Set out below is a series of multiple choice questions designed to test your understanding of the three articles in our series on the menopause (The menopause and its implications [October 30, p712], Management of the symptomatic menopause [November 6, p750] and Hormone replacement therapy in the longer term [this week p862]).
All pharmacists are invited to complete the questions and send their answers, together with a stamped and addressed A5 (230 x 160mm) envelope, to: The College of Pharmacy Practice, Barclays Venture Centre, University of Warwick Science Park, Coventry CV4 7EZ, by December 20. Results will be returned along with a certificate of completion which, for college members, will count towards continuing education requirements. Negative marking will not be used. The correct answers will be published in The Journal.
A provisional time of four hours is given for the articles relating to this Credit for Learning exercise.
Genus Pharmaceuticals will provide a £500 prize to the pharmacist who achieves the highest marks overall in the four Credit for Learning exercises published in 1999. There will be a runner up prize of £200.
While we will correct obvious errors, The Journal does not have the resources to enter into correspondence about answers to questions.
This page is for information only - answers should be supplied on a copy of the original page printed in The Pharmaceutical Journal November 27, 1999, page 868
| Draw a ring around either T or F (T=true, F=false). There may be more than one true answer to each question. | ||
| 1. The menopause: | ||
| (a) Occurs at a median age of 51 in women in the UK | T | F |
| (b) Is defined as the time of life when a woman's periods become less frequent | T | F |
| (c) Precedes the climacteric | T | F |
| (d) Occurs when the ovaries fail to secrete oestrogen | T | F |
| (e) Occurs at a later age in US women than in European women | T | F |
| 2. In relation to the signs and symptoms associated with the climacteric: | ||
| (a) Menstrual bleeding may become heavier | T | F |
| (b) Aching of joints may occur | T | F |
| (c) Sleep disturbance is common | T | F |
| (d) Vasodilatation and flushing arise through a direct response of vascular smooth muscle to changing levels of oestrogen | T | F |
| (e) Short-term memory loss is common | T | F |
| 3. After the menopause: | ||
| (a) Oestrogen levels in women may be lower than those in men of the same age | T | F |
| (b) Cortical bone is more likely than trabecular bone to be lost through osteoporosis | T | F |
| (c) The sites of major bone loss include the spine, the femoral neck and the distal radius | T | F |
| (d) Osteoblast activity exceeds that of osteoclast | T | F |
| (e) Dietary vitamin D absorption may be reduced | T | F |
| 4. In relation to long-term risks following the menopause: | ||
| (a) The risk of bone fracture is quadrupled when a patient's bone mass density is two standard deviations below normal | T | F |
| (b) In postmenopausal women, the incidence of coronary heart disease approaches that of men at around the age of 60 | T | F |
| (c) A woman's lipid profile is likely to alter adversel | T | F |
| (d) Insulin resistance is likely to increase | T | F |
| (e) Alzheimer's disease is less common in older women than in men of the same age | T | F |
| 5. The following menopausal symptoms may be expected to improve with oestrogen replacement: | ||
| (a) Hot flushes | T | F |
| (b) Night sweats | T | F |
| (c) Headaches | T | F |
| (d) Vaginal dryness | T | F |
| (e) Broken sleep pattern | T | F |
| 6. Regarding HRT: | ||
| (a) Women without a uterus should be offered combined oestrogen:progestogen replacement | T | F |
| (b) Younger women tend to require lower doses of oestrogen than older women | T | F |
| (c) A dose of oestrogen which controls symptoms will generally also prevent bone loss | T | F |
| (d) Tibolone does not require a progestogen to be given in combination | T | F |
| (e) HRT may need to be started before menstruation has stopped | T | F |
| 7. In HRT: | ||
| (a) Combination regimens which involve continuous oestrogen will invariably result in "bleed free" therapy | T | F |
| (b) Continuous progestogen inhibits the effects of oestrogen on the endometrium | T | F |
| (c) The use of tibolone is normally associated with a withdrawal bleed | T | F |
| (d) Continuous combined HRT is a suitable choice for symptom control at the onset of the menopause | T | F |
| (e) Combination therapy with continuous progestogen may confer an advantage over regimens which include cyclical progestogen in terms of a reduction in risk of endometrial neoplasia | T | F |
| 8. Regarding possible adverse effects of HRT: | ||
| (a) Loss of appetite is a common "start-up" effect of HRT | T | F |
| (b) HRT can double the risk of venous thromboembolism | T | F |
| (c) Breast cancer incidence is increased in women receiving HRT | T | F |
| (d) HRT adversely affects the lipid profile | T | F |
| (e) HRT increases the risk of hyperuricaemia and gout | T | F |
| 9. Long term HRT has been shown in randomised controlled trials to produce the following benefits: | ||
| (a) An increase in bone density | T | F |
| (b) A reduction in the incidence of vertebral fracture | T | F |
| (c) Improvement of symptoms in osteoarthritis | T | F |
| (d) A slowing of the progression of Alzheimer's disease | T | F |
| (e) Improved muscle strength | T | F |
| 10. HRT is associated with: | ||
| (a) Reduction in LDL-cholesterol and an increase in HDL-cholesterol | T | F |
| (b) Reduction in plasma fibrinogen | T | F |
| (c) Reduced cerebral perfusion | T | F |
| (d) Increased levels of certain central neurotransmitters | T | F |
| (e) Inhibition of nitric oxide synthase in the blood vessels | T | F |
The College of Pharmacy Practice Credit for Learning: 4