Sept6 M3-Week 2 review

Question 1

oligomenorrhea def

Answer 1

<9 periods a year

Question 2

5 stigmata assoc with Turner

Answer 2

• diff BP in 2 arms
• high arch palate
• low hair line
• angiomas
• webbed neck

Question 3

why are pregnancies in Turner high risk?

Answer 3

because of heart issues. do US before pregnancy

Question 4

most common cause of secondary amenorrhea

Answer 4

PCOS

Question 5

how do you treat a MRKH (Mullerian agenesis) patient who would like to have sex?

Answer 5

-new vagina (surgery)
OR
-dilation

Question 6

first line tx for ovulation induction in PCOS

Answer 6

diet and exercise

Question 7

see a polyp occluding the external os of the cervix: what to do

Answer 7

refer to colposcopy or gynecology bc they have specific ways of stopping the bleeding

Question 8

mech of action of ulipristal acetate + used when

Answer 8

selective progesterone R modulator.

• to treat leiomyomas (fibroids)
• morning after pill

Question 9

FSH and LH R blockers examples

Answer 9

don’t exist

note: FSH and LH Rs are in the gonads. GnRH Rs are in the pit

Question 10

selective estrogen R modulators some examples

Answer 10

• tamoxifen

- clomiphene citrate

Question 11

most common cause of primary amenorrhea

Answer 11

POF

Question 12

long term consequences of PCOS

Answer 12

• endometrial cancer
• metabolic syndrome
• CVD

Question 13

why is hormone replacement imp in people with POF (2)

Answer 13

1. prevent osteoporosis (estrogen is imp for bone health)

2. prevent CV disease

Question 14

main mechanism of action of LNG-IUS (Mirena progesterone IUD)

Answer 14

thickening of the cervical mucous + progesterone effect on endometrial lining (thinning)

Question 15

main mech of action of copper IUD

Answer 15

spermicide action secondary to intrauterine inflammation

Question 16

common SEs of OCP

Answer 16

-breast tenderness
-nausea
-irregular spotting
(resolve after 3 months)

Question 17

uncommon SEs of OCP

Answer 17

• venous thromboembolism

- headaches

Question 18

false SEs of OCP (things people think are SEs of OCP but are NOT. OCP don’t cause these)

Answer 18

• weight gain

- bloating

Question 19

contraindications to IUD insertion

Answer 19

• active PID
• 2 to 28 days post-delivery (BUT RIGHT AFTER DELIVERY IS FINE!! but high rate of expulsion bc cervix dilated)
• abnormal uterine cavity

Question 20

OCP helps reduce risk of what cancers

Answer 20

-ovarian ca
-endometrial ca
-colon ca
(breast = no effect or slightly increased risk)

Question 21

most OCPs contain what form estrogen?

Answer 21

ethynil estradiol

Question 22

how many days break should be taken between each course of progesterone only pill?

Answer 22

0 days

Question 23

charact of P only pill

Answer 23

• no periods

- have to be taken in the same 3 hours window every day

Question 24

how lactation amenorrhea works as a contraception (what’s the method)

Answer 24

breastfeed every 3 hours

Question 25

which Abx strongly interacts with COCs reducing their efficacy

Answer 25

rifampin

other Abx killing bugs in the gut also have an effect

Question 26

where is the combined hormonal patch applied

Answer 26

somewhere where lot of fat and not too much friction

• buttocks
• abdomen

Question 27

many of the meds to treat which condition are known to interact with COCs?

Answer 27

epilepsy