Reproductive

Question 1

action of raloxifene and what is it primarily used to treat

Answer 1

selective oestrogen receptor antagonist at breast + uterus and agonist at bone
parimarily used for osteoporosis

Question 2

action of tamoxifen

Answer 2

selective oestrogen receptor antagonist at breast and agonist at uterus and bone

Question 3

side effects of tamoxifen

Answer 3

hot flushes
thromboembolic events
endometrial cancer

Question 4

action of clomiphene and what is it used to treat

Answer 4

oestrogen receptor antagonist at hypothalamus which prevents normal feedback inhibition = increased LH and FSH release from pituitary
used to treat an ovulation i.e infertility in PCOS

Question 5

treatment for ER positive breast cancer in pre and post menopausal women

Answer 5

pre-menopausal = tamoxifen (oestrogen receptor antagonist)

post-menopausal = anastrozole (aromatase inhibitor)

Question 6

mode of action of penicillin

Answer 6

interferes with transpeptidase and blocks cross linking of the cell wall

Question 7

gives rise to reactive intermediates leading to reduced bacterial protein synthesis

Answer 7

nitrofurantoin

Question 8

mode of action of metronidazole

Answer 8

forms free radicals that damage DNA

Question 9

mechanism of IUD

Answer 9

prevents sperm viability and survival
affects sperm acrosomal reaction and migration ability
induces endometrial inflammation

Question 10

mechanism of progesterone contraceptives

Answer 10

decreases growth and increases vascularization of
endometrium
thickens cervical mucous

Question 11

how does COCP inhibit ovulation

Answer 11

reduces GnRH - decreased LH/FSH - reduces oestrogen levels during follicular phase (usually oestroge surge) required for the midcycle LH surge

Question 12

side effects of raloxifene

Answer 12

thromboembolic events
hot flushes
(NO increased risk of endometrial cancer unlike tamoxifen)

Question 13

where does clomifene act on

Answer 13

anterior hypothalamus

Question 14

action of aromatase inhibitors

Answer 14

i.e. anastrozole, exemestane
block peripheral conversion of androgens to oestrogen

Question 15

mode of action of mifepristone and ullipristal

Answer 15

(anti-progestins)
competitive inhibitor of progestins at progesterone receptors

Question 16

examples of tocolytics and their indication

Answer 16

tocolytics are used to relax the uterus to decrease contractions in preterm labour
i.e. nifedipine (CCB), terbutaline (b2 agonist) and indomethacin (NSAID)

Question 17

side effects of clomiphene

Answer 17

ovarian enlargement
multiple simultaneous pregnancies
hot flushes
visual disturbances

Question 18

indications and risk factors associated with ethinyl estradiol

Answer 18

Oestrogen component of COCP, or given in menopause or ovarian failre/hypogonadism

risk of endometrial cancer (reduced with addition of progesterone)
hepatic adenoma
breast tenderness
thromboembolic event
bleeding in post menopausal women

Question 19

contraindications to ethinyl estradiol

Answer 19

> 35 yrs + smoke
headache with aura
CVD (stroke, IHD, clots)
BRCA gene, active breast cancer
liver disease

Question 20

mode of action of degarelix and indication

Answer 20

GnRh antagonist
used in prostate cancer

Question 21

side effects of degarelix

Answer 21

liver toxicity
hot flushes

Question 22

how are GnRh analogues given in infertility vs prostate cancer

Answer 22

pulsatile for pregnancy
continuous for cancer

Question 23

mode of action of leuprolide and indications

Answer 23

GnRH analogue
used in infertility/ovulation failue (endometriosis etc), prostate cancer, fibroids

Question 24

examples of GnRH analogues

Answer 24

leuprolife
goserelin
nafarelin
histrelin

Question 25

side effects of GnRH analogues i.e. leuprolide, goserelin

Answer 25

decreased libido. hypogonadism, erectile dysfunction, N&V

Question 26

what is the benefit of degarelix compared to goserelin for management of prostate cancer

Answer 26

Degarelix is gnRH antagonist Goserelin is GnRH analogue when GnRH analogue is given in continuous fashion it initially acts as a GnRH agonist and causes a tumour flare. Degarelex doesnt cause a flare.

Question 27

mode of action of Danazol and indication

Answer 27

snthetic androgen - acts as agonist at androgen receptors used in endometriosis, herediatry angioedema

Question 28

indications for testosterone or methyltestosterone and side effects

Answer 28

hypogonadism, promote secondary sexual characteristics side effects: virulization in females, testicular atrophy, increased LDH and decreased HDL, premature closure of epiphyseal plates

Question 29

action of tamsulosin

Answer 29

Alpha1 antagonist selective for alpha d receptors in prostate which decreases smooth muscle tone

Question 30

minoxidel indication and mode of action

Answer 30

pattern baldness and refractory hypertension direct arteriolar vasodilator

Question 31

action of spironolactone on androgens

Answer 31

anti-androgen by inhibiting androgen receptor and 17alpha hydroxylase (17,20 lyase inhibitor)

Question 32

action of ketaconazole on androgens

Answer 32

inhibits 17 alpha hydroxylase (17,20 lyase inhibitor)

Question 33

misoprostol mode of action

Answer 33

prostaglandin E1 agonist - causes uterine contraction and expulsion of uterine contents