Obgyn Menopause

Front 1

risk factors for premature ovarian failure

Back 1

1. genetic- partial- total deletions on long arm of X chromosome
2. Gonadotropin-resistant ovarian syndrome (Savage Syndrome) -- normal number of ovarian follicles, but resistent to FSH and LH (may treat with exogenous estrogen)
3. autoimmune- autoantibodies to ovarian endocrine tissues
4. smoking- smokers may undergo menopaues 3-5 years earlier than expected
5. Alkylating chemotherapeutic agents- may want to cryopreserve eggs
6. hysterectomy- menopause 3-5 years early, may be due to disruption of ovarian blood flow

Front 2

risk factors for osteoporotic fractures

Back 2

1. adult fracture
2. fx in first degree relative
3. white race
4. advanced age
5. dementia
6. poor health/frailty
7. smoking
8. low body weight
9. estrogen deficiency
10. early menopause or bilateral oopherectomy (<45 yo)
11. prolonged premenopausal amenorrhea (>1 yr)
12. alcoholism
13. inadequate physical activity

Front 3

contraindications to hormone therapy

Back 3

1. undiagnosed abnormal genital bleeding
2. known or suspected estrogen-dependent neoplasm except in appropriately selected patients
3. active DVT, PE, or h/o these
4. active or recurrent arterial thromboembolic disease (stroke, MI)
5. liver dysfunction or liver disease
6. known or suspected pregnancy
7. hypersensitivity to hormone txs

Front 4

alternatives to hormone therapy

Back 4

1. soy and isoflavones
2. st. john's wort
3. black cohosh

Front 5

dangers of unopposed estrogen therapy?

Back 5

increased risk of endometrial hyperplasia and carcinoma-- thus must give with progestin unless the women has had a hysterectomy

Front 6

two principal regimens for hormone therapy

Back 6

-- continuous estrogen replacement with cyclic progestin-- cyclic withdrawal bleeding (if do not want period-- can have daily low dose of progestin)
-- may either have gradually increasing progestin amt or constant daily dose

Front 7

function of progestin in hormone replacement therapy for perimenopausal sx

Back 7

converts the ednometrium into a secretory state--> endometrial sloughing and prevention of endometrial hyperplasia and cellular atypia

Front 8

influence of hormone replacement therapy (estrogen plus progestin) on the risk of ...
1. heart attack
2. stroke
3. colorectal cancer
4. thromboembolic disease
5. breast cancer
6. hip fracture

Back 8

1. increased
2. increased
3. decreased
4. increased
5. increased
6. decreased

Front 9

role of soy and isoflavones in tx of menopausal sx

Back 9

short-term (< 2 yrs)- decreased hot flushes, long term-- improved lipoprotein profiles and protective against osteoporosis

Front 10

side effect of soy products

Back 10

interaction with thyroid medications

Front 11

side effectos dong quai and red clover

Back 11

potentiation of warfarin and other anticoags

Front 12

what symptom of menopause may progesterone help eliminate?

Back 12

hot flushes

Front 13

what commonly used medication class can help with mood and hot flushes?

Back 13

SSRIs (also gabapentin and cetirizine may help)