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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor=Dr. Neeraja Danda
|QuestionAuthor=Neeraja Danda M.B.B.S
|ExamType=USMLE Step 2 CK
|ExamType=USMLE Step 2 CK
|MainCategory=Internal medicine
|MainCategory=Internal medicine
Line 21: Line 21:
|SubCategory=Cardiovascular
|SubCategory=Cardiovascular
|Prompt=A  50 year old  female with a history of hypertension for the last 5 years presents to her physician’s office for  an annual physical examination. In the history her last menstrual period was 8 months ago, and she shows interest in knowing about menopause and its effects. Further questioning reveals that her father died of Myocardial Infarction at the age of 60 and mother is hypertensive. She says she has been researching about menopause recently and asks “Can I take estrogen replacement to decrease my risk of coronary artery disease”. Administration of estrogen replacement  leads to which of the following?
|Prompt=A  50 year old  female with a history of hypertension for the last 5 years presents to her physician’s office for  an annual physical examination. In the history her last menstrual period was 8 months ago, and she shows interest in knowing about menopause and its effects. Further questioning reveals that her father died of Myocardial Infarction at the age of 60 and mother is hypertensive. She says she has been researching about menopause recently and asks “Can I take estrogen replacement to decrease my risk of coronary artery disease”. Administration of estrogen replacement  leads to which of the following?
|Explanation=Menopause is caused by decreased production of estrogen and progesterone from  oocytes in females and usually between the age of 48 to 52 years. It is diagnosed by elevated levels of gonadotropins (FSH and LH) . Decreased estrogen in menopause may lead to Osteoporosis, Hot flashes, vaginal dryness, and increased LDL levels, Decreased HDL levels. Until the onset of menopause women are considered to be at lower risk for coronary artery disease than men because of the protective effect of estrogen. But Hormone replacement therapy can never be given to prevent risk of Coronary artery disease. Studies say hormone replacement therapy may decrease the levels of low density lipoproteins but cannot decrease the risk of coronary artery disease.


|Explanation=Menopause is caused by decreased production of estrogen and progesterone from  oocytes in females and usually between the age of 48 to 52 years. It is diagnosed by elevated levels of gonadotropins (FSH and LH) . Decreased estrogen in menopause may lead to Osteoporosis, Hot flashes, vaginal dryness, and increased LDL levels, Decreased HDL levels. Until the onset of menopause women are considered to be at lower risk for coronary artery disease than men because of the protective effect of estrogen. But Hormone replacement therapy can never be given to prevent risk of Coronary artery disease. Studies say hormone replacement therapy may decrease the levels of low density lipoproteins but cannot decrease the risk of coronary artery disease.
'''Educational Objective''': After menopause the protective effect of estrogen over coronary artery disease risk in females Is lost. While administration of estrogen to post-menopausal women decreases LDL, it does not decrease the risk of coronary artery disease
 
'''References''': Page 50, 482  Master the Boards Step 2 CK  Second edition, Page 445 Master the boards Step 3 2009 edition
|AnswerA=50% decrease in the risk of Coronary artery disease in this patient
|AnswerA=50% decrease in the risk of Coronary artery disease in this patient
|AnswerAExp=Estrogen does not decrease risk of coronary artery disease
|AnswerAExp='''Incorrect''' Estrogen does not decrease risk of coronary artery disease
|AnswerB=20% decrease in the risk of coronary artery disease in this patient
|AnswerB=20% decrease in the risk of coronary artery disease in this patient
|AnswerBExp=Estrogen does not decrease the risk of coronary artery disease
|AnswerBExp='''Incorrect''' Estrogen does not decrease the risk of coronary artery disease
|AnswerC=25% decrease in the risk of coronary artery disease and 25% decrease in low density lipoprotein levels
|AnswerC=25% decrease in the risk of coronary artery disease and 25% decrease in low density lipoprotein levels
|AnswerCExp=Estrogen may decrease low density lipoprotein levels but may not help coronary artery disease
|AnswerCExp='''Incorrect''' Estrogen may decrease low density lipoprotein levels but may not help coronary artery disease
|AnswerD=No decrease in low density lipoprotein levels
|AnswerD=No decrease in low density lipoprotein levels
|AnswerDExp=Estrogen may decrease Low density lipoprotein levels
|AnswerDExp='''Incorrect''' Estrogen may decrease Low density lipoprotein levels
|AnswerE=Decreased low density lipoprotein level but may not help in Coronary artery disease
|AnswerE=Decreased low density lipoprotein level but may not help in Coronary artery disease
|AnswerEExp=After menopause the protective effect of estrogen over coronary artery disease risk in females Is lost. While administration of estrogen to post-menopausal women decreases LDL, it does not decrease the risk of coronary artery disease
|AnswerEExp=Administration of estrogen to post-menopausal women decreases LDL, it does not decrease the risk of coronary artery disease
|RightAnswer=E
|RightAnswer=E
|Approved=No
|Approved=Yes
}}
}}

Latest revision as of 00:15, 28 October 2020

 
Author PageAuthor::Neeraja Danda M.B.B.S
Exam Type ExamType::USMLE Step 2 CK
Main Category MainCategory::Internal medicine
Sub Category SubCategory::Cardiovascular
Prompt [[Prompt::A 50 year old female with a history of hypertension for the last 5 years presents to her physician’s office for an annual physical examination. In the history her last menstrual period was 8 months ago, and she shows interest in knowing about menopause and its effects. Further questioning reveals that her father died of Myocardial Infarction at the age of 60 and mother is hypertensive. She says she has been researching about menopause recently and asks “Can I take estrogen replacement to decrease my risk of coronary artery disease”. Administration of estrogen replacement leads to which of the following?]]
Answer A AnswerA::50% decrease in the risk of Coronary artery disease in this patient
Answer A Explanation AnswerAExp::'''Incorrect''' Estrogen does not decrease risk of coronary artery disease
Answer B AnswerB::20% decrease in the risk of coronary artery disease in this patient
Answer B Explanation AnswerBExp::'''Incorrect''' Estrogen does not decrease the risk of coronary artery disease
Answer C AnswerC::25% decrease in the risk of coronary artery disease and 25% decrease in low density lipoprotein levels
Answer C Explanation AnswerCExp::'''Incorrect''' Estrogen may decrease low density lipoprotein levels but may not help coronary artery disease
Answer D AnswerD::No decrease in low density lipoprotein levels
Answer D Explanation AnswerDExp::'''Incorrect''' Estrogen may decrease Low density lipoprotein levels
Answer E AnswerE::Decreased low density lipoprotein level but may not help in Coronary artery disease
Answer E Explanation AnswerEExp::Administration of estrogen to post-menopausal women decreases LDL, it does not decrease the risk of coronary artery disease
Right Answer RightAnswer::E
Explanation [[Explanation::Menopause is caused by decreased production of estrogen and progesterone from oocytes in females and usually between the age of 48 to 52 years. It is diagnosed by elevated levels of gonadotropins (FSH and LH) . Decreased estrogen in menopause may lead to Osteoporosis, Hot flashes, vaginal dryness, and increased LDL levels, Decreased HDL levels. Until the onset of menopause women are considered to be at lower risk for coronary artery disease than men because of the protective effect of estrogen. But Hormone replacement therapy can never be given to prevent risk of Coronary artery disease. Studies say hormone replacement therapy may decrease the levels of low density lipoproteins but cannot decrease the risk of coronary artery disease.

Educational Objective: After menopause the protective effect of estrogen over coronary artery disease risk in females Is lost. While administration of estrogen to post-menopausal women decreases LDL, it does not decrease the risk of coronary artery disease

References: Page 50, 482 Master the Boards Step 2 CK Second edition, Page 445 Master the boards Step 3 2009 edition
Educational Objective:
References: ]]

Approved Approved::Yes
Keyword
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