Question 1

What is the duration of selective estrogen receptor modifier (SERM) use for menopausal issues?&#10;A)It matches the five year duration for estrogen products.&#10;B)The bone health impact allows long-term use.&#10;C)The increased risk of breast cancer encourages tapering as soon as possible.&#10;D)The abnormal lipid profile contributes to an early termination as soon as hot flashes no longer occur.&#10;

Accepted Answer

Selective estrogen receptor modifiers (SERMs) are often used for their beneficial effects on bone health, which allows for their long-term use in managing menopausal issues. Unlike estrogen products, which may have a recommended duration due to risks of cancer and other side effects, SERMs can be used over a longer period primarily because of their positive impact on bone density and lower risk profile regarding breast cancer.

Question 2

Re-evaluation of the Women's Health Study has resulted in what changes in HRT implementation?&#10;A)A combination of estrogen and progestin is no longer required in patients with an intact uterus.&#10;B)Women with breast cancer survivorship over 10 years are no longer considered &#34;at risk.&#34;&#10;C)HRT can be used in the first five years of menopause without major risk increase.&#10;D)Low-dose estrogen can be used again in women over 6&#10;

Accepted Answer

HRT can be used in the first five years of menopause without significantly increasing major health risks, according to re-evaluations of the Women's Health Study. This period is considered critical for managing menopausal symptoms effectively with reduced risk.

Question 3

Dosage changes of conjugated equine estrogen (Premarin) are made at _________ intervals.&#10;A)1 to 2 week&#10;B)2 to 4 week&#10;C)6 to 8 week&#10;D)12 week&#10;

Accepted Answer

Dosage changes of conjugated equine estrogen (Premarin) are typically made at 6 to 8 week intervals to allow the body to adjust and to assess the effectiveness and side effects of the treatment.

Question 4

Women with an intact uterus should be treated with HRT with both estrogen and progestin due to:&#10;A)Increased risk for endometrial cancer if estrogen alone is used&#10;B)Combination therapy providing the best relief of menopausal vasomotor symptoms&#10;C)Reduced risk for colon cancer with combined therapy&#10;D)Lower risk of developing blood clots with combined therapy&#10;

Accepted Answer

Estrogen therapy alone in women with an intact uterus increases the risk of endometrial cancer. Adding progestin helps counteract this risk by causing the endometrium to shed through a monthly bleed, similar to a menstrual period, thus reducing the potential for endometrial hyperplasia and subsequent cancer.

Question 5

The optimal maximum time frame for HRT or estrogen replacement therapy (ERT) is:&#10;A)Two years&#10;B)Five years 3.10 years&#10;C)15 years&#10;

Accepted Answer

The optimal maximum time frame for hormone replacement therapy (HRT) or estrogen replacement therapy (ERT) is generally considered to be five years. This recommendation is based on balancing the benefits of symptom relief and prevention of osteoporosis against the potential risks, such as increased risk of breast cancer, heart disease, and stroke, which may rise with longer durations of use.

Question 6

Kristine would like to start HRT to treat the significant vasomotor symptoms she is experiencing during menopause. Education for a woman considering HRT includes:&#10;A)Explaining that HRT is totally safe if used short term&#10;B)Telling her to ignore media hype regarding HRT&#10;C)Discussing the advantages and risks of HRT&#10;D)Encouraging her to use phytoestrogens with HRT&#10;

Accepted Answer

Discussing the advantages and risks of HRT is crucial for informed decision-making. HRT can offer relief from menopausal symptoms but also comes with potential risks, such as an increased risk of certain cancers and cardiovascular events. It's important for patients to understand both the benefits and risks to make an informed choice. Choices A, B, and D are not appropriate as they either oversimplify the safety of HRT, dismiss valid concerns, or suggest combining treatments without evidence of safety or efficacy.

Question 7

Which of the following is not an indication for starting HRT?&#10;A)Symptomatic hot flashes&#10;B)Treatment or prevention of vaginal atrophy&#10;C)Prevention of osteoporosis&#10;D)Early surgical menopause&#10;

Accepted Answer

Prevention of osteoporosis alone is not a primary indication for starting hormone replacement therapy (HRT) due to the availability of other treatments with fewer risks. HRT is primarily indicated for managing menopausal symptoms like symptomatic hot flashes, vaginal atrophy, and conditions like early surgical menopause.

Question 8

All of the following are risks of exogenous hormones except:&#10;A)Breast cancer&#10;B)Uterine cancer&#10;C)Increased cardiovascular problems&#10;D)Vaginal atrophy&#10;

Accepted Answer

Vaginal atrophy is more commonly associated with a decrease in endogenous hormones, particularly estrogen, rather than with the use of exogenous hormones. Exogenous hormones are often used to treat symptoms of menopause, including vaginal atrophy, by supplementing the body's hormone levels.

Question 9

The goals of therapy when prescribing hormone replacement therapy (HRT) include reducing:&#10;A)Cardiovascular risk&#10;B)Risk of stroke or other thromboembolic event&#10;C)Risk of breast cancer&#10;D)Vasomotor symptoms&#10;

Accepted Answer

Hormone replacement therapy (HRT) is primarily prescribed to alleviate vasomotor symptoms associated with menopause, such as hot flashes and night sweats.

Question 10

Why are SERMs generally not ordered for women early into menopause?&#10;A)The rapid onset of severe hot flashes can be unbearable.&#10;B)The bone remodeling effect results in osteoporosis.&#10;C)They tend to induce intermittent spotting.&#10;D)The increased risk of breast cancer isn't worth the benefits of a SERM.&#10;

Accepted Answer

SERMs can exacerbate hot flashes, which are already common and often severe in early menopause, making them less tolerable for women during this time.

Question 11

Herbals that have proven efficacy for improving vasomotor symptoms include:&#10;A)Black cohosh&#10;B)Red clover&#10;C)Evening primrose&#10;D)None of the above&#10;

Accepted Answer

The answer of Herbals that have proven efficacy for improving...

Question 12

The advantage of vaginal estrogen preparations in the treatment of vulvovaginal atrophy and dryness is:&#10;A)Ability to deliver higher doses of estrogen in a nonoral form&#10;B)The vaginal cream formula provides moisture to the vaginal area.&#10;C)Relief of symptoms without increasing cardiovascular risk&#10;D)All of the above&#10;

Accepted Answer

The answer of The advantage of vaginal estrogen preparations in...

Question 13

&#34;Menopause&#34; is diagnosed when:&#10;A)The patient has no menses for 12 months.&#10;B)The patient has onset of vasomotor symptoms with irregular menses.&#10;C)The patient has no bleeding cycle for six months.&#10;D)Precise laboratory values are documented.&#10;

Accepted Answer

The answer of &#34;Menopause&#34; is diagnosed when:&#10;A)The patient has no...

Question 14

Ongoing monitoring for women on ERT includes:&#10;A)Lipid levels, repeated annually if abnormal&#10;B)Annual health history and review of risk profile&#10;C)Annual mammogram&#10;D)All of the above&#10;

Accepted Answer

The answer of Ongoing monitoring for women on ERT includes:&#10;A)Lipid...

Deck 40: Hormone Replacement Therapy