Question 1

The use of estrogen plus progestin replacement therapy in postmenopausal women with an intact uterus:&#10;A) Does not show an increase in thromboembolic disease&#10;B) Should be limited to treatment for acute symptoms and for the shortest time possible&#10;C) Is advisable as long as there is no family history of breast cancer&#10;D) Decreases the incidence of ovarian cancer&#10;E) Decreases mortality

Accepted Answer

The Women's Health Initiative randomized, placebo-controlled clinical trial published in July 2002 changed the way physicians use replacement hormone therapy. A 26% increase in breast cancer was identified with long-term therapy.

Question 2

The pharmacologic action of mifepristone (RU 486) is:&#10;A) Blocks the production of progesterone&#10;B) Changes the ratio between estrogen and progesterone&#10;C) Blocks the receptors for progesterone&#10;D) Blocks the receptors for estrogen&#10;E) Blocks the receptors for testosterone

Accepted Answer

RU 486 blocks progesterone receptors, thereby preventing endogenous progesterone from protecting the implanted zygote. It also binds glucocorticoid receptors as well, leading to adverse effects.

Question 3

Prolonged unopposed estrogen usage can lead to:&#10;A) Gallbladder disease&#10;B) Endometrial cancer&#10;C) Thromboembolic disease&#10;D) A, B, and C&#10;E) B and C

Accepted Answer

The more serious, long-term side effects occasionally encountered with estrogen usage include endometrial cancer, thromboembolic disorders, and gallbladder disease. The incidence of endometrial cancer is increased as much as 24-fold in those exposed to prolonged (>5 years) unopposed estrogens, but this increased risk can be eliminated by using a progestin in combination.

Deck 40: Estrogens and Progestins