Sex Hormone

Question 1

what type of activities does TIBOLONE has

Answer 1

oestrogenic, progestogenic and weak androgenic

Question 2

examples of NATURAL estrogens

Answer 2

estradiol, estrone, estriol

Question 3

examples of SYNTHETIC estrogens

Answer 3

ethinylestradiol, mestranol

Question 4

how is TIBOLONE take

Answer 4

continously without cyclical progestogen

Question 5

MHRA advises HRT should ONLY be used for…

Answer 5

post-menapausal symptoms adversely affecting quality of life

Question 6

which type of HRT has the highest risk of breast cancer

Answer 6

combined continuous oestrogen-progestogen HRT more than oestrogen-only HRT

Question 7

is the risk of breast cancer determined by the type of oestrogen/progestogen or the duration of use?

Answer 7

no and yes

Question 8

how should HRT be stopped and why

Answer 8

gradually to minimise recurrence of menopausal symptoms

Question 9

choice of HRT for women with uterus

Answer 9

oestrogen and cyclical/continuous progestogen (to reduce the risk of cystic hyperplasia) for last 12-14 days of cycle

Question 10

what is the purpose of adding progestogen to oestrogen HRT

Answer 10

to reduce the risk of endometrial cancer

Question 11

vasomotor symptoms (VMS) of menapause

Answer 11

hot flushes and night sweats

Question 12

vasomotor symptoms (VMS) treatment

Answer 12

systemic oestrogen OR clonidine

Question 13

which two options are not suitable for menopause women or within 12m of last period

Answer 13

continuous combined HRT or tibolone

Question 14

HRT option for women without a uterus

Answer 14

oestrogen alone

Question 15

for how long in advance should HRT be stopped before major surgery, and when should restart

Answer 15

4-6 weeks, restart after full mobilisation

Question 16

which drug should be used for unplanned surgery for pt on HRT

Answer 16

LMWH or compression hosiery

Question 17

what are the indications of ethinylestradiol

Answer 17

short term oestrogen deficiency, osteoporosis prophylaxis if others failed, hereditary haemorrhagic telagiectasia (abnormal connections, called arteriovenous malformations (AVMs), to develop between arteries and vein) palliative trt of prostate cancer

Question 18

what does raloxifene treat and not treat

Answer 18

prevent postmenopausal osteoporosis, not reduce menopausal vasomotor symp

Question 19

two main groups of progestogen

Answer 19

progesterone and testosterone

Question 20

what are the newer progestogens

Answer 20

desogestrel, norgestimate, gestodene

Question 21

where are newer progestogens derived from

Answer 21

from norgestrel (testosterone)

Question 22

norgestrel has an active isomer that has twice its potency which is

Answer 22

levonorgestrel

Question 23

what treatments are used in menorrhagia and dysmenorrhoea, which is more effective

Answer 23

progestogen and tranexamic acid (more effective), mefenamic acid (if dys)

Question 24

are progestogens recommended for miscarriage prevention?

Answer 24

NO

Question 25

MOA of ulipristal

Answer 25

progesterone rec modulator with partial progesterone antagonist effect

Question 26

what are the three treatment options for endometriosis

Answer 26

• para +NSAID
• COC/ progestogen
• surgery (excision/ablation/hysterectomy- remove womb)

Question 27

treatment options for menorrhagia

Answer 27

usually levonorgestrel-releasing-uterine system then tranexamic acid, NSAID, COC or cyclical PO progestogen

Question 28

what is clomifene, what is the indication

Answer 28

anti-oestrogen, used to treat infertility due to ovulatory dysfunction

Question 29

name a anti-androgen

Answer 29

cyproterone acetate

Question 30

what is cyproterone used for

Answer 30

severe hypersexuality and sexual deviation in male (acne, hirsutism)