A post menopausal woman comes to you to discuss hormone replacement therapy (HRT). She has a history of migraines and a strong family history of osteoporosis.
What would be an appropriate choice?
Correct Answer C:
Oral forms of estrogen and progesterone can cause several side effects, one of which is migraines. For this patient the only medicine appropriate is a bisphosphonate like Actonel or Fosamax to prevent her from developing osteoporosis.
A 53-year-old white female visits your office for her annual examination. During the last year she has stopped having menstrual periods and has had moderately severe sleep disturbance. She has been waking up at night with sweats. She denies other problems or complaints. She has a previous history of depression and her family history is significant for osteoporosis, heart disease, and Alzheimer’s disease in older members of her family. There is no family history of breast cancer. The patient is concerned about her future and current health and wants to know the benefits and risks of hormone replacement therapy (HRT).
Which one of the following statements about HRT is correct?
Correct Answer D:
Hormone replacement therapy (HRT) improves the urogenital symptoms of menopause, such as vaginal dryness and dyspareunia. However, recent research regarding HRT has not shown a benefit for reducing coronary events, slowing the progression of Alzheimer’s disease, improving depression, or improving urinary incontinence. It does not decrease risk of invasive breast cancer.
A 56-year-old female has been on combined continuous hormone therapy for 6 years.
This is associated with a reduced risk for which one of the following?
Correct Answer A: Hormone replacement therapy that includes estrogen has been shown to decrease osteoporosis and bone fracture risk. The risk for colorectal cancer also is reduced after 5 years of estrogen use. The risk for myocardial infarction, stroke, breast cancer, and venous thromboembolism increases with long-term use.
An 18-year-old white female presents with small, localized warts on the vulva and lower vaginal mucosa. She wants to avoid injections and surgical treatment if possible. Which one of the following is an acceptable topical agent for treating these vaginal lesions?
Correct Answer A:
Tricholoroacetic acid is acceptable for use on vaginal mucosa. It is also acceptable for use when pregnancy is a possibility. Professional application is necessary.
→ Podofilox and podophyllin in alcohol are not safe for use on mucosa.
→ Imiquimod cream is also not approved for mucosal use.
→ Interferon requires injection.
Which one of the following is recommended for the treatment of intravaginal genital warts in pregnant women?
Genital warts can proliferate and fragment during pregnancy, and many specialists recommend that they be eliminated. Imiquimod, podophyllin, and podofilox are not recommended for use during pregnancy. For the treatment of vaginal warts, the Centers for Disease Control and Prevention (CDC) recommends the use of cryotherapy. Liquid nitrogen, rather than a cryoprobe, should be used to avoid possible vaginal perforation and subsequent fistula formation. An alternative is the use of trichloroacetic acid or bichloroacetic acid carefully applied to the lesions to avoid damage to adjacent tissue. Interferon is no longer recommended for routine use in treating genital warts, due to a high frequency of systemic adverse effects.
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