A leukemia b acne c congestive heart failure d

A. Leukemia
B. Acne
C. Congestive heart failure
D. Melanoma
E. Down's syndrome
View Answer
C. Absolute contraindications to the use of HRT include the
presence of an estrogen-related cancer, undiagnosed abnormal
vaginal bleeding, liver disease, active thromboembolic disorders,
pregnancy, and prior complications of HRT. Relative
contraindications include risk for thromboembolic disorders,
gallstones, the presence of conditions aggravated by fluid
retention, active endometriosis, uterine fibroids, acute intermittent
porphyria, and previous breast cancer. Since congestive heart
failure may be worsened by fluid retention, it is a relative
contraindication for HRT.
37. Compared to estrogen therapy, raloxifene (Evista) is
more likely to cause which of the following?
A. Hot flashes
B. Migraine headaches
C. Cough
D. Nausea
E. Arthritis
View Answer
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A. Raloxifene (Evista) is a selective estrogen receptor modulator
(SERM), which acts as both an estrogen agonist and an antagonist.
Other medications in this class are tamoxifen (Nolvadex) and
clomiphene (Clomid). Raloxifene has prospectively proven beneficial
effects on bone and reduces the risk of breast cancer. It also
improves lipid profiles. However, because of the antagonist effects,
it may exacerbate menopausal symptoms, such as hot flashes and
atrophic vaginitis.
38. What is the major advantage of raloxifene (Evista) over
estrogen?
A. Better control of atrophic vaginitis
B. Better control of hot flashes
C. Fewer endometrial changes
D. Fewer thromboembolic events
E. Better lipid effects
View Answer
C. As a SERM, raloxifene (Evista) acts on target tissues to produce
some effects that are similar to estrogen and others that are
distinctly different. Like estrogen, raloxifene can cause
thromboembolic events, improve serum lipids, and increase bone
density. Unlike estrogen, typical side effects include hot flashes
and atrophic vaginitis. A major advantage of raloxifene over
estrogen is the lack of proliferative effect on the endometrium,
which in turn reduces the risk of endometrial adenocarcinoma.
39. A 28-year-old woman presents to your office complaining
of irregular periods every 2 to 4 months for the past 8
months. She reports menarche at age 15. She started on an
oral contraceptive pill at the age of 17. She had a regular
period up until 9 months ago. She stopped taking the oral
contraceptive pill 9 months ago. On exam, she has normal
vital signs. Her exam is unremarkable except for obesity and
mild facial hair that she reports she has had “for as long as I
can remember.” This patient most likely has an anovulatory
pattern of bleeding secondary to:
A. Obesity
B. Polycystic ovarian syndrome (Stein–Leventhal syndrome)
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