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CPT > Reproductive Health > Flashcards

Reproductive Health Flashcards

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1
Q

What is the major effect of oestrogen?

A

Stimulates growth of endometrium and breast

Stimulates production of progesterone receptors

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2
Q

What is the major effect of progesterone?

A

Stimulates growth of endometrium and breast
Maintains pregnancy
Inhibits production of oestrogen receptors

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3
Q

What is the major effect of testosterone?

A

Stimulates secondary male characteristics

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4
Q

What actions does oestrogen have?

A 
Mild anabolic 
Sodium and water retention 
Raise HDL, lowers LDL
Decrease bone resorption 
Impairs glucose tolerance 
Increase blood coagulability
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5
Q

What are the side effects of oestrogen?

A 
Breast tenderness 
Nausea, vomiting 
Increased blood coagulability => VTE 
Impaired glucose tolerance 
Endometrial hyperplasia, ovarian metaplasia, breast hyperplasia => cancer
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6
Q

What are the actions of progesterone?

A 
Secretory endometrium 
Anabolic 
Increases bone mineral density 
Fluid retention 
Mood changes 
Maintains pregnancy
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7
Q

What are the side effects of progesterone?

A 
Weight gain 
Fluid retention 
Anabolic 
Acne 
Nausea/vomiting 
Irritability, PMS 
Lack of concentration
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8
Q

What are actions/side effects of testosterone?

A

Male secondary sec characteristics
Acne
Voice changes
Aggression

Increased LDL - therefore males have increased risk of atherosclerosis disease

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9
Q

How does hormonal contraception affect menstruation/HPO axis?

A

Interruption of physiological control go the menstrual cycle
Effect on endometrial and cervical mucus
Inhibition of ovulation

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10
Q

How does the COCP act as contraception?

A

Prevent ovulation
Reduce endometrial receptivity => inhibit implantation
Thicken cervical mucus

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11
Q

How does the progesterone depot act as contraception?

A

High dose of progesterone =>

Prevents ovulation
Thickens cervical mucus
Prevents endometrial proliferation

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12
Q

How does the progesterone implant act as contraception?

A

High dose of progesterone:
Inhibition of ovulation
Thickens cervical mucus
Prevents endometrial proliferation

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13
Q

How does the progesterone only pill act as contraception?

A

Low dose progesterone:
Thickens cervical mucus

Not enough progesterone to inhibit ovulation

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14
Q

What is an adverse effect of the COCP?

A

VTE
However this risk is v small
Increased with smoking and high BMI

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15
Q

What are COCP and POP metabolised by?

A

CYP 450 enzymes in the liver

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16
Q

What can reduce efficacy of COCP and POP?

A

Enzyme inducing drugs
Increase production of CYP 450 => increase in metabolism of the drugs

Anti-epileptics; carbamazepine
Antibiotics; rifampicin
Natural products; St John’s wort

17
Q

Why is HRT prescribed?

A

Management of symptoms such as hot flushes and dyspareunia

Osteoporosis

18
Q

What are some risks of HRT?

A

Unopposed oestrogen: increases risk of endometrial and ovarian cancers
Opposed oestrogen: increases risk of breast cancer

Increase risk of VTE
Increase risk of stroke

19
Q

What is a potential benefit of HRT?

A

Increase HDL, decrease LDL

However this isn’t an effect if the patient is already overweight
Also must not prescribe HRT for treatment of CVS disease

20
Q

How does mifepristone act, and when is it used?

A

Progesterone receptor antagonist
Myometrium is made sensitive to prostaglandin induced contractions

Used for termination of pregnancy

21
Q

How does clomiphene act, and what is it used for?

A

Competes with oestrogen
Used in treatment of anovulation in women of reproductive age
Leads to ovulation by increased production of anterior pituitary enzymes

22
Q

How does tamoxifen act, and what is it used for?

A

Used as a treatment for breast cancer

In the breast: ER antagonist => cells arrest in the cell cycle
In the endometrium: ER agonist => endometrial hyperplasia

Therefore can lead to endometrial cancer

23
Q

How does ulipristal acetate act, and what is it used for?

A

Selective progesterone receptor modulator

Used as emergency contraception as it delays or inhibits ovulation
Can also be used as treatment for fibroids

CPT (21 decks)

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