NU 665D EXAM 2025/2026 QUESTIONS WITH ANSWERS
GRADED A+
✔✔hormone replacement therapy - ✔✔-combined estrogen/progesterone therapy that
MUST be used in a woman with an intact uterus
-Cyclic or Continuous treatment
✔✔Hormone replacement therapy: Indications? - ✔✔-Bothersome Vasomotor
symptoms
-Prevention of bone loss ( remember lack of estrogen increases a womens risk for
osteoporosis)
-Hypoestrogenism caused by hypogonadism, castration, or POI
-Genitourinary symptoms
✔✔Hormone replacement therapy: Contraindications - ✔✔-Undiagnosed vaginal
bleeding
-Known or suspected pregnancy
-Vascular thromboembolic episodes (CVA,MI, DVT, Thrombophlebitis)
-Abrnormal mammogram ( Brst CA?)
-Active liver disease acute or chronic
-Known or suspected cancer of the breast or reproductive tract
✔✔Hormone replacement therapy: Precaution with these type of pt: - ✔✔-Type I DM
-Active gallbladder disease
-> 1ppd smoker
-Obesity
-FMH breast cancer
-Fibroid uterus
-HX of peripheral vascular episode
-Migraines
-Elevated triglycerides
✔✔Hormone replacement therapy: Ideal candidates - ✔✔-Newly menopausal (within 5
years)
-Good health
-No risk factors for heart disease or breast CA (no first degree relative and neg fmx for
BRCA1 or 2)
-Non smoker
-Non-obese
-Normal Blood sugar and blood pressure
-Moderate to severe vasomotor s/s or menopausal s/s
✔✔Hormone replacement therapy: Increase risk for... - ✔✔-Blood Clots
-Gallbladder Disease
-Breast Cancer: Use for < 4yr, no increase
, -Breast Cancer: Use for 4-10 years, risk is questionable
-Breast Cancer: Use for > 10 years, increased risk
-Increased cardiac events in 1st year use with patient with prior heart disease - HERS II
✔✔Hormone replacement therapy: Side Effects - ✔✔-withdrawal bleeding
-Progesterone: breast tenderness, fluid retention, wgt gain, depression, irritability
-Increase fibroids
-Allergic reaction to patch
-Virilization with testosterone products
✔✔Non-hormonal alternative Meds for Menopausal vasomotor s/s: - ✔✔-Brisdelle 7.5
mg QHS (paroxetine)
-Venlafexine- venlafaxine ER 37.5 qd x 1 week then 75mg once a day or Immediate
release 37.5mg qd x 1 week then 37.5 mg bid
-Gabapentin- 600mg q hs or 300mg TID depending on when the flashes take place (Hot
flashes or night sweats)
Clonidine - 50-75 mcg/day
-SSRI some effect+/-: Paroxetine 25mg qdFluoxetine 10-20mg qdSertraline 50mg qd
✔✔Menopause: Alternatives to insomnia issues - ✔✔--Melatonin
-Gabapentin - 300mg 1-2 hours before bedtime, some patients may need 600mg
-Lunesta - 2mg qhs
-Ambien - 5mg qhs (no longer 10mg)
✔✔Menopause: Complimentary Methods - ✔✔-May be effective - Estroven, Black
Cohash, Soy, Vitamin E
-No evidence - Dong quai, acupuncture, yoga, Evening primrose, Ginseng, Kava, Red
Clover, Flaxseed
✔✔Estrogen Replacement Therapy - ✔✔-Conjugated estrogen - Premarin
(0.3/0.45/0.625,0.9,1.25mg/d)
-Esterified estrogen - Menest (0.3/0.625,1.25,2.5mg/d)
-Transdermal estrogen - Vivelle dot, Vivelle, Estraderm, Alora, Climara, Esclim,
Menostar, FemPatch
**avoids liver effects and less effect on triglycerides and lipids compared to oral
formulations.
-Micronized estrogen - Estradiol 1.0mg/d
✔✔Progesterone Therapy - ✔✔*MUST be used in ALL patients intact uterus - b/c it
protect uterine lining from estrogen effects
-Provera or Prometrium
Scheduling:
-Cyclic - taken the first 10-15 days of the month with estrogen
-Continuous - taken everyday that estrogen is taken, usually 2.5-5.0 mg qd of MPA
GRADED A+
✔✔hormone replacement therapy - ✔✔-combined estrogen/progesterone therapy that
MUST be used in a woman with an intact uterus
-Cyclic or Continuous treatment
✔✔Hormone replacement therapy: Indications? - ✔✔-Bothersome Vasomotor
symptoms
-Prevention of bone loss ( remember lack of estrogen increases a womens risk for
osteoporosis)
-Hypoestrogenism caused by hypogonadism, castration, or POI
-Genitourinary symptoms
✔✔Hormone replacement therapy: Contraindications - ✔✔-Undiagnosed vaginal
bleeding
-Known or suspected pregnancy
-Vascular thromboembolic episodes (CVA,MI, DVT, Thrombophlebitis)
-Abrnormal mammogram ( Brst CA?)
-Active liver disease acute or chronic
-Known or suspected cancer of the breast or reproductive tract
✔✔Hormone replacement therapy: Precaution with these type of pt: - ✔✔-Type I DM
-Active gallbladder disease
-> 1ppd smoker
-Obesity
-FMH breast cancer
-Fibroid uterus
-HX of peripheral vascular episode
-Migraines
-Elevated triglycerides
✔✔Hormone replacement therapy: Ideal candidates - ✔✔-Newly menopausal (within 5
years)
-Good health
-No risk factors for heart disease or breast CA (no first degree relative and neg fmx for
BRCA1 or 2)
-Non smoker
-Non-obese
-Normal Blood sugar and blood pressure
-Moderate to severe vasomotor s/s or menopausal s/s
✔✔Hormone replacement therapy: Increase risk for... - ✔✔-Blood Clots
-Gallbladder Disease
-Breast Cancer: Use for < 4yr, no increase
, -Breast Cancer: Use for 4-10 years, risk is questionable
-Breast Cancer: Use for > 10 years, increased risk
-Increased cardiac events in 1st year use with patient with prior heart disease - HERS II
✔✔Hormone replacement therapy: Side Effects - ✔✔-withdrawal bleeding
-Progesterone: breast tenderness, fluid retention, wgt gain, depression, irritability
-Increase fibroids
-Allergic reaction to patch
-Virilization with testosterone products
✔✔Non-hormonal alternative Meds for Menopausal vasomotor s/s: - ✔✔-Brisdelle 7.5
mg QHS (paroxetine)
-Venlafexine- venlafaxine ER 37.5 qd x 1 week then 75mg once a day or Immediate
release 37.5mg qd x 1 week then 37.5 mg bid
-Gabapentin- 600mg q hs or 300mg TID depending on when the flashes take place (Hot
flashes or night sweats)
Clonidine - 50-75 mcg/day
-SSRI some effect+/-: Paroxetine 25mg qdFluoxetine 10-20mg qdSertraline 50mg qd
✔✔Menopause: Alternatives to insomnia issues - ✔✔--Melatonin
-Gabapentin - 300mg 1-2 hours before bedtime, some patients may need 600mg
-Lunesta - 2mg qhs
-Ambien - 5mg qhs (no longer 10mg)
✔✔Menopause: Complimentary Methods - ✔✔-May be effective - Estroven, Black
Cohash, Soy, Vitamin E
-No evidence - Dong quai, acupuncture, yoga, Evening primrose, Ginseng, Kava, Red
Clover, Flaxseed
✔✔Estrogen Replacement Therapy - ✔✔-Conjugated estrogen - Premarin
(0.3/0.45/0.625,0.9,1.25mg/d)
-Esterified estrogen - Menest (0.3/0.625,1.25,2.5mg/d)
-Transdermal estrogen - Vivelle dot, Vivelle, Estraderm, Alora, Climara, Esclim,
Menostar, FemPatch
**avoids liver effects and less effect on triglycerides and lipids compared to oral
formulations.
-Micronized estrogen - Estradiol 1.0mg/d
✔✔Progesterone Therapy - ✔✔*MUST be used in ALL patients intact uterus - b/c it
protect uterine lining from estrogen effects
-Provera or Prometrium
Scheduling:
-Cyclic - taken the first 10-15 days of the month with estrogen
-Continuous - taken everyday that estrogen is taken, usually 2.5-5.0 mg qd of MPA
