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Obstetrics and Gynecology
Menopause and Hormone Replacement Therapy: Review Questions
Jordan G. Pritzker, MD, MBA, FACOG
Dr. Pritzker is an Assistant Professor, Albert Einstein College
of Medicine/Montefiore Medical Center, Bronx, NY; and a practicing faculty
member in the Department of Obstetrics and Gynecology, Womens
Comprehensive Health Center, Long Island Jewish Medical Center, New Hyde
Park, NY.
Choose the single best answer for each question.
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1. A 46-year-old woman (G3P3) visits her physician because of a
12-month history of hot flashes, decreased libido, and no menses.
She has no significant medical/surgical history, had menarche at
age 12 years, and has smoked 1 pack of cigarettes daily for many
years. She uses no contraception because she feels she is too old
to conceive. Physical examination reveals no significant abnormalities.
Her follicle-stimulating hormone (FSH) level is 76 mIU/mL. She
is concerned that many of her friends of the same age still have
regular menstruation and no hot flashes. She is interested in hormone
replacement therapy (HRT) because she is worried about "aging too fast."
Which of the following statements concerning the menstrual status of
this patient is most accurate?
- Her cessation of menstruation is not caused by ovarian follicular
activity cessation
- Her serum FSH level is consistent with menopause
- She is unlikely to be experiencing menopause because the average age
of menopause has increased with the increase in life expectancy of women
- She is younger than the average age of menopause in the United States
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2. Which of the following variables is associated with earlier onset
of menopause?
- Age of menarche
- Parity
- Race
- Smoking
- Socioeconomic status
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3. Which of the following symptoms is the most common reason
that patients seek medical care during menopause?
- Hot flashes
- Insomnia
- Irregular menstruation
- Urinary incontinence
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4. Which of the following conditions can result from using HRT
for management of menopause?
- Colorectal cancer
- Improved visual acuity
- Osteoporosis
- Urogenital atrophy
- Vasomotor flushes
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5. Which of the following is NOT a potential adverse effect of
HRT in the management of menopause?
- Abdominal bloating
- Breast tenderness
- Fluid retention in extremities
- Uterine bleeding
- Weight gain
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6. Which of the following is NOT a contraindication to postmenopausal HRT?
- Chronically impaired liver function
- Endometrial adenocarcinoma
- History of breast cancer
- Hypertriglyceridemia
- Impaired glucose tolerance
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