CMN 572 Test 2 – Questions With Complete
Solutions
When should screening for osteoporosis based on ↓ bone mineral
density begin for women? Correct Answer - 65 yrs for women
w/o hx of fractures or secondary osteoporosis
< 65 yrs for women whose 10 year fracture risk is ≥ the risk of a 65
year old woman without additional factors (i.e. FRAX score of 9.3%)
McPhee p 11 + USPSTF
What interventions should be provided to offset risk of osteoporosis
due to long term corticosteroid tx? Correct Answer - + Calcium
and vitamin D supplementation for ALL patients.
+ Consider bone densitometry for pts with IBD who have other
osteo. risk factors AND for all patients with a lifetime use of
corticosteroids for 3 months or more.
McPhee p 660
S/S of menopause Correct Answer - 1) Cessation of
menstruation
2) Hot flashes
3) Vaginal atrophy
4) Osteoporosis
McPhee p 802-803
Definition of menopausal transition Correct Answer - No
bleeding ≥ 1 year
McPhee p 803
,Women of which ethnicity report longer duration of vasomotor
symptoms related to menopause? Correct Answer - African-
American
McPhee p 803
Vasomotor symptoms related to menopause were found to last
more than ______________ years in 50% of women. Correct Answer -
SEVEN YEARS
McPhee p 803
One way to prevent vaginal atrophy related to menopause Correct
Answer - Continued sexual activity
McPhee p 803
Definition of premature menopause Correct Answer - Ovarian
failure and menstrual cessation before age 40.
McPhee p 802
Physical appearance of genitalia after vaginal atrophy Correct
Answer - Pale, smooth vaginal mucosa and a small cervix and
uterus.
McPhee p 803
Hormone treatment of moderate to severe menopause-related
vasomotor symptoms Correct Answer - Intact -- Estrogen or
estrogen/progestin regimens
Post-hysterectomy -- Estrogen only
,McPhee p 803
Maximum time that post-menopausal women should use
combination progestin-estrogen therapy? Correct Answer - ≤3
- 4 years.
McPhee p 803
Alternatives to hormone therapy for tx of vasomotor symptoms in
post-menopausal women? Correct Answer - + SSRIs (e.g.
Paroxetine or Venlafaxine)
+ Gabapentin (900 mg po daily)
+ Clonidine (100-150 mcg po or transdermally, but caution with side
effects of dry mouth, drowsiness and hypotension)
McPhee p 803
Treatment of vaginal atrophy in post-menopausal women Correct
Answer - + Vaginal ring with 2 mg of estradiol can be left in place
for 3 months and is ok for long term use. (Use with caution)
+ Vaginal estrogen cream - Short term use only, and absorption is
variable.
+ Estradiol tablet (10 mcg) inserted in vagina daily for 2 weeks and
then twice a week for long term use.
+ Testosterone propionate cream (1-2%, 0.5 - 1 g) can be used if
estrogen is contraindicated.
McPhee p 803
How much calcium and Vitamin D per day do women need
throughout life? Correct Answer - Calcium ≥ 800 mg/day
Vitamin D ≥ 800 IU/day from food, sunlight or supplements.
McPhee p 804
, High risk groups of women at risk for osteoporotic fractures
Correct Answer - White and Asian women, especially with these
characteristics:
+ Have family hx of osteoporosis
+ Thin
+ Short
+ Smokers
+ Hx of hyperthyroidism
+ Long term corticosteroid use
+ Physically inactive
McPhee p 804
Suggested interventions for women at risk of osteoporotic fractures
Correct Answer - 1) Biphosphonates
2) Raloxifene
3) Hormone replacement
McPhee p 804
True/False: Estrogen-progestin replacement therapy in post-
menopausal women provides cardiovascular benefits. Correct
Answer - FALSE.
McPhee p 804
True/False: WHI and HERS studies indicated that risks outweigh
benefits of long term use of estrogen/progesterone medications
Correct Answer - TRUE.
McPhee p 804
Solutions
When should screening for osteoporosis based on ↓ bone mineral
density begin for women? Correct Answer - 65 yrs for women
w/o hx of fractures or secondary osteoporosis
< 65 yrs for women whose 10 year fracture risk is ≥ the risk of a 65
year old woman without additional factors (i.e. FRAX score of 9.3%)
McPhee p 11 + USPSTF
What interventions should be provided to offset risk of osteoporosis
due to long term corticosteroid tx? Correct Answer - + Calcium
and vitamin D supplementation for ALL patients.
+ Consider bone densitometry for pts with IBD who have other
osteo. risk factors AND for all patients with a lifetime use of
corticosteroids for 3 months or more.
McPhee p 660
S/S of menopause Correct Answer - 1) Cessation of
menstruation
2) Hot flashes
3) Vaginal atrophy
4) Osteoporosis
McPhee p 802-803
Definition of menopausal transition Correct Answer - No
bleeding ≥ 1 year
McPhee p 803
,Women of which ethnicity report longer duration of vasomotor
symptoms related to menopause? Correct Answer - African-
American
McPhee p 803
Vasomotor symptoms related to menopause were found to last
more than ______________ years in 50% of women. Correct Answer -
SEVEN YEARS
McPhee p 803
One way to prevent vaginal atrophy related to menopause Correct
Answer - Continued sexual activity
McPhee p 803
Definition of premature menopause Correct Answer - Ovarian
failure and menstrual cessation before age 40.
McPhee p 802
Physical appearance of genitalia after vaginal atrophy Correct
Answer - Pale, smooth vaginal mucosa and a small cervix and
uterus.
McPhee p 803
Hormone treatment of moderate to severe menopause-related
vasomotor symptoms Correct Answer - Intact -- Estrogen or
estrogen/progestin regimens
Post-hysterectomy -- Estrogen only
,McPhee p 803
Maximum time that post-menopausal women should use
combination progestin-estrogen therapy? Correct Answer - ≤3
- 4 years.
McPhee p 803
Alternatives to hormone therapy for tx of vasomotor symptoms in
post-menopausal women? Correct Answer - + SSRIs (e.g.
Paroxetine or Venlafaxine)
+ Gabapentin (900 mg po daily)
+ Clonidine (100-150 mcg po or transdermally, but caution with side
effects of dry mouth, drowsiness and hypotension)
McPhee p 803
Treatment of vaginal atrophy in post-menopausal women Correct
Answer - + Vaginal ring with 2 mg of estradiol can be left in place
for 3 months and is ok for long term use. (Use with caution)
+ Vaginal estrogen cream - Short term use only, and absorption is
variable.
+ Estradiol tablet (10 mcg) inserted in vagina daily for 2 weeks and
then twice a week for long term use.
+ Testosterone propionate cream (1-2%, 0.5 - 1 g) can be used if
estrogen is contraindicated.
McPhee p 803
How much calcium and Vitamin D per day do women need
throughout life? Correct Answer - Calcium ≥ 800 mg/day
Vitamin D ≥ 800 IU/day from food, sunlight or supplements.
McPhee p 804
, High risk groups of women at risk for osteoporotic fractures
Correct Answer - White and Asian women, especially with these
characteristics:
+ Have family hx of osteoporosis
+ Thin
+ Short
+ Smokers
+ Hx of hyperthyroidism
+ Long term corticosteroid use
+ Physically inactive
McPhee p 804
Suggested interventions for women at risk of osteoporotic fractures
Correct Answer - 1) Biphosphonates
2) Raloxifene
3) Hormone replacement
McPhee p 804
True/False: Estrogen-progestin replacement therapy in post-
menopausal women provides cardiovascular benefits. Correct
Answer - FALSE.
McPhee p 804
True/False: WHI and HERS studies indicated that risks outweigh
benefits of long term use of estrogen/progesterone medications
Correct Answer - TRUE.
McPhee p 804
