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Genitourinary syndrome of menopause: A new name for an old condition

doi: 10.1097/01.NPR.0000488685.10520.c8
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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.

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia, Georgia, and Florida CE Broker #50-1223.

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.

  1. The hormonal changes of menopause cause which of the following?
    1. lowered pH
    2. vaginal shortening
    3. vaginal mucosa thickening
  2. Which of the following statements is correct?
    1. Menopause causes increased elasticity of the urethra.
    2. As estrogen declines, there is enlargement of the labia minora.
    3. GSM symptoms are estimated to occur in more than 40% of menopausal women.
  3. The term GSM is preferable to “vaginal dryness” because it
    1. is more consistent with ICD-10 terminology.
    2. provides a more socially acceptable vocabulary.
    3. is the traditional scientific term for the condition.
  4. What is the MBS of women who are suffering from GSM?
    1. dyspareunia
    2. vaginal atrophy
    3. urinary incontinence
  5. Vaginal atrophy is improving when the VMI shows the number of parabasal cells are becoming
    1. more numerous than superficial cells.
    2. more numerous in relation to mature epithelial cells.
    3. less numerous relative to mature epithelial cells.
  6. The most valid approach to diagnosis of GMS is combining the physical exam with
    1. VMI results.
    2. vaginal pH.
    3. MBS.
  7. Among the physical findings in GMS is
    1. friability or petechiae on the vaginal wall.
    2. enlarged introitus.
    3. presence of rugae on vaginal wall.
  8. The WHI discovered that in women treated with equine estrogen, the risk of cardiovascular events and breast cancer is
    1. about the same whether administered orally or locally.
    2. increased when administered locally.
    3. increased when administered orally.
  9. A limitation to the generalizability of the WHI study was
    1. that most participants were newly menopausal.
    2. that only two oral preparations were studied.
    3. the lack of evaluating for quality of life issues.
  10. Using petroleum jelly to alleviate vaginal symptoms
    1. increases the risk of candidiasis.
    2. increases the risk of bacterial vaginosis.
    3. is a first-line nonhormonal therapy.
  11. In patients treated with estrogen, which of the following is not used to investigate vaginal bleeding?
    1. VMI
    2. ultrasound
    3. endometrial biopsy
  12. Lubricants containing glycol or parabens
    1. can be irritating to the vaginal tissue.
    2. are associated with bacterial vaginosis.
    3. provide maximal lubrication.
  13. According to a Cochrane review, which low-dose vaginal estrogen preparation is the most effective at relieving GSM?
    1. All vaginal preparations are equally effective.
    2. Creams are more effective than vaginal tablets or rings.
    3. Vaginal rings are more effective than creams or tablets.
  14. Compared with women in the general population, women with a history of breast cancer who are taking an aromatase inhibitor have
    1. fewer symptoms of GSM.
    2. an increased rate of vaginal dryness and dyspareunia.
    3. less physiologic changes of the vaginal mucosa.
  15. Adverse reactions of ospemifene include
    1. hot flashes.
    2. osteoporosis.
    3. sloughing of the vaginal mucosa.
  16. DHEA is a hormone produced by the
    1. ovaries.
    2. testes.
    3. adrenal gland.
  17. Compared with twice-weekly dosing, daily vaginal application of DHEA
    1. rapidly and effectively reversed GSM symptoms.
    2. did not significantly improve sexual function.
    3. had more adverse reactions.
  18. To treat vulvodynia, estradiol cream can be compounded with
    1. testosterone.
    2. 4% aqueous lidocaine.
    3. 1% hydrocortisone.


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