Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
19 Cards in this Set
- Front
- Back
|
four causes of uterine bleeding include
|
1. endometrial cancer
2. polyps 3. leiomyomas 4. hyperplasia |
|
|
what are the two types of endometrial cancer? how are they different?
|
Type 1 is estrogen-sensitive: found in obese, DM, HTN, nulliparous, younger, late onset menopause
Type 2 is non-estrogen-dependent and is found in multiparous, thin, older women type 1 has a better prognosis than type 2 |
|
|
what are the prototypes of each type of endometrial cancer
|
type 1: endometriod carcinoma
type 2: serous carcinoma |
|
|
what are some conditions that cause increased estrogen
|
1. chronic anovulation - PCOD
2. estrogen producing ovarian tumors - granulosa cell tumors, thecomas 3. obesity 4. unopposed estrogen therapy 5. tamoxifen |
|
|
when staging endometrial carcinoma, what is important?
|
cervical involvement found in stage 2 is important because the lymphovascular system is different and there is a worse prognosis if the cervix is involved
|
|
|
uterine sarcomas are rare but there are five types of them - what are they?
|
1. endometrial stromal sarcoma
2. leiomyosarcoma 3. mixed tumor 4. adenosarcoma 5. mmmt/carcinosarcoma |
|
|
what are the diagnostic factors of leiomyosarcomas?
|
1. mitotic activity
2. cytologic atypia 3. coagulative tumor cell necrosis |
|
|
hormonal changes associated with perimenopause include
|
1. variations in cyclic levels of estrodiol from very low to very high
2. progesterone not always made - causes abnormal bleeding - lots of breast tenderness |
|
|
hot flushes are a common symptom of menopause. what hormones is it mediated by?
|
interflush: lower epinephrine, higher norepinephrine
flush: higher epinephrine, lower norepinephrine |
|
|
what are some treatment options for hot flushes?
|
1. lifestyle changes, cool environment
2. natural supplements (same effect as placebo) 3. phyoestrogens 4. clonidine 5. megastrol 6. SSRI/SNRI therapy |
|
|
what are the hormonal changes that occur with menopause
|
perimenopause: high FSH, low/normal estrogen, inhibin B begins to decrease
menopause: high FSH, lower estrogen, inhibin lower postmenopause: high FSH, low estrogen, absent inhibin |
|
|
how do you treat the symptoms of menopause?
|
estrogen therapy
1. improve REM sleep --> mood & daily living 2. maintain skin thickness 3. increase vaginal secretions 4. improves vasomotor symptoms (hot flushes) 5. may aid in memory |
|
|
what is the pathophysiology of osteoporosis in menopausal women?
|
loss of estrogen causes increases in IL-1, IL-6, TNF --> Oblast increase --> Oclast activation
cytokines also causes increase in number of monocytes --> more Oclast activation |
|
|
is the timing of ERT important to the effect it has on bone loss?
|
yes - if started immediately, no loss. if three years or less, can increase BMC a little bit, if at six years, maintain at women's current BMC status
|
|
|
how does estrogen affect the lipid levels in menopausal women?
|
increases HDL, decreases LDL (good)
BUT increases TGs (not good) |
|
|
what is the effect of estrogen on carotid intima thickness
|
prevents carotid intimal thickening
|
|
|
then why don't we give it?
|
risk of nonfatal MI or CHD deaths is too high
|
|
|
how should we manage menopause if we can't use ERT?
|
1. GU problems: local estrogen or artificial mucus
2. coronary artery disease: weight control, etc. 3. osteoporosis: calcium, vit D, bisphophonates, parathyroid |
|
|
should you give estrogen alone to a woman who has a uterus?
|
no! estrogen alone will increase risk of endometrial cancer - also give progesterone, etc.
|
