Menopause: hormone therapy: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Menopause: hormone therapy

Sample item

A 52-year-old woman with an intact uterus has severe vasomotor symptoms. Which hormone therapy is appropriate?

AUnopposed oestrogenBProgestogen alone for all womenCOestrogen with a progestogenDTestosterone alone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Oestrogen with a progestogen

Women with a uterus must receive progestogen with oestrogen to prevent endometrial hyperplasia and carcinoma. Unopposed oestrogen is used after hysterectomy. Contraindications to HRT include breast cancer, active thromboembolism, undiagnosed vaginal bleeding and active liver disease.

Option by option

A. Unopposed oestrogen
Unopposed oestrogen raises the risk of endometrial cancer.
B. Progestogen alone for all women
Progestogen alone is less effective for hot flushes.
C. Oestrogen with a progestogen (correct)
Correct. A progestogen protects the endometrium.
D. Testosterone alone
Testosterone alone does not treat vasomotor symptoms.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Oestrogen with a progestogen. Women with a uterus must receive progestogen with oestrogen to prevent endometrial hyperplasia and carcinoma.

Why is "Unopposed oestrogen" not the answer?

Unopposed oestrogen raises the risk of endometrial cancer.

Why is "Progestogen alone for all women" not the answer?

Progestogen alone is less effective for hot flushes.

Why is "Testosterone alone" not the answer?

Testosterone alone does not treat vasomotor symptoms.

What concept does this question test?

It tests Menopause: hormone therapy in OBG. Unopposed oestrogen is used after hysterectomy. Contraindications to HRT include breast cancer, active thromboembolism, undiagnosed vaginal bleeding and active liver disease.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Menopause: hormone therapy?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.