Deck 38: Hormone Replacement Therapy and Osteoporosis

Question 1

Kristine would like to start hormone replacement therapy (HRT)to treat the significant vasomotor symptoms she is experiencing during menopause.Education for a woman considering hormone replacement would include:

A) Explaining that HRT is totally safe if used short term
B) Telling her to ignore media hype regarding HRT
C) Discussing the advantages and risks of HRT
D) Encouraging the patient to use phytoestrogens with the HRT

Answer 1

Discussing the advantages and risks of HRT

Question 2

Dosage changes of conjugated equine estrogen (Premarin)are made at intervals.

A) 1 to 2 week
B) 2 to 4 week
C) 6 to 8 week
D) 12 week

Answer 2

6 to 8 week

Question 3

The goals of therapy when prescribing hormone replacement therapy (HRT)include reducing:

A) Cardiovascular risk
B) Risk of stroke or other thromboembolic event
C) Breast cancer
D) Vasomotor symptoms

Answer 3

Vasomotor symptoms

Question 4

The drug recommended as primary prevention of osteoporosis in men over age 70 years is:

A) Alendronate (Fosamax)
B) Ibandronate (Boniva)
C) Calcium carbonate
D) Raloxifene (Evista)

Question 5

The advantage of vaginal estrogen preparations in the treatment of vulvovaginal atrophy and dryness is:

A) Ability to deliver higher doses of estrogen in a non-oral form
B) The vaginal cream formula provides moisture to the vaginal area
C) Relief of symptoms without increasing cardiovascular risk
D) All of the above

Question 6

Sallie has been diagnosed with osteoporosis and is asking about the "once a month" pill to treat her condition.How do bisphosphonates treat osteoporosis?

A) By selectively activating estrogen pathways in the bone
B) By reducing bone resorption by inhibiting PTH
C) By reducing bone resorption and inhibiting osteoclastic activity
D) By increasing parathyroid hormone production

Question 7

Drugs that increase the risk of osteoporosis developing include:

A) Oral combined contraceptives
B) Carbamazepine
C) Calcium channel blockers
D) High doses of Vitamin D

Question 8

Inadequate Vitamin D intake can contribute to the development of osteoporosis by:

A) Increasing calcitonin production
B) Increasing calcium absorption from the intestine
C) Altering calcium metabolism
D) Stimulating bone formation

Question 9

The drug recommended as primary prevention of osteoporosis in women over age 70 years is:

A) Alendronate (Fosamax)
B) Ibandronate (Boniva)
C) Calcium carbonate
D) Raloxifene (Evista)

Question 10

Angela is a black woman who has heard that women of African descent do not need to worry about osteoporosis.What education would you provide Angela about her risk?

A) She is correct,black women do not have much risk of developing osteoporosis due to their dark skin
B) Black women are at risk of developing osteoporosis due to their lower calcium intake as a group
C) If she doesn't drink alcohol,her risk of developing osteoporosis is low
D) If she has not lost more than 10% of her weight lately,her risk is low

Question 11

The optimal maximum time frame for hormone replacement therapy (HRT)or estrogen replacement therapy (ERT)is:

A) 2 years
B) 5 years
C) 10 years
D) 15 years

Question 12

Selective estrogen receptor modifiers (SERMs)treat osteoporosis by selectively:

A) Inhibiting magnesium resorption in the kidneys
B) Increasing calcium absorption from the GI tract
C) Acting on the bone to inhibit osteoblast activity
D) Selectively acting on the estrogen receptors in the bone

Question 13

Cassie is a 15-year-old female who presents to clinic for a sports physical.Her diet history indicates she drinks less than one glass of milk per day and avoids dairy products to lose weight.What is the recommended daily calcium intake for Cassie?

A) 500 mg
B) 1,000 mg
C) 1,300 mg
D) 1,500 mg

Question 14

Women with an intact uterus should be treated with both estrogen and progestin due to:

A) Increased risk for endometrial cancer if estrogen alone is used
B) Combination therapy provides the best relief of menopausal vasomotor symptoms
C) Reduced risk for colon cancer with combined therapy
D) Lower risk of developing blood clots with combined therapy

Question 15

The ongoing monitoring for patients over age 65 years taking alendronate (Fosamax)or any other bisphosphonate is:

A) Annual DEXA scans
B) Annual Vitamin D level
C) Annual renal function evaluation
D) Electrolytes every 3 months

Question 16

Susan is a 52-year-old perimenopausal woman who is lactose intolerant.What is her recommended calcium and vitamin D requirement?

A) 1,500 mg calcium and 200 IU Vitamin D
B) 1,200 mg calcium and 400 IU Vitamin D
C) 1,300 mg calcium and 400 IU Vitamin D
D) 1,000 mg calcium and 400 IU Vitamin D

Question 17

Intranasal calcitonin is used in the treatment of osteoporosis.Calcitonin therapy is appropriate for which patient?

A) Thin,Caucasian perimenopausal women
B) Men over age 65 with osteoporosis
C) Women over age 65 years with osteopenia
D) Women over age 65 with severe osteoporosis

Question 18

Ongoing monitoring for women on estrogen replacement therapy (ERT)includes:

A) Lipid levels,repeated annually if abnormal
B) Annual health history and review of risk profile
C) Annual mammogram
D) All of the above