chap 48: Women as patients

Question 1

1. Prescribing for women during their childbearing years requires constant awareness of the possibility of:
2. Pregnancy unless the women is on birth control
3. Risk for silent bacterial or viral infections of the genitalia
4. High risk for developmental disorders in their infants
5. Decreased risk for abuse during this time

Answer 1

2. Risk for silent bacterial or viral infections of the genitalia

Question 2

2. Intimate partner violence is a serious public health problem. It should be screened for:
3. At every encounter within the health-care system
4. When a women is being seen for symptoms of depression
5. Throughout pregnancy
6. If a sexually transmitted disease is diagnosed

Answer 2

1. At every encounter within the health-care system

Question 3

3. Because of their longer life expectancy, women are more likely than men to experience a disabling condition. Common conditions in older women that can produce disability include:
4. Depression
5. Panic disorders
6. Dementia
7. All of the above

Answer 3

4. All of the above

Question 4

4. Gender differences between men and women in pharmacokinetics include:
5. More rapid gastric emptying so that drugs absorbed in the stomach have less exposure to absorption sites
6. Higher proportion of body fat so that lipophilic drugs have relatively greater volumes of distribution
7. Increased levels of bile acids so that drugs metabolized in the intestine have higher concentrations
8. Slower organ blood flow rates so drugs tend to take longer to be excreted

Answer 4

2. Higher proportion of body fat so that lipophilic drugs have relatively greater volumes of distribution

Question 5

5. Which of the following drug classes is associated with significant differences in metabolism based on gender?
6. Beta blockers
7. Antibiotics
8. Serotonin reuptake inhibitors
9. Angiotensin-converting-enzyme (ACE) inhibitors

Answer 5

3. Serotonin reuptake inhibitors

Question 6

6. Since 40% of bone accrual occurs during adolescence, building bone during this time is critical. Ways to improve bone accrual in adolescents include:
7. Use of bisphosphonates early if dual energy X-ray absorptiometry (DEXA) scans show limited bone accrual
8. Encouraging a daily dietary intake of 1,300 mg of calcium and 400 IU of vitamin D
9. Avoiding all birth control methods that include progesterone
10. Fostering the intake of iron mainly in green and leafy vegetables

Answer 6

2. Encouraging a daily dietary intake of 1,300 mg of calcium and 400 IU of vitamin D

Question 7

7. Hot flashes are often a concern during menopause. Which of the following may help in reducing them?
8. Drink one caffeinated liquid per day
9. Take progesterone supplementation
10. Exercise 20-40 minutes/day
11. Increase intake of carrots, yams, and soy products

Answer 7

4. Increase intake of carrots, yams, and soy products

Question 8

8. Factors common in women that can affect adherence to a treatment regimen include all of the following EXCEPT:
9. Number of drugs taken: Women tend to take fewer drugs over longer periods of time
10. Fear that medications can cause disease: Information obtained from social networks may be inaccurate for a specific woman
11. Nutritional status: Worries about possible weight gain from a given drug may result in nonadherence
12. Religious differences: A patient’s belief system that is not congruent with the treatment regimen presents high risk for nonadherence

Answer 8

1. Number of drugs taken: Women tend to take fewer drugs over longer periods of time

Question 9

9. Dysmenorrhea is one of the most common gynecological complaints in young women. The first line of drug treatment for this disorder is:
10. Oral contraceptive pills
11. Caffeine
12. NSAIDs
13. Aspirin

Answer 9

3. NSAIDs

Question 10

10. Premenstrual dysphoric disorder (PMDD) occurs in a fairly small number of patients. Theories of the pathology behind PMDD that are supported in research include:
11. Altered sensitivity in the serontonic system
12. Inhibition of the cyclooxygenase system
13. Fluctuations of the gonadal hormones
14. All of these are theories supported by research

Answer 10

4. All of these are theories supported by research

Question 11

11. Treatment of PMDD that affects all or most of the symptoms includes:
12. Tryptophan up to 6 g/d
13. Vitamin E 200-400 mg/d
14. Evening primrose oil 500 mg/d
15. Fluoxetine 20 mg/d

Answer 11

4. Fluoxetine 20 mg/d

Question 12

12. Women are now the fastest growing population with HIV infection and AIDS. HIV-infected women:
13. Are less likely to become pregnant or to carry a pregnancy to term
14. Have higher rates of cervical dysplasia and HPV-concurrent infections
15. Are most often over 35 years of age
16. Most often come from Asian and Caucasian ethnic groups

Answer 12

2. Have higher rates of cervical dysplasia and HPV-concurrent infections

Question 13

13. Maternal-to-child transmission of HIV infection during pregnancy may be prevented by:
14. Use of antiviral drugs such as zidovudine
15. Use of condoms during intercourse
16. Both 1 and 2
17. Neither 1 nor 2

Answer 13

1. Use of antiviral drugs such as zidovudine

Question 14

14. Erroneous information about LGBTQ individuals can lead to failure to give accurate advice to them as patients. Which of the following statements is true about lesbians:
15. Lesbians cannot contract a sexually transmitted infection from their female partner.
16. Screening for cervical cancer is not required.
17. Lesbians as a group are less likely to have health-care insurance.
18. Like women in general, lesbians are more likely than gay men to seek care for health-related issues.

Answer 14

3. Lesbians as a group are less likely to have health-care insurance.

Question 15

15. Which of the following holds true for the pharmacokinetics of women?
16. Gastric emptying is faster than that of men.
17. Organ blood flow is the same as that of men.
18. Evidence is strong concerning renal differences in elimination.
19. Medications that involve binding globulins are impacted by estrogen levels.

Answer 15

4. Medications that involve binding globulins are impacted by estrogen levels.

Question 16

16. The metabolism of drugs in women is primarily impacted by:
17. Hepatic blow flow
18. Enzymes of the CYP450 system differences with men
19. The amount of gastric secretions
20. Whether they are pre- or postmenopausal

Answer 16

2. Enzymes of the CYP450 system differences with men

Question 17

17. The interpretation of DEXA scores in the rare cases of adolescent osteoporosis in teens:
18. Use the same T scores that are established for women
19. Cannot be done because of less-than-mature bones
20. Must use special Z-scores developed for this reason
21. Can only be done if bisphosphonates have already been started

Answer 17

3. Must use special Z-scores developed for this reason

Question 18

18. The timing of NSAIDS for best control of severe menstrual cramps includes:
19. Taking them for 2-3 days prior to the start of bleeding
20. Taking them 2-3 times a day during the first 2 days
21. Taking them every 2-3 hours
22. They have not been found to be helpful at all

Answer 18

1. Taking them for 2-3 days prior to the start of bleeding

Question 19

19. Which of the following is true concerning lesbian health concerns?
20. They cannot contract an STI from another woman.
21. Pap smears are not required to screen for cervical cancer.
22. Lesbian women have a tendency to be frequent clinic visitors.
23. The health risks associated with smoking, alcohol, and depression are higher than in the heterosexual population.

Answer 19

4. The health risks associated with smoking, alcohol, and depression are higher than in the heterosexual population.