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Self-Assessment Questions

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, Women’s Comprehensive Health Center, Long Island Jewish Medical Center, New Hyde Park, NY.

Choose the single best answer for each question.

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?
  1. Her cessation of menstruation is not caused by ovarian follicular activity cessation
  2. Her serum FSH level is consistent with menopause
  3. She is unlikely to be experiencing menopause because the average age of menopause has increased with the increase in life expectancy of women
  4. 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?

  1. Age of menarche
  2. Parity
  3. Race
  4. Smoking
  5. Socioeconomic status
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  3. Which of the following symptoms is the most common reason that patients seek medical care during menopause?
  1. Hot flashes
  2. Insomnia
  3. Irregular menstruation
  4. Urinary incontinence
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4. Which of the following conditions can result from using HRT for management of menopause?

  1. Colorectal cancer
  2. Improved visual acuity
  3. Osteoporosis
  4. Urogenital atrophy
  5. Vasomotor flushes
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5. Which of the following is NOT a potential adverse effect of HRT in the management of menopause?

  1. Abdominal bloating
  2. Breast tenderness
  3. Fluid retention in extremities
  4. Uterine bleeding
  5. Weight gain
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6. Which of the following is NOT a contraindication to postmenopausal HRT?

  1. Chronically impaired liver function
  2. Endometrial adenocarcinoma
  3. History of breast cancer
  4. Hypertriglyceridemia
  5. Impaired glucose tolerance
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