptoms of perimenopause

A

Changes in length of menstrual cycle

Hot flushes / night sweats

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8
Q

when does perimenopause begin

A

If menopause at 50yrs, climacteric begins a year earlier

If menopause <40yrs, climacteric begins 4 years earlier

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9
Q

what causes the symptoms of menopause

A

Symptoms of Ovarian Failure ie oestrogen deficiency

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10
Q

what are the 2 categories of symptoms of menopause

A

Short term symptoms

Long term consequences

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11
Q

name the 4 short term symptoms

A
  • vasomotor
  • psychological
  • urogenital
  • collagen
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12
Q

describe the 4 short term symptoms

A

vasomotor

  • Hot flushes
  • Night sweats
  • Headaches
  • Palpitations

psychological

  • Depression
  • Mood swings
  • Insomnia
  • Memory loss
  • Panic

urogenital

  • Urinary frequency
  • Dysuria
  • Stress and urge incontinence
  • Vaginal dryness
  • Dyspareunia

collagen

  • Dry inelastic skin
  • Brittle nails
  • Hair loss
  • Joint/muscle pains
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13
Q

name the 5 long term consequences

A 
CVS
Skeletal 
skin 
psychological 
genito-urinary
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14
Q

describe the 5 symptoms

A

CVS
Hyperlipidaemia
IHD

Genito-urinary 
Atrophic changes 
Prolapse
Incontinence
Depressed libido 
Dyspareunia

Skeletal
Osteopenia
Osteoporosis

Skin
Inelastic thin flaky skin
Easy bruising

Psychological
- Alzheimer’s Disease

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15
Q

how do you investigate menopause

A

Triad of diagnostic features

  • Typical symptomatology
  • 12 months’ amenorrhoea
  • FSH>15iu/ml

Serum oestradiol levels
- Only useful

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16
Q

what is the treatment for menopause

A

Hormone replacement therapy (HRT)

Non-hormonal methods

17
Q

what are the two HRT treatments

A

If uterus present :
oestrogen + progesterone

If uterus absent :
oestrogen alone

18
Q

what are the routes of administration for the two HRT treatments

A 
Oral
Patches and gel 
Implants + injections 
Intravaginal creams, pessaries, rings 
Nasal sprays
19
Q

what are the side effects of HRT

A

Heavy cyclical / unscheduled irregular bleeding
Bloating, fluid retention and weight gain
Mastalgia (breast pain)
Headaches, muscle cramps, abdominal pain
Depression

20
Q

what are the serious complication of HRT

A

Breast cancer
Risk increases >5yrs of use, by approx. 2-6/1000 women

Thrombo-embolic events
DVT/PE affect approx. 5/10,000 women on HRT, and most commonly occur in the first year of use

21
Q

what are the contraindications to HRT

A 
Breast cancer 
Endometrial cancer 
TED 
Endometriosis 
Fibroids 
IHD
22
Q

what are the non hormonal treatment

A

Bisphosphonates & Calcitonin: decrease osteoclast activity

Selective oestrogen receptor modulators (SERM)

Clonidine & Venlaflaxine: Reduce vasomotor symptoms

23
Q

what are lifestyle changes for non hormonal treatments

A 
Lifestyle 
Vitamins 
Herbs 
Phyto-oestrogens 
Exercise 
No smoking
24
Q

what happens to the sex hormones during the menopause

A

Low oestrogen
Low progesterone
High LH and FSH
Declining testosterone (with age not menopause)

25
Q

what age is the MMR vaccine given at

A

1 year

3 years 4 months

Human Development PBL (5 decks)

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