WBR0350

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
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