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Chapter 40: Gonadal Hormones & Inhibitors

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A teenager seeks postcoital contraception. Which of the following preparations will be effective for this purpose?

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(A) Clomiphene

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(B) Ethinyl estradiol

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(C) Diethylstilbestrol (DES)

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(D) Mifepristone

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(E) Norgestrel

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Mifepristone, an antagonist at progesterone and glucocorticoid receptors, has a luteolytic effect and is effective as a postcoital contraceptive. When combined with a prostaglandin, it is also an effective abortifacient. The answer is D.

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A 23-year-old woman desires a combined oral contraceptive for pregnancy protection. Which of the following patient factors would lead a health professional to recommend an alternative form of contraception?

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(A) Evidence of hirsutism

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(B) History of gastroesophageal reflux disease and is currently taking omeprazole

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(C) History of pelvic inflammatory disease

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(D) History of migraine headache that is well controlled by sumatriptan

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(E) She plans to use this contraceptive for about 1 yr and will then attempt to become pregnant

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Estrogen-containing hormonal contraceptives increase the risk of episodes of migraine headache. The answer is D.

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Men who use large doses of anabolic steroids are at increased risk of which of the following?

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(A) Anemia

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(B) Cholestatic jaundice and elevation of aspartate transaminase levels in the blood

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(C) Hirsutism

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(D) Hyperprolactinemia

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(E) Testicular enlargement

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In men, large doses of anabolic steroids are associated with liver impairment, including cholestasis and elevation of serum concentrations of transaminases. The answer is B.

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A 50-year-old woman with a positive mammogram undergoes lumpectomy and a small carcinoma is removed. Biochemical analysis of the cancer reveals the presence of estrogen and progesterone receptors. After this procedure, she will probably receive which of the following drugs?

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(A) Danazol

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(B) Flutamide

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(C) Leuprolide

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(D) Mifepristone

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(E) Tamoxifen

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Tamoxifen has proved useful in adjunctive therapy of breast cancer; the drug decreases the rate of recurrence of cancer. The answer is E.

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