destiny
Forum Senior
Topics: 35
Posts: 38
|
a 52 year old female comes to u because of severe hot flushes. she has history of dvt after hysterectomy done 4 yrs ago.. wat would u advise her?
a.. combined estrogen and progesterone
b.. estrogen 0.625mg per os
c.. estrogen 1.25mg per os.
d.. transdermal patch of estradiol and norethisterone
e.. transdermal patch of estradiol 2mg
|
| asmi
Forum Hero
Topics: 1043
Posts: 4,609
|
D...
|
| drmka
Forum Junior
Topics: 1
Posts: 59
|
deep venous thrombosis she had,why should we give estrojen?
|
| goneskuba
Forum Junior
Topics: 4
Posts: 47
|
i think the answer is combined estrogen and progesterone patch
she will need estrogen replacement shortly after menopause anyway and to control her endometrium she will need progesterone
dvt is not necessarily an absolute contraindication for estrogen...even though it has shown to inc the chances for dvt
contraindications to estrogen replacement is:
1- personal Hx of estrogen sentitive Ca (breast or endometrium)
2- active liver disease
3- active thrombosis
4- unexplained vaginal bleeding
since she is not actively thrombosing at the moment and the probability that the hysterectomy itself was a precursor to her dvt....
and so on
|
| mkodumagulla
Forum Senior
Topics: 12
Posts: 99
|
Is it necessary to give Progesteron also since it is mentioned that she underwent hysterctomy. Why not give transdermal estrogen alone?
|
| goneskuba
Forum Junior
Topics: 4
Posts: 47
|
ur right mo....
actually no uterus means no need for progesterone replacement, since the majority of the signs and symptoms arise from the lack of estrogen and the elev of gonadotropins (fsh & lh)
nice catch
|
| usmledoctor1
Forum Junior
Topics: 4
Posts: 77
|
i still have doubts
___________________
usmledoctor2@yahoo.com message me on my yahoo messenger anytime.
|
| rafaoli
Forum Newbie
Topics: 0
Posts: 16
|
B or C!? I read about both doses!?
dvt it is not a contra indiction to estrogen.
She doesn´t have a uterus so doesn´t progesterone.(no risk for endometrial ca)
The patch is just used in pt that doesn´t tolerate oral intake. Patch doesn´t protect against cardiovasc., it decresases cholesterol much slower than oral intake
|
| cerebral cortex
Forum Junior
Topics: 2
Posts: 60
|
I think it s D coz wth a h/o DVT, we shud give her Estradiol & not estrogen, but cant make out if norethesterone 2 b given ??? or estradiol alone ?
hello..... destiny ....... let us knw theright anser !!
|
|
| |
| | | | | | | | | |
