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Clin Med II - Exam 5 > Seibert - Menopause > Flashcards

Seibert - Menopause Flashcards

1
Q

menopause is defined as final menstrual period (FMP) confirmed ___ of no menstrual bleeding

A

1 year

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2
Q

average age of menopause

A

51 yo

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3
Q

classic sx of menopause

A

change in menstrual cycle

night sweats

dyspareunia

sleep disturbances

memory/concentration issues

dpn/anxiety/moodiness

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4
Q

menstrual cycle and hormonal changes that occur a few years before and 12 mo after the final menstrual period

A

perimenopause

aka the menopause transition

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5
Q

cessation of menstruation that follows bilateral oophrectomy (w. or w.o hysterectomy) or chemo/pelvic xrt or iatrogenic

A

induced menopause

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6
Q

any menopause that occurs before 40 yo - can be natural or induced

A

premature menopause

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7
Q

lifestyle factor associated w. premature menopause

A

smoking

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8
Q

the years after the FMP resulting from natural or premature menopause; ⅓ of lifespan of most North American women

A

postmenopause

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9
Q

diagnostic tests for menopause

A

low estradiol: < 20

elevated FSH: 21-100

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10
Q

FSH > __ is highly suggestive of menopause

A

30

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11
Q

what kinds of menstrual bleeding changes are common w. menopause

A

all types!

light/heavy/amenorrhea

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12
Q

abnormal uterine bleeding (AUB) includes

A

heavy

>7 days or 2 or more days more than usual

< 21 days from onset of last period

spotting/bleeding btw periods

bleeding after sex

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13
Q

tx for vasomotor sx of menopause (ex hot flashes)

A

estrogens

progestins

clonidine

SSRIs/SNRIs

black cohosh

gabapentin

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14
Q

t/f hot flashes can also involve chills

A

T!

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15
Q

vaginal sx of menopause

A

dryness/itching/irritation

vaginal atrophy

dysuria/urge incontinence/easy bleeding

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16
Q

what vaginal sx is progressive and unlikely to resolve on its own

A

vaginal atrophy

17
Q

urinary sx related to menopause

A

urge incontinence

stress incontinence

dysuria

atrophic cystitis

18
Q

6 mc sx of menopause

A

hot flush/sweating

heart discomfort

sleep problems

dpn/anxiety

irritability

physical/mental exhaustion

19
Q

sexual health sx related to menopause

A

decreased libido

decreased estrogen/testosterone → decreased lubrication/desire

20
Q

__ increases risk for STIs in menopausal women

A

vaginal atrophy

21
Q

main sleep disturbance related to menopause

A

insomnia

22
Q

what should you counsel women about in regards to cognitive changes of menopause

A

memory/concentration problems more likely related to normal aging/mood/stress/sleep disturbances

23
Q

is hormone replacement therapy recommended for cognitive sx of menopause

A

no!

might even make them worse

24
Q

what makes women more likely to have depressive sx

A

hx of PMS

stress

sexual dysfxn

physical inactivity

hot flashes

25
Q

most predictive factor for menopausal dpn

A

prior hx of dpn

26
Q

skin/hair changes related to menopause

A

less elastic hair

hair loss

brittle nails

facial hair

27
Q

classic osteoporosis pt

A

post menopausal

COPD/asthma

steroids

frail/low BMI

smoker

28
Q

BMD testing recs for post menopausal women

A

postmenopausal pt < 65 yo w. > or equal to one additional rf

all women 65 or older

29
Q

should HRT be used for prevention of CHD in post menopausal women

A

no!

30
Q

best tx for cardiovascular health for post menopausal women

A

lifestyle modifications

31
Q

screening for what 3 cancers is recommended for post menopausal women

A

breast

colorectal

cervical

32
Q

pharm options for menopause

A

HRT

antidepressants

eszopiclone (Lunesta)

antihypertensive

pregabalin

33
Q

HRT options for menopause

A

estrogen therapy (ET)

estrogen-progesterone therapy (EPT)

bioidentical hormone therapy (BHT)

34
Q

ET (unopposed estrogen) can be used for

A

systemically if no uterus

locally in low doses for vaginal sx

35
Q

if a woman as a uterus, what type of HRT should be used

A

EPT

to protect against endometrial ca

36
Q

absolute contraindications for HRT

A

thrombosis

stroke

cardiovascular events

37
Q

possible contraindications for HRT based on shared decision making

A

undiagnosed vaginal bleeding

active DVT or PE or hx of one

arterial thromboembolic dz (MI/stroke)

liver dz

hx endometrial/breast ca

38
Q

pharm for insomnia

A

eszopiclone (Lunesta)

Clin Med II - Exam 5 (23 decks)

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