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Menopause exam study test guide with actual questions
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Menopause exam study test guide with actual questions
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Menopause exam study test guide withactual questions
Which 2 nonpharmacologic treatments are HIGHLY recommended by the North American
Menopause Society (NAMS) to treat VMS? - ANS Cognitive behavioral therapy, clinical
hypnosis
What other nonpharmacologic options are used to treat VMS? - ANS Temperature control
(colder pillow)
Yoga/relaxation therapy
Avoid spicy foods, chocolate, caffeine
Exercise
Acupuncture
Paced respiration (slowed down breathing)
What are vasomotor symptoms? - ANS Hot flushes and night sweats
What are the non-VMS of menopause? - ANS Dyspareunia, vaginal dryness, mood
changes, sleep disturbances, concentration and memory issues, arthralgia
If patient has a uterus, you must give them - ANS estrogen + progestin combo
If patient does NOT have a uterus, you can give them - ANS estrogen alone
What are the 3 main differences in estrogen of transdermal estrogens? - ANS Lower VTE
risk
No impact on triglycerides
Potential lower stroke risk, so lower blood clot risk
What are the 2 main differences in estrogen of oral estrogens? - ANS Increases
triglycerides
Potential for decreased libido
What is the Women's Health Initiative (WHI)? - ANS Clinical study started in 1991. Studied
the use of conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA) in
women with and without a uterus
What was the most important "shocking" result from the WHI? - ANS Estrogen + progestin
combo resulted in an increased risk of breast cancer
, What was the problem with how the WHI ended? - ANS There was some bias in the study,
since it stopped early. Upon further investigation 18 years later, increased mortality was not
associated with hormone therapy. Women would have less side effects over time
When is it considered safe to start menopause hormone therapy (MHT) in women? - ANS
Likely safe to start in patients with no contraindications who are within 10 years of menopause,
and/or <60 years old according to NAMS (North American Menopause Society)
Is tobacco use a contraindication to MHT? - ANS Tobacco use is NOT a contraindication to
hormone therapy, but transdermal therapy may be preferred
What is the 1st line treatment to help with VMS of menopause after trying nonpharmacologic
therapies? - ANS Systemic hormone therapy (HT), since it provides optimal relief of hot
flushes
What symptoms should be present for a woman to be on HT? - ANS VMS
If patients have vaginal symptoms only, only use what kind of products? - ANS Vaginal
products
What are the 2 most common estrogens used in HT? - ANS Estradiol and Conjugated
equine estrogens (CEE)
What are the 2 most common progestogens used in HT? - ANS Medroxyprogesterone
acetate (MPA) and Micronized progesterone (MP)
Which hormone should be used with caution in patients with a peanut allergy? - ANS
Micronized Progesterone (MP)
What are all of the contraindications to MHT? - ANS -History/concern for breast cancer
-Estrogen-sensitive malignancies
-Undiagnosed genital bleeding
-Untreated endometrial hyperplasia
-Past idiopathic or current DVT/PE
-Active or recent arterial thrombolic disease (stroke or MI)
-Uncontrolled hypertension >140/90
-Active liver disease
-Porphyria cutanea tarda (skin condition more sensitive to bruising)
What are the nonhormonal medications that can be used to treat VMS? - ANS SSRIs,
SNRIs, Clonidine, Gabapentin, Pregabalin
What SSRI should be used if the patient is taking Tamoxifen for breast cancer? - ANS
Escitalopram
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