Author Question: Having heard positive reports of the benefits of hormone therapy (HT) from her sister-in-law and ... (Read 34 times)

justinmsk · **on:** Jun 25, 2018

Having heard positive reports of the benefits of hormone therapy (HT) from her sister-in-law and friends, a 49-year-old woman has presented to her family physician asking to start HT.

Her uterus is intact, and previous bone scans have indicated low bone density. The client also has a family history of heart disease. She characterizes her symptoms of menopause as noticeable, but not debilitating by any means. Based on the most current research, what is her physician's best course of action?
A)
Begin estrogen-progesterone HT (EPT) to prevent future menopausal symptoms and coronary heart disease (CHD).
B)
Forego HT in light of her preexisting low bone density and consequent risk of osteoporosis.
C)
Forego HT but consider alternative therapies and reevaluate if her symptoms significantly affect her quality of life.
D)
Begin low-dose HT but perform regular breast cancer screening and heart health checks.

Question 2

A 71-year-old man has visited his family physician for a checkup, during which the physician has initiated a discussion about the client's sexual function.

Which of the following phenomena would the physician most likely consider pathological rather than age-related changes?
A)
The presence of an enlarging prostate gland
B)
A decrease in the size and firmness of the client's testes
C)
Cessation of androgen production
D)
A decrease in the force of the man's ejaculation

swimkari · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Ans:
C

Feedback:

Current recommendations for HT, in light of the findings of the WHI and other clinical trials, are to avoid HT for primary or secondary prevention of CHD; develop an individual risk profile for every woman contemplating HT and provide information regarding known risks; utilize HT only in those women who require relief from menopausal symptoms that affect quality of life; consider lower than standard doses and alternative routes of administration; limit the use of HT to the shortest duration consistent with goals, benefits, and risks of treatment for each woman; and because of the potential risks associated with HT products that are FDA approved for the prevention of postmenopausal osteoporosis, consider alternative therapies if the woman is not symptomatic.

Answer to Question 2

Ans:
C

Feedback:

Absence of androgen production and release would be considered a pathological finding rather than a normal accompaniment of the aging process. Androgen replacement in aging men with low androgen levels shows an increase in lean body mass and a decrease in bone turnover. Although they would not necessarily remain untreated, hypogonadism, testicular atrophy, and a decreased force of ejaculation are common reproductive changes that are associated with advanced age.