INSTRUCTIONS Genitourinary syndrome of menopause: A new name for an old condition
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Lippincott Williams & Wilkins, publisher of The Nurse Practitioner journal, will award 2.0 contact hours for this continuing nursing education activity.
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Your certificate is valid in all states. This activity has been assigned 1.0 pharmacology credits.
Genitourinary syndrome of menopause: A new name for an old condition
General Purpose: The purpose of this learning activity is to provide information about GSM and its treatment. Objectives/Outcomes: After completing this continuing-education activity, you will be able to: 1. Describe the physiology, symptoms, and diagnosis of GSM. 2. Identify hormonal and nonhormonal treatments for GSM.
- The hormonal changes of menopause cause which of the following?
- lowered pH
- vaginal shortening
- vaginal mucosa thickening
- Which of the following statements is correct?
- Menopause causes increased elasticity of the urethra.
- As estrogen declines, there is enlargement of the labia minora.
- GSM symptoms are estimated to occur in more than 40% of menopausal women.
- The term GSM is preferable to “vaginal dryness” because it
- is more consistent with ICD-10 terminology.
- provides a more socially acceptable vocabulary.
- is the traditional scientific term for the condition.
- What is the MBS of women who are suffering from GSM?
- vaginal atrophy
- urinary incontinence
- Vaginal atrophy is improving when the VMI shows the number of parabasal cells are becoming
- more numerous than superficial cells.
- more numerous in relation to mature epithelial cells.
- less numerous relative to mature epithelial cells.
- The most valid approach to diagnosis of GMS is combining the physical exam with
- VMI results.
- vaginal pH.
- Among the physical findings in GMS is
- friability or petechiae on the vaginal wall.
- enlarged introitus.
- presence of rugae on vaginal wall.
- The WHI discovered that in women treated with equine estrogen, the risk of cardiovascular events and breast cancer is
- about the same whether administered orally or locally.
- increased when administered locally.
- increased when administered orally.
- A limitation to the generalizability of the WHI study was
- that most participants were newly menopausal.
- that only two oral preparations were studied.
- the lack of evaluating for quality of life issues.
- Using petroleum jelly to alleviate vaginal symptoms
- increases the risk of candidiasis.
- increases the risk of bacterial vaginosis.
- is a first-line nonhormonal therapy.
- In patients treated with estrogen, which of the following is not used to investigate vaginal bleeding?
- endometrial biopsy
- Lubricants containing glycol or parabens
- can be irritating to the vaginal tissue.
- are associated with bacterial vaginosis.
- provide maximal lubrication.
- According to a Cochrane review, which low-dose vaginal estrogen preparation is the most effective at relieving GSM?
- All vaginal preparations are equally effective.
- Creams are more effective than vaginal tablets or rings.
- Vaginal rings are more effective than creams or tablets.
- Compared with women in the general population, women with a history of breast cancer who are taking an aromatase inhibitor have
- fewer symptoms of GSM.
- an increased rate of vaginal dryness and dyspareunia.
- less physiologic changes of the vaginal mucosa.
- Adverse reactions of ospemifene include
- hot flashes.
- sloughing of the vaginal mucosa.
- DHEA is a hormone produced by the
- adrenal gland.
- Compared with twice-weekly dosing, daily vaginal application of DHEA
- rapidly and effectively reversed GSM symptoms.
- did not significantly improve sexual function.
- had more adverse reactions.
- To treat vulvodynia, estradiol cream can be compounded with
- 4% aqueous lidocaine.
- 1% hydrocortisone.