This quiz, titled 'Rotation 10 ERT - AUB Labor Menopause', assesses knowledge on hormonal changes, symptoms, and treatments associated with menopause. It covers hormone levels, vasomotor symptoms, and the impact of hormone replacement therapies, highlighting key findings from significant studies like the Women's Health Initiative.
Allow the patient to continue pushing and completely discontinue epidural
Insert an intrauterine pressure catheter and calculate montevideo units (MVUs)
Arrange for operative vaginal delivery using vacuum device
Arrange for primary cesarean delivery
Increase oxytocin with close monitoring of fetal monitor strip
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First stage
Second stage
Third stage
Fourth stage
Second (latent)and third (active) stage
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Chorioamnionitis
Uterine tachysystole
Chemical vaginitis
Maternal nausea and vomiting
Vaginal bleeding
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Exsanguination
Hyperbilirubinemia
Hypoglycemia
Meconium Aspiration syndrome
Postpartum uterine atony and hemorrhage
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Surgical repair is more difficult
It is more likely to extend into a fourth degree laceration
It is more likely to break down
There is decrease blood loss
Less pleasing cosmetic result.
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Prostaglandin PG E2
Prostaglandin PG F2 Alpha
Leukotriene (LTC4)
Thromboxane (TXA2)
Ergot Alkaloid
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Metrorrhagia describes intermenstrual bleeding
Oligomenorrhea refers to cycles with intervals that are shorter than 35 days
Hypomenorrhea refers to menses with diminished or shortened interval
Menorrhagia is defined as prolonged or heavy cyclic menstruation
Amenorrhea is a term for the absence of menses
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Primiparity
Macrosomia
Vaginal birth after cesarean section (VBAC)
Operative vaginal delivery
Persistent occiput posterior position
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Breast Cancer
Venous thromboembolism (VTE)
Coronary Heart Disease
Stroke
Colon Cancer
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Colposcopy
LEEP procedure of the cervix
Cystoscopy
Proctoscopy
CT Scan or MRI of the pelvis
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Oxytocin administration
Expectant Management
Artificial rupture of membranes
Initiate oxytocin induction
Offer elective primary cesarean section delivery
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Raloxifene (Evista ®)
Clomiphene Citrate (Clomid®)
Tamoxifene (Nolvadex®)
Letrozole (Femora®)
Ospemifene (Osphena®)
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The Mirena and Skyla both contain the hormone agent Etonorgesterol
The Copper T (Paragard®) IUD is equally effective as the Mirena in controlling bleeding dysfunction and can be used for up to 10 years
Progesterone containing IUDs are contraindicated in all woman with a prior history of pelvic inflammatory disease
Pogesterone containing IUD will result in amonorrhea in approximately 75% of users
The Mirena IUD is FDA approved for birth control, as well as, the management of heavy menstrual bleeding
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Improving lipid panel
Improving libido
Decreasing breast cancer risk
Improvement in skin health (acne and hirsuitism)
None of the above
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Based on her symptoms and concerns switch her to a progestin only contraceptive agent
Provide her with counseling and reassurance and continue her current COCs
Her symptoms likely reflect endomyometrial pathology and ultrasound and/or SIS should be considered
Hormonal inbalance that requires use of a higher dose pill and/or different progestational agent
Although only 19, based on symptoms, perform pap and reflex HPV testing to exclude cervical neoplasm
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Serotonergic
Autonomic
Noradrenergic
Thermoregulation
Neurogenic
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Animal derived
Phytoestrogen
Synthetic xeno estrogen
Mycoestrogen
None of the above
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Most of the complementary therapies that have been marketed for the treatment of vasomotor symptoms are approved and well tested by the FDA in regards to efficacy and safety.
A cochrane database meta-analysis confirmed significant benefit with the use of phytoestrogens when adminitistered in high doses only
Specific products found to offer the greatest benefit in managing vasomotor symptoms include Ginseng and Saint John's Wort.
Black Cohosh has demonstrated potential benefit in managing vasomotor symptoms but has also been shown to cause liver toxicity.
Lifestyle modification including optimization of diet and weight bearing exercise has shown good benefit in managing the frequency and intensity of vasomotor symptoms.
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Left Occiput Posterior (LOP)
Left Occiput Anterior (LOA)
Right Occiput Posterior (ROP)
Right Occiput Anterior (ROA)
Right Occiput Transverse (ROT)
Oral Premarin, 2.5mg daily, x 14 days
Dilation and Curettage
Medroxyprogesterone acetate, 20mg daily, x 10 days
Leuprolide Depo, 11.25 mg IM, immediately
Combined Oral contraceptive pills (COCs), 3 tablets daily per day, for 7 days
Intramural Leiomyoma
Leiomyosarcoma
Adenomyosis of the uterus
Endometrial polyp
Hematometra
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Paroxitene (Paxol®)
Gabapentin (Nuerontin®)
Ospemifene (Osphena®)
Clonodine (Catapress®)
Desfenlafaxine (Prestiq®)
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Vertex
Military
Face
Brow
Sinciput
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Transvaginal ultrasound
Thyroid function studies
Cervical pap smear
Endometrial biopsy
Coagulation profile (PT/PTT/INR)
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A Selective-Estrogen Receptor Modulator
A Progesterone
A Testosterone Derivative
An Estrogen Agonist/ Antagonist
A Gonadotropin Releasing Analogue
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Replens
Vagifem
Vagisil
Astroglide
Mineral Oil
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Thyroxin (T4)
Prolactin
Testosterone
Progesterone
17-Beta-estradiol
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Vulvar biopsy
Empiric treament with Lotrisone (Clortrimazole + Betamethsone) cream for 3 months and re-evaluation
Initiation of vaginal and vulvar estrogen with followup in 6 months
Start systemic hormone replacement therapy and followup on symptoms in 2 months.
Refer to gynecologic oncology for assessment and wide local excision of the vulva
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Morbid obesity
Use of Tamoxifen for breast cancer
Nuliparity
Tobacco use
History of polycystic ovary syndrome (PCOS)
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Dilation and curettage under ultrasound guidance
Hysteroscopy, operative myomectomy, and dilation and curettage
Hysteroscopy, myomectomy, and endometrial ablation
Hysterescopy, polypectomy, and dilation and curettage
Laparoscopic/Robotic myomectomy
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10%
18%
33%
60%
87%
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Increase blood pressure
Decreased cardiac output
Increased heart rate
Increased body temperature
Decrease in oxygenation
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Localized vasoconstriction
Formation of platelet plug
Vascular fibrin disposition
Fibrinolysis
Myometrial contractions
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Quiz Review Timeline (Updated): Mar 20, 2023 +
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