NU665D 2026 TEST PAPER SOLVED
QUESTIONS AND SOLUTIONS
◉ Hormone replacement therapy: Side Effects Answer: -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:
Answer: -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 Answer: --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 Answer: -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 Answer: -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 Answer: *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
-Combined products - Prempro, Premphase, FemHRT, Activella,
Ortho-Prefest, CombiPatch
-Duavee - conjugated estrogen/bazedoxifene (SERM)
◉ Menopause: How to diagnose? Answer: -Amenorrhea for 12
months
-•Routine gyn exam
•Rectal included in pelvic exam
•Educate on importance of f/u if any bleeding
•Pap per guidelines
•TSH
•FSH > 30
•Estradiol <30
•Bone density
◉ HBsAg Answer: hepatitis B surface antigen'
-The body can SEE this
-Indicates: Active infections
QUESTIONS AND SOLUTIONS
◉ Hormone replacement therapy: Side Effects Answer: -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:
Answer: -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 Answer: --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 Answer: -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 Answer: -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 Answer: *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
-Combined products - Prempro, Premphase, FemHRT, Activella,
Ortho-Prefest, CombiPatch
-Duavee - conjugated estrogen/bazedoxifene (SERM)
◉ Menopause: How to diagnose? Answer: -Amenorrhea for 12
months
-•Routine gyn exam
•Rectal included in pelvic exam
•Educate on importance of f/u if any bleeding
•Pap per guidelines
•TSH
•FSH > 30
•Estradiol <30
•Bone density
◉ HBsAg Answer: hepatitis B surface antigen'
-The body can SEE this
-Indicates: Active infections
