2024 MENOPAUSE AND HORMONE
THERAPY EXAM WITH CORRECT
ANSWERS
what is the gold standard for treatment of hot flashes - CORRECT-
ANSWERShormone therapy
what are your treatment options for atrophic vaginitis - CORRECT-ANSWERS-
esterase cream
- premarin cream
- estring
- vagifem
- femring
- Ospemifene (osphena)
would you use Femring for the tx of atrophic vaginitis alone - CORRECT-
ANSWERSno but may use to tx atrophic vaginitis if also having menopausal
s/s
if prescribing femring what will you also need if a uterus is present -
CORRECT-ANSWERSprogestin
with estrogen cream therapies for the treatment of atrophic vaginitis a pt
can expect to experience relief in what time frame - CORRECT-ANSWERS2
weeks
a pt should avoid sexual contact for what time period after applying local
estrogen cream - CORRECT-ANSWERS12 hours
what drug category does ospemifene or osphena fall under - CORRECT-
ANSWERSselective estrogen receptor modulator (SERM) estrogen
agonist/antagonist
Orphan makes vaginal tissue thicker and less fragile but may lead to what
complication - CORRECT-ANSWERSendometrial hyperplasia
Ospemifene (Osphena) is indicated for the treatment of what 2 conditions -
CORRECT-ANSWERS- Atrophic vaginitis
- Dyspareunia
,Ospemifene (osphena) can lead to endometrial hyperplasia what s/s should
you monitor for which may indicate this complication - CORRECT-
ANSWERSuterine bleeding
why is ospemifene (Osphena) not first line therapy for atrophic vaginitis -
CORRECT-ANSWERSsystemic treatment for local problem
what is the black box warning associated with ospemifene (osphena) -
CORRECT-ANSWERSincreased risk for endometrial cancer
if a pt has an increased risk for endometrial cancer such as obesity, HTN, DM
and is taking ospemifene (osphena) for dyspareunia what med should you
also prescribe and why - CORRECT-ANSWERSProgestin. Increased risk for
endometrial cancer
what are some side effects of ospemifene (osphena) - CORRECT-ANSWERS-
hot flashes
- vaginal d/c
- muscle spasms
- excessive sweating
would you prescribe ospemifene (osphena) to a women c/o of dyspareunia
who is also c/o hot flahses - CORRECT-ANSWERSno - most common side
effect is hot flashes
what drugs is ospemifene (osphena) known to interact with - CORRECT-
ANSWERS- azole ATB's
- Rifampin
- other SERMS
- Estrogen therapy
Use of ospemifene (osphena) is contraindicated in what pts - CORRECT-
ANSWERS- undiagnosed vaginal bleeding
- pregnancy
- estrogen dependent neoplasia
- active/hx VTA
- HX stroke, HD, MI
- Liver problems
what are some non hormonal options for the treatment of atrophic vaginitis -
CORRECT-ANSWERS-moisturizers
-lubricants
what are the 2 basic lubricant formulations - CORRECT-ANSWERSwater
silicone
, lubricants are used primarily for what - CORRECT-ANSWERSdyspareunia
what is the only FDA approved treatment for female low libido or hypoactive
sexual desire disorder - CORRECT-ANSWERSFlibanserin (Addyi)
how long does flibanserin (addyi) take to work - CORRECT-ANSWERS4-8
weeks
flibranserin (addyi) is contraindicated in what - CORRECT-ANSWERSliver
disease
ETOH use
can NP's prescribe flibanserin (addyi) for low libido - CORRECT-ANSWERSonly
if take online course
what must a pt sign before being given flibanserin (addyi) - CORRECT-
ANSWERSstatement that says they will not drink ETOH
there is a decreased risk for dvt with use of what preparation of estrogens -
CORRECT-ANSWERStransdermals and gels
before starting HT what risk factors should you work your pt up for -
CORRECT-ANSWERS-CVA
-CHD
-VTE
-Osteoporosis
-Breast CA
before starting HT your pt should of had a mammogram within what time
frame - CORRECT-ANSWERSprevious 12 months
should HT be used for primary or secondary prevention of heart disease -
CORRECT-ANSWERSno
is a 64y female with menopause at age 52y eligible for HT for her c/o hot
flashes - CORRECT-ANSWERSno - current age over 60. menopause > 10
years ago
would you prescribe fenlafaxine to a pt with a hx of htn - CORRECT-
ANSWERSno
Femring is ideal for a pt who has had a hysterectomy and also c/o what -
CORRECT-ANSWERS- hot flashes
- night sweats
- vaginal dryness
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