Test 4 part 1

Question 1

onset of puberty occurs between ages

Answer 1

8-13

Question 2

puberty is stimulated by

Answer 2

Gonasotropin releasing hormone from the hypothalamus

Question 3

Is stimulated to secrete gonadotropins

Answer 3

anterior pituitary

Question 4

gonadotropin stimulate the secretion of

Answer 4

estrogen form ovaries

Question 5

when does menarche occur

Answer 5

2 years after the onset of secondary sex characteristics

Question 6

Cycles are usually ______ the first few years after menarche

Answer 6

annovulatory

Question 7

Hormones stimulating hormones (FSH) and luteinizing hormone (LH) mature the follicles 
Dominant follicle (Graafian) mature and produces estrogen

Answer 7

Follicular phase

Question 8

Estrogen levels peak and begin to fall, progesterone levels increase
This is followed by surge in KH stimulating release of the oocyte from the dominate follicle

Answer 8

Ovulatory phase

Question 9

Day 14 in the cycle
Empty follicle forms the corpus luteum
Corpus leuteum produces progesterone and will continue to produce progesterone and estrogen if pregnancy occurs
If no pregnancy occurs, the corpus leteum degenerates and progesterone levels decrease
This triggers the onset of menstruation

Answer 9

Luteal phase

Question 10

Labs and test to test for menstruration abnormalities

Answer 10

hormone levels and thyroid panel

Ultrasound

Question 11

Is moving from concrete thinking to more abstract thinking and problem solving
Consider moral and social issues
(Piagets formal operations stage)

Answer 11

developmental stage

Question 12

Role identity, sense of self-esteem and worth, sexual identity
(Erikson)

Answer 12

psychosocial stage

Question 13

Health problems specific to female adolescents may include

Answer 13

Eating disorders
STIs and pregnancy
Menstrual disorders
Acne

Question 14

menopausal transition period

Answer 14

perimenopause

Question 15

age range for perimenopause

Answer 15

35-58

Question 16

when does the perimenopause transition end

Answer 16

cessation of menses for one full year

Question 17

physical symptoms of hot flashes, sweating, and irregular periods
Mechanism is unknown

Answer 17

Vasomotor symptoms

Question 18

when do perimenopause symptoms occur

Answer 18

2-8 years prior to menopause

Question 19

what happens to labs during perimenopause

Answer 19

FSH levels increase
Estradiol decrease
TSH to rule out thyroid disease

Question 20

Test form perimenopause women

Answer 20

DXA

Mammography

Question 21

administration of hormones to alleviate menopausal symptoms

Answer 21

hormone replacement therapy

Question 22

Estrogen only hormone replacement therapy can be used only in women who have had a

Answer 22

hysterectomy

Question 23

combined therapy is used for women with

Answer 23

a uterus

Question 24

plant absorbed products with estrogen properties such as yams, soy, carrots, and red clover

Answer 24

phytoestrogen

Question 25

supplement that breaks down in the body as estrogen and testosterone Suggested anti-aging effects, increase in sexual desire, better mood, cognition and bone density (RCTs and observational studies)

Answer 25

DHEA

Question 26

is the permanent cessation of menses from loss of ovarian function Defined as absence of menstruation for one full year

Answer 26

Menopause

Question 27

Causes menopause

Answer 27

Spontaneous Surgical Chemical Pelvic irradiation

Question 28

Lipoprotein profile changes

Answer 28

Increase in triglycerides increase in total and LDL cholesterol Decrease in HDL

Question 29

how often should lipid screening be done

Answer 29

every 5 years | Soon for women at risk for CAD

Question 30

risks for breast cancer

Answer 30

``` Age Family History BMI Prolonged HRT (after 5 years) ```

Question 31

anxiety and irritability of menopause

Answer 31

climacteric syndrome

Question 32

are signs that vertebrae are being compresses because of reduced bone mass

Answer 32

Loss of height | Nontraumatic fractures

Question 33

Loss of bone mass (osteopenia) that compromises bone strength causing a predisposition to risk of bone fractures

Answer 33

Osteoporosis

Question 34

is characterized by loss of trabecular bone and thinning or cortical bone shell

Answer 34

osteoporotic bone

Question 35

Races at higher risk for osteoporosis

Answer 35

Non-hispanic caucasian | Asian

Question 36

Maximum level of bone density (peak of bone mass) is reached by age ____ and is genetically influenced

Answer 36

25 to 30

Question 37

medical conditions that can cause osteoporosis

Answer 37

``` Hyperthyroidism Cushing's syndrome Kidney disease RA Organ transplant ```

Question 38

osteoporosis testing is done via

Answer 38

dual x-ray absorptiometry (DEXA)

Question 39

Common fracture sites

Answer 39

Vertebrae Hip fracture Wrist fracture

Question 40

Fractures may be followed by

Answer 40

Full recovery Chronic pain Disability Death

Question 41

Daily calcium intake for ages 9-18

Answer 41

1300mg

Question 42

Daily calcium intake for ages 19-50

Answer 42

1000mg

Question 43

Daily calcium intake for ages >50 (and taking HRT)

Answer 43

12000mg

Question 44

DAily calcium intake for ages > 50 (not taking HRT)

Answer 44

1500mg

Question 45

when should calcium supplements be considered

Answer 45

if daily calcium intake is less than 600 mg

Question 46

Daily vitamin D intake for ages 9-70

Answer 46

400-600 IU

Question 47

Daily vitamin D intake for > 70

Answer 47

800 IU

Question 48

Know Vitamin D deficiency or autoimmune disease associated with deficiency should take

Answer 48

1000-2000 IU

Question 49

Food hight in vitamin D

Answer 49

Fatty fish Cheese Egg yolk Beef liver

Question 50

Are found naturally in some plants and may bind to calcium and inhibit absorption

Answer 50

Phytic and oxalic acid

Question 51

Phytic and oxalic acids are found in

Answer 51

``` Spinach Collard greens Sweet potatoes Rhubarb Beans ```

Question 52

when should you take calcium when palnning to eat foods contain phytic or oxalic acid

Answer 52

1 hour before or 2 hours after

Question 53

What DXA score indicated need for treatment

Question 54

BMD testing (DXA) should occur

Answer 54

2 years after starting drug therapy and every 2 years after that

Question 55

(antiresorptive) PO nitrogen containing bisohosphonates- calcium regulators that act by inhibiting bone resorption and increase bone mass are

Answer 55

Alendronate (Fosomax) Risedronate (Actonel) Ibandronate (Boniva) PO and IV Zoledronic Acid (Zometa) IV

Question 56

Side effects of of anriresorptive drugs

Answer 56

GI disturbance Abdominal pain Dyspepsia Esophageal ulceration (rare)

Question 57

Patients taking Alendronate and risedronate need to remain upright and take nothing else for how long after taking medication

Answer 57

30 min | take with water

Question 58

Patients taking PO Ibandronate need to remain upright and take nothing else for how long

Answer 58

60 min

Question 59

Raloxifene (Evista) will not help with vasomotor S and S Will not stimulate uterine/ breast tissue Preserves estrogen

Answer 59

selective estrogen-receptro modulators

Question 60

Reserved for patients who do not respond to other treatments or those with severe disease

Answer 60

teriparatide (parathyroid hormone)

Question 61

Slows bone loss Given intranasally Used when non-responsive to other meds or uses in combo with other meds

Answer 61

Salmon calcintonin- calcium regulator

Question 62

Surgery used to stabilize vertebral fractures (does not reduce bone resorption) Cement mixture is injected into fractured bone Outcome is better in those with

Answer 62

Percutaneous vertebroplasty