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Chapter 50. Hormone Therapy in Menopause

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Which of the following statements regarding menopause is true?

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A. Menopause is diagnosed after a series of increasing FSH concentrations.

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B. The primary symptom of menopause is vulvovaginal atrophy.

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C. Women who undergo surgical menopause experience similar vasomotor symptoms as women who undergo natural menopause.

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D. The perimenopausal period is characterized by an increase in cycle interval and a decrease in cycle length.

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A 48-year-old woman wants to know about the overall use of hormones based upon recent data, including WHI and HERS. The most accurate statement would be:

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A. Estrogen with and without progesterone has been shown to increase heart attacks and breast cancer in postmenopausal women.

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B. Estrogen and progesterone increased the risk of invasive breast cancer in postmenopausal women, but estrogen alone did not.

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C. Evidence indicates topical and compounded products are safer than oral products because absorption is minimal and cardiovascular risks have not been shown to be significantly increased.

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D. Evidence had demonstrated an increase in cardiovascular events in postmenopausal women who started estrogen regardless of time since initiation.

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A 49-year-old woman who had a hysterectomy 6 months ago is seeking treatment for her vasomotor symptoms. Which of the following recommendations would be most appropriate?

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A. Combination estrogen/progestogen for no longer than 2 years

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B. Estrogen alone for no longer than 5 years

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C. Estradiol vaginal cream until symptoms resolve

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D. Black cohosh for no longer than 2 years

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A 60-year-old woman has suffered from worsening hot flashes and urinary incontinence over the past year. Her last menstrual period was over 3 years ago. PMH is significant for hyperlipidemia taking simvastatin 40 mg daily. She smokes 1 ppd and has one glass of wine with dinner. Recommend the most appropriate treatment for this patient.

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A. CEE 0.3 mg daily + MPA 1.5 mg daily

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B. Venlafaxine 75 mg daily

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C. CEE 0.625 mg daily

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D. Estradiol vaginal cream, apply as directed

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A 54-year-old postmenopausal woman presents to the clinic complaining of hot flashes. Her PMH is significant for tobacco use and ...

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