The old, the young, the preggos

Question 1

What is menopause?

Answer 1

permanent cessation of menses due to loss of ovarian follicular function.
After 1yr of no menstrual bleeding

Question 2

How many women in 2020 will be in menopause?

Answer 2

61 million

Question 3

What is the natural age for menopause?

Answer 3

51 yr

Question 4

What are 3 ways menopause can occur?

Answer 4

• Natural
• Premature due to medical intervention
• Impaired ovarian function

Question 5

What are the 3 classic symptoms of menopause?

Answer 5

• Change in menstrual cycle
• Vasomotor symptoms
• Vulvovaginal symptoms, dyspareunia

Question 6

“The menopause transition”

Answer 6

perimenopause

Question 7

What is the most symptomatic phase for women?

Answer 7

perimenopause

Question 8

Cessation of menstrauation after bilateral oophorectomy w/wo hysterectomy

Answer 8

induced menopause

Question 9

Cessation of menstruation after chemotherapy or pelvic radiation therapy?

Answer 9

Iatrogenic menopause

Question 10

What is the age for premature menopause?

Answer 10

before 40yo

Question 11

Impaired ovarian function leading to amenorrhea younger than 40

Answer 11

Primary ovarian insufficiency

Question 12

Years after FMP resulting from natural or premature menopause

Answer 12

Postmenopause

Question 13

Postmenopausal years make up what fraction of women lifespan?

Answer 13

1/3 to 1/2

Question 14

What percent of women experience vasomotor symptoms

Answer 14

75%

Question 15

What is the # 1 vasomotor symptom women experience?

Answer 15

hot flushes

Question 16

What are vaginal symptoms seen in menopause?

Answer 16

dryness, irritation, dyspareunia

Question 17

What is the treatment for hot flushes

Answer 17

usually abate

but depends on woman preference

Question 18

What is the treatment for vaginal atrophy?

Answer 18

regular sexual activity, lubricants, local vaginal estrogen

Question 19

What causes vaginal atrophy

Answer 19

low estrogen

Question 20

T/F sexual issues increase w/ aging?

Answer 20

True

Question 21

What percent of women 50-82 report a ongoing sexual relationship?

Answer 21

50%

Question 22

Vaginal atrophy increases the risk for what?

Answer 22

STI

Question 23

Besides hot flushes, menopausal women are more likely to experience what other symptoms?

Answer 23

sleep disturbances, cognitive changes, sexual issues,

Question 24

Women w/ a hx of premenstrual syndrome, stress, sexual dysfunction, or hot flashes are more vulnerable to what?

Answer 24

depressive symptoms

Question 25

Most predictive factor for depression at midlife and beyond is prior history of what??

Answer 25

Clinical depression

Question 26

Treatment for urinary symptoms in menopause women?

Answer 26

weight loss for overweight Kegel exercises meds for OAB

Question 27

Treatment for mood changes in menopause women?

Answer 27

relaxation and stress reduction antidepressants counseling or psychotherapy

Question 28

Osteoporosis T score?

Answer 28

-2.5

Question 29

Osteopenia T score

Answer 29

-1.0 and -2.5

Question 30

What is second leading cause death among US women 45-54?

Answer 30

CVD

Question 31

Leading cause of death for women > 65?

Answer 31

CVD

Question 32

T/F menopause is associated w/ increased cancer risk?

Answer 32

FALSE

Question 33

Screening for breast cancer?

Answer 33

every 2 yrs 50-74y

Question 34

Colorectal cancer screening?

Answer 34

colonoscopy q 10 yr at 50y

Question 35

Cervical cancer screening?

Answer 35

Pap smear every 3 yrs or every 5 yr if combined w/ HPV after 3 normal 3 yrs in a row for 50-64

Question 36

When is a pap smear not needed?

Answer 36

>65 w/3 or more normal pap test in a row, no abnormal pap in past 10yrs, or 2 more neg HPV in past 10yr

Question 37

What is the only government improved treatment for menopausal symptoms?

Answer 37

Hormone therapy HT

Question 38

What are risks for HT use?

Answer 38

thrombosis, stroke, CV events

Question 39

What are some lifestyle changes alternatives for HT therapy?

Answer 39

relaxation, eat a healthy diet, exercise, avoid hot flash triggers, keep cool

Question 40

Medical treatment for improving vaginal moisture?

Answer 40

Replens

Question 41

What can minors consent to?

Answer 41

``` 16 yrs older residing own urself Unmarried and pregnant consenting to treatment related to pregnancy other than abortion Dx treatment of an infection. Suicide or chemical abuse Active duty w/ armed services ```

Question 42

What important thing must be taken at a adolescent visit?

Answer 42

History

Question 43

T/F no pap smear is needed before <21

Answer 43

True

Question 44

What is used to address secondary sexual characteristics?

Answer 44

Tanner staging

Question 45

If a female is <24yr or younger and sexually active what should be tested?

Answer 45

Chlamydia and gonorrhea

Question 46

Median age for menstruation?

Answer 46

12yrs

Question 47

Mean cycle interval

Answer 47

32 days

Question 48

Menstrual cycle use?

Answer 48

3-6 pads or tampons per day

Question 49

What menstrual abnormalities must be evaluated?

Answer 49

- haven't started within 3 yrs of thelarche - haven't started by 14yrs w/ hirsutism - haven't started by 14yrs w/ excessive exercise or eating disorder - Have not started by 15yrs - Last more than 7 days

Question 50

What has happen to the adolescent birth rate?

Answer 50

historic low

Question 51

Why has adolescent birth rates fallen?

Answer 51

becoming more effective contraceptive users

Question 52

What two factors affect the pregnancy rate?

Answer 52

contraceptive use | sexual activity

Question 53

What is the ideal contraceptive for adolescent?

Answer 53

dual method use (IUD or implants and condoms)

Question 54

What is associated w/ oropharyngeal and anogenital cancer?

Answer 54

HPV

Question 55

What is the recommend age for HPV vaccination?

Answer 55

11-12yr can start @ 9yr

Question 56

What HPV vaccine is recommend?

Answer 56

9-valent

Question 57

What does 9-valent cover?

Answer 57

HPV 6, 11, 16, 18, 31, 33, 45, 52, 58

Question 58

T/F vaccination is recommended regardless of sexual activity or prior exposure to HPV

Answer 58

TRUE

Question 59

T/F HPV vaccine is associated w/ earlier onset of sex and increased STI

Answer 59

FALSE

Question 60

T/F HPV vaccine is given in pregnancy?

Answer 60

FALSE

Question 61

What are two severe allergies that is seen in HPV vaccine?

Answer 61

allergy to yeast | prior HPV vaccine dose