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Yero exam 4

Total questions: 71

Worksheet time: 44mins

Name
Class
Date
1.

painful menstruation, typically involving cramps. Can be primary or secondary.

a)

Menorrhagia

b)

Amenorrhea

c)

Dysmenorrhea

d)

Oligomenorrhea

2.

absence of menstrual bleeding

a)

menorrhagia

b)

dysmenorrhea

c)

amenorrhea

d)

oligomenorrhea

3.

menstrual cycle interval>35 days

a)

menorrhagia

b)

dysmenorrhea

c)

amenorrhea

d)

oligomenorrhea

4.

regular menstrual bleeding with blood loss>80ml per cycle OR prolonged menstrual bleeding>7 days

a)

dysmenorrhea

b)

Menorrhagia

c)

Oligomenorrhea

d)

amenorrhea

5.

Dysmenorrhea not due to any pelvic disease, typically begins during adolescence with ovulatory cycles, pain can be severe enough to limit daily activities, most common among menstruating girls and women

a)

primary

b)

secondary

6.

Cascade of prostaglandins and leukotrienes helps to relieve pain

a)

False

b)

True

7.

Dysmenorrhea that is more common in adulthood when no history of dysmenorrhea in younger years is present. Results from pelvic organ pathology(fibroids, endometriosis, adenoyosis, use of contraceptive or IU devices.

a)

primary

b)

secondary

8.

Which of the following apply to secondary dysmenorrhea?

a)

Most intense at beginning of onset, may last up to 72 hours

b)

Occurs 6-12 months after menarche

c)

Includes crampy, spasmodic abdominal pain hours before onset of menstruation

d)

Includes backache, thigh pain, N/V, HA, fatigue

e)

Most intense at the end of menstruation, may last up to 24 hours

9.

Which of the following are considered for nonpharm treatment of dysmenorrhea?

a)

Relaxation and biofeedback training

b)

Continuous, low-level, topical heat

c)

Electrical nerve stimulation

d)

Cold compress and cool bath

10.

As far as Pharmacologic treatment, NSAIDs are considered first line treatment

a)

True

b)

False

11.

Which are true regarding hormonal contraceptives as treatment for dysmenorrhea?

a)

Progestin only products can be used

b)

They work by inhibiting ovulation and decreasing thickness of endometrium

c)

Hormonal contraceptives are not considered a safe treatment option for dysmenorrhea

d)

Only Estrogen-only products should be used

12.

Amenorrhea in which no menstrual bleeding has occured by the age of 16 in normal growth

a)

Primary

b)

Secondary

13.

Amenorrhea that is classified as the absence of periods for at least 3 previous cycles or 6 months in those that have previously menstruated

a)

Primary

b)

Secondary

14.

Which of the following are true regarding Oligomenorrhea

a)

Commonly caused by anovulation

b)

Clinical eval is similar to that of amenorrhea

c)

Commonly caused by Dysmenorrhea

d)

Clinical eval is similar to that of Dysamenorrhea

15.

The following can be used as treatment for Amenorrhea and Oligomenorrhea

a)

Bromocriptine

b)

Cabergoline

c)

Bisoprolol

d)

Cholestyramine

16.

Menorrhagia is the abnormally heavy regular menstruation over several consecutive cycles or prolonged(>7 days) menstrual bleeding

a)

True

b)

False

17.

Which of the following are considered for treatment of menorrhagia?

a)

Danazol and Antifibrinolytics

b)

NSAIDs

c)

Combined Oral Contraceptives

d)

Levonorgestrel-releasing intrauterine system

e)

Gonadotropin-releasing hormone agonists(nafarelin, histrelin)

18.

In Menorrhagia, Hysterectomy is considered for

a)

Women who have pelvic pathology

b)

Women with dysfunctional uterine bleeding

c)

Surgical tx of menorrhagia

d)

Is considered as a dangerous alternative and should only be used when no other option is left

19.

How does Endometriosis present?

a)

Painful intercourse( dyspareunia)

b)

Difficult or painful defecation(dyschezia)

c)

Dysmenorrhea and pelvic pain

d)

Loss of menstrual cycles

20.

Of the following, which are considered Pharmacologic tx for endometriosis?

a)

Combined Oral Contraceptives

b)

GnRH

c)

Progestin-only therapy

d)

Danazol

e)

NSAIDs

21.

NSAIDs are not considered very effective for dysmenorrhea

a)

True

b)

False

22.

Danazol is the first approved tx for

a)

Oligomenorrhea

b)

Endometriosis

c)

Dysmenorrhea

d)

Amenorrhea

23.

Which of the following are nonpharm tx's for Infertility?a

a)

Smoking cessation

b)

Limiting caffeine intake

c)

limiting marijuana use

d)

stress control

e)

weight management

24.

Which are true regarding Clomiphene as tx for infertility?

a)

Usually given for 3 days(days 5-7) during cycle

b)

Should be used for no more than 3 ovulatory cycles

c)

Stimulates release of gonadotropins by downregulating estrogen receptors in hypothalamus

d)

Enhances normal follicular maturation process and ovulation

25.

Letrozole and anastrazole are FDA approved treatments for inducing ovulation

a)

True

b)

False

26.

If a patient has a peanut allergy, what medication is cautioned against use?

a)

Estrogen

b)

Progesterone

c)

Clomiphene

d)

Letrozole

27.

Metformin is used in pts with PCOS who need help with insulin resistance. It is also considered first line for ovulation induction and is more efficacious than clomiphene

a)

true

b)

false

28.

Which of the following are used to treat hyperprolactinemia

a)

NSAIDs

b)

Bromocriptine

c)

Cabergoline

d)

Letrozole

29.

Anticholinergic agents, dopamine antagonists, estrogens/antiandrogens, antidepressants, CNS depressants, antihypertensives, and misc drugs such as finasteride/dutasteride, lithium, gemfibrozil, and opiates can all cause

a)

Amenorrhea

b)

BPH

c)

Erectile Dysfunction

d)

Oligomenorrhea

30.

Risk factors for ED include

a)

HTN

b)

CAD

c)

Dyslipidemia

d)

DM

e)

Smoking/chronic alcohol abuse

31.

Of the following, which can be used as treatment therapy for ED?

a)

Letrozole

b)

PDE-5 inhibitors

c)

Testosterone replacement

d)

Alprostadil

32.

Which of the following are PDE-5 inhibitors?

a)

Sildenafil

b)

Vardenafil

c)

Tadalafil

d)

Avanafil

33.

What is the brand name of Sildenafil?

a)

Stendra

b)

Viagra

c)

Cialis

d)

Staxyn

34.

What is the brand name(s) of Vardenafil?

a)

Levitra

b)

Cialis

c)

Staxyn

d)

Viagra

35.

What is the brand name of Tadalafil?

a)

Levitra

b)

Stendra

c)

Cialis

d)

Staxyn

36.

What is the brand name of Avanafil?

a)

Viagra

b)

Staxyn

c)

Stendra

d)

Cialis

37.

Which of the following are true regarding Viagra?

a)

Can have visual effects that include blue-green color

b)

Can not be taken with Nitrates

c)

Should be taken 5-10 minutes prior to intercourse

d)

Can be taken with Nitrates

38.

Which of the following are true regarding Vardenafil?

a)

Is taken 1 hour prior to intercourse

b)

Can not be taken with Nitrates

c)

Produces a blue-green color visual effect

d)

Produces a red-orange color visual effect

39.

Which of the following apply to Tadalafil?

a)

2.5-5mg tabs can be dosed daily

b)

10-20mg can be taken 30 mins before intercourse

c)

Has no visual effects

d)

Produces blue-green color visual effect

40.

Avanafil should be taken 1 hour prior to intercourse

a)

True

b)

False

41.

Priapism is considered a medical emergency that requires immediate medical attention. It is defined as a sustained painful erection of longer than 1-2 hours in absence of sexual stimulation.

a)

True

b)

False

42.

Which PDE-5 inhibitors have the fasted onset of action?

a)

Avanafil

b)

Tadalafil

c)

Vardenafil

d)

Sildenafil

43.

When it comes to testosterone replacement, topical is the preferred treatment

a)

False

b)

True

44.

Which are true regarding testosterone replacement?

a)

Testosterone enenthate and cypionate are administered IM every 2-4 weeks

b)

Testosterone undecanoate is the long-acting depot formulation dosed every 10 weeks

c)

Can cause mood swings

d)

All formulations of testosterone are dosed weekly

45.

For testosterone injections, Intracavernosal are preferred over intraurethral

a)

True

b)

False

46.

If a pt presents with weak urine stream, a full bladder feeling, urinary retention, "dribbles", and the need to press on bladder to force out the urine, They likely have

a)

Obstructive LUTS(Lower urinary trac5 symptoms)

b)

Erectile Dysfunciton

c)

Irritative voiding LUTS(Lower Urinary Tract Symptoms)

47.

If a pt presents with supersensitivity to small volumes of urine, Bladder muscle hypertrophy, urinary frequency/urgency, bedwetting, and nocturia q12h, they likely have which type of Lower Urinary Tract Symptoms

a)

Obstructive

b)

Irritative Voiding

48.

Which of the following medications should be avoided in BPH?

a)

Testosterone Replacement as it can increase prostate growth

b)

a-adrenergic agonists cause urethral constriction

c)

anticholinergics cause acute urinary retention

d)

Diuretics cause polyuria

e)

Beta blockers cause arrythmia

49.

What are behavioral modifications that can be used to help tx BPH?

a)

Restrict fluids before bedtime

b)

avoid caffeine and alcohol

c)

empty bladder frequently while awake

d)

avoid exacerbating medications

e)

set aside timed bathroom breaks

50.

Pharmacologic agents that relax the prostatic smooth muscle and thus are used in treatment of BPH include

a)

a1-adrenergic antagonists

b)

tadalafil

c)

Sildenafil

d)

B1-antagonists

51.

5-alpha reductase inhibitors are pharmacologic agents that interfere with testosterone's stimulatory effect on the prostate gland enlargement and thus are useful in treating BPH

a)

True

b)

False

52.

Which of the following agents are effective in treatment of BPH because they relax the bladder detrusor muscle

a)

Antimuscarinic agents

b)

Mirabegron

c)

Dutasteride

d)

Finasteride

53.

5a-reductase inhibitors are considered the preferred treatment for BPH symptoms

a)

True

b)

False

54.

In cases of BPH where the prostate is >40 grams, what is the preferred medication to treat symptoms?

a)

a1-adrenergic antagonists

b)

5-a reductase inhibitors

c)

Mirabegron

d)

Finasteride

55.

In what situation should combination therapy be considered for BPH?

a)

Prostate >40 grams

b)

PSA>1.4ng/mL

c)

PSA>40 ng/mL

d)

Prostate >1.4 grams

56.

Which is considered a 2nd generation(a1) nonselective a1-adrenergic antagonist?

a)

Terazosin

b)

Silodosin

c)

Tamsulosin

57.

Which are considered 3rd generation uroselective a1-adrenergic antagonist?

a)

Silodosin

b)

Tamsulosin

c)

Doxazosin

d)

Alfuzosin

58.

A1-adrenergic antagonists do not reduce or affect size of the prostate or PSA levels, and it does not prevent progression of the disease. It simply relaxes smooth muscle in prostate and bladder neck to increase urinary flow rate

a)

True

b)

False

59.

What is a precaution with a1-adrenergic antagonists, particularly tamsulosin

a)

Irregular heartbeat

b)

Intraoperative floppy iris syndrome

c)

Erectile Dysfunction

d)

Blue-green color

60.

Of the 2nd generation a1-adrenergic antagonists, which one(s) have no renal or hepatic precautions, but have proven interactions with antihypertensives?

a)

Terazosin

b)

Alfuzosin

c)

Doxazosin

61.

Which are true regarding 5a-reductase inhibitors?

a)

considered for moderate to severe bPH

b)

used in cases where prostate gland >40 grams

c)

works by slowing disease progression and decreasing surgical need

d)

Has a relatively quick onset of action of 3-4 weeks

62.

Which of the following are true regarding 5a-reductase inhibitors?

a)

Reduce PSA levels by 50%

b)

Are a Pregnancy category X

c)

Should not be handled by those who are childbearing or potentially childbearing

d)

Reduces PSA levels by 10-15%

63.

PDE-5 inhibitors are reserved for

a)

BPH

b)

Erectile dysfunction

c)

pts with both conditions

d)

Neither condition

64.

PDE-5 inhibitors are safe when used in combination with a-adrenergic antagonists

a)

False

b)

True

65.

PDE-5 inhibitors, when used in combination with 5a-reductase inhibitors, may be associated with

a)

less risk of blue-green vision

b)

more risk of blue-green vision

c)

less sexual dysfunction

d)

more sexual dysfunction

66.

Which are true regarding beta3-adrenergic agonist Mirabegron(Myrbetriq)?

a)

CV AE is HTN and shouldn't be used in severely uncontrolled HTN

b)

Relaxes the detrusor muscle during the storage phase to reduce irritative voiding symptoms

c)

Helps to increase intervals between voidings

d)

Works by contracting the detrusor muscle so that the bladder is able to empty completely

67.

Ideal candidates of 5a-reductase inhibitors and A1-adrenergic antagonists combination therapy must have

a)

Severe symptoms

b)

Prostate 40+ grams

c)

PSA 1.4+mg/dL

d)

Asymptomatic

68.

Which combos are the preferred combination therapy for BPH?

a)

Finasteride + Doxazosin

b)

Dutasteride + Tamsulosin

c)

Dutasteride + Doxazosin

d)

Finasteride + Tamsulosin

69.

Saw palmetto berry, stinging nettle, south african star grass, pumpkin seed, and african plum are considered alternative medicines for treatment of BPH. Which one is most commonly used?

a)

Star grass

b)

Saw palmetto

c)

Stinging nettle

d)

pumpkin seet

70.

What are important counseling points?

a)

a1-adrenergic antagonists should not be handled by pregnant patients

b)

5a-reductase inhibitors may cause Priapism

c)

A1-adrenergic antagonists--symptom relief begins after 1-2 weeks

d)

5a-reductase inhibitors may take up to 3-6 months to see benefit

71.

If a drug decreases PSA and shrinks the prostate, it could mask prostate cancer. Which of the following drugs have these effects?

a)

Tamsulosin

b)

Silodosin

c)

Alfuzosin

d)

Finasteride

e)

Doxazosin

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