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47 Cards in this Set
- Front
- Back
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Hallmark of perimenopause (hormone change)
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increased FSH
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What part of the cycle changes in perimenopause?
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first half
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In early perimenopause what's the change?
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interval of cycle changes
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In late perimenopause, what's the change?
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cycles gets skipped
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What is the definition of menopause?
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no cycle for one year
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Hallmark of perimenopause (hormone change)
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increased FSH
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What part of the cycle changes in perimenopause?
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first half
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In early perimenopause what's the change?
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interval of cycle changes
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In late perimenopause, what's the change?
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cycles gets skipped
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What is the definition of menopause?
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no cycle for one year
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The perimenopausal period generally starts around what age?
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45
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Which hormone decreases during perimenopause
a) LH b) E2 c) progesterone |
b) E2
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What produces LH?
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corpus luteum
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In perimenopause, the Shortening of the cycle is due to shortening of _______ phase
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follicular
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Physiologic menopause – nearly all oocytes reduced by atresia, menopause occurs when oocytes responsive to gonadotropins disappear- average age is what?
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50-51
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menarche, Birth Control Pills, kids, ect, are not assoc. with early menopause, but
________ IS assoc. with early menopause |
Smoking
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Spontaneous menopause before age 40 is premature or _________
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ovarian failure (0.9%)
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Causes of ARTIFICIAL MENOPAUSE
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Occasionally surgery, disease, radiation or chemo can cause menopause
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Hormones that drop after oophorectomy
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Testosterone (>50% decrease)
Androstenedione (~10%) Estradiol (~65%) Estrone (~15%) |
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During Menopause, androgens, estrogens & progesterone all drop; what horomones markedly rise?
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gonadotropins
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During menoapuse, there is generalized atrophy of all genital organs. This may be beneficial for patients with what issues?
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fibroids, adenomyosis, & endometriosis
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Menopause causes the following changes with the URINARY TRACT- atrophic cystitis, urethral prolapse, & what else?
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incontinence
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Menoapause causes what changes to the MAMMARY GLANDS?
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decrease in size,
decrease in glandular tissue with replacement by fat decrease in pain & cysts with marked decrease in glandular tissue |
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What condition is this?
decreased glycogen > decreased lactic acid > ^ph > normal flora is replaced by gram negatives of the rectum > environ is more favorable to candida |
atrophic vaginitis
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what is the treatment for atrophic vaginitis?
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topical estrogen
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Describe hot flashes.
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they last for ~4 mins and occur every hour or more
75% of menopausal women have them 82% who have them, have themfor more than 1 year 25-50% have them for more than 5 years |
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What hormone levels change with skin temperature during hot flashes?
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FSH and LH
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What is the treatment for hot flashes?
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Estrogens, progestins, SSRI’s, black cohosh, gabapentin(Nuerontin)
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What's the biggest problem that comes with menopause?
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osteoporosis
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The biggest single traumatic event occuring b/c of osteoporosis
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hip fracture
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What hormones have an effect on bone remodeling?
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Estrogen, Androgens, progestins, parathyroid hormone
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What test can diagnose osteopenia and osteoporosis by studying femur neck?
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Bone Mineral Density test
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Both men and women have hip and colles' fractures. What other type of fracture is more assoc with women?
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vertebrae
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Prevention & treatment of osteoprosis
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adequate Ca, Vit D, exercise. Meds include bisphosphonates, calcitonin, estrogen, PTH, and SERM’s (raloxafene)
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Sexual Dysfunction is due to what during menopause?
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Mostly related to genital atrophy, decr. secretions, decr. vasocongestion
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Treatment of genital atrophy, decr. secretions, decr. vasocongestion during menopause
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estrogen replacement therapy
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INDICATIONS for homone replacement
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-Genital atrophy, osteoporosis, & vasomotor symptoms
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If pt has a uterus and has estrogen replacement therapy, what do you have to do to avoid ENDOMETRIAL CANCER-
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cycle progesterone
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So, if you avoid endometrial cancer with dual estrogen and progesterone therapy, what are you now at risk for?
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BREAST CANCER
^ risk with combined therapy, no ^ with estrogen alone |
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THROMBOEMBOLIC DISEASE- Effect on coag factors decr by use of ________ estrogen
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transdermal
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risk of ischemic stroke with hormone replacement
a) increrased b) decreased |
a) increased
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GALLBLADDER & LIPID CHANGES during HRT
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^cholesterol in bile, ^ stones; ^HDL, decr LDL
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Comment on UTERINE BLEEDING risk during HRT
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dose dependent
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CONTRAINDICATIONS for HRT
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Abn bleeding, breast CA, estrogen dependent neoplasm, DVT, PE, MI or stroke, liver disease
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MANAGEMENT OF ESTROGEN REPLACEMENT- many formulations available, use _____ dose, informed patient, treat for proper indications
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lowest
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INDICATIONS for HRT
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TX of osteoporosis, genital atrophy, & vasomotor symptoms
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PREPARATIONS AVAILABLE for HRT
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- Oral, injection, transdermal
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