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40 Cards in this Set
- Front
- Back
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What is the definition of menopause? Answer ANo menstrual period for 60 consecutive days. BNo menstrual period for 120 consecutive days. CNo menstrual period for 6 consecutive months. DNo menstrual period for 12 consecutive months. ENo menstrual period for 24 consecutive months.
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DNo menstrual period for 12 consecutive months. |
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Which test is considered the gold-standard for identifying low bone density? Answer ABMP BDEXA CMRI DUltrasound
ECAT scan |
BDEXA |
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What percentage of elemental calcium is present in calcium carbonate tablets? Answer A15% B18% C21% D23%
E40% |
E40% |
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The use of testosterone can cause the following effects: Answer ADecreased creatinine BDecreased cholesterol CIncreased appetite DImproved acne
EHair loss |
CIncreased appetite |
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Nancy is a frail 73 year-old female. Nancy has been using alendronate for severe osteoporosis for the past 11 months. However, she has recently had a fall and fractured her hip. The physician has discontinued alendronate and started teriparatide. Counsel the patient on the use of teriparatide: (Select ALL that apply.) Answer AThe medicine is delivered with a very small needle into your abdomen or thigh. BThe brand name is Fentora. CYou should not take this medicine for more than three years. DSIt down in a comfortable "easy" chair or on the side of your bed when you inject so you can lie down if you get dizzy without having to stand up. EThis medication will reduce your chance of having a bone fracture if you take it each day.
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AThe medicine is delivered with a very small needle into your abdomen or thigh.
DSIt down in a comfortable "easy" chair or on the side of your bed when you inject so you can lie down if you get dizzy without having to stand up. EThis medication will reduce your chance of having a bone fracture if you take it each day.
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Cassidy is a 66 year-old female who frequents your pharmacy. The patient has many medical conditions, including hypertension, epilepsy and stress incontinence. She had a myocardial infarction this past spring. During the hospital stay, she was diagnosed with heart failure. Her current prescriptions include Coreg, Lasix, Klor-Con, Catapres TTS and phenytoin. Which of the following medications increase the risk for low bone density? (Select ALL that apply.) Answer ACatapres TTS BFurosemide CPhenytoin DKlor-Con
ECoreg |
BFurosemide CPhenytoin |
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Counseling on the use of teriparatide should include the following points: (Select ALL that apply.) Answer AThere may be a small risk of bone cancer with the use of this medicine. BEach injection pen lasts 60 days. CKeep the pens frozen until use; refrigerate the pen in use. DIf you have bone pain you should let your doctor know right away.
EThe brand name of this medicine is Forteo. |
AThere may be a small risk of bone cancer with the use of this medicine.
DIf you have bone pain you should let your doctor know right away.
EThe brand name of this medicine is Forteo. |
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Choose the correct statements concerning calcitonin nasal spray: (Select ALL that apply.) Answer ACalcitonin nasal spray is a first-line agent, but many women do not like the route of administration. BInhale 1 spray in one nostril daily. CCalcitonin nasal spray can cause nasal irritation. DInstruct the patient to alternate which nostril they use (left side one day, right side the next).
EThe brand name is Mupirocin. |
BInhale 1 spray in one nostril daily. CCalcitonin nasal spray can cause nasal irritation. DInstruct the patient to alternate which nostril they use (left side one day, right side the next). |
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Which of the following medications put a patient at increased risk for falls (and consequently) injury and fractures? (SelectALL that apply.) Answer ALortab BSoma CLoratidine DCelexa
EArmodafinil |
ALortab BSoma
DCelexa |
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A patient gave the pharmacist a prescription for Prempro. Which of the following is an appropriate generic substitution forPrempro? Answer AConjugated estrogens BEthinyl estradiol, conjugated CMedroxyprogesterone acetate DEstriol, synthetic
EConjugated estrogens/medroxyprogesterone |
EConjugated estrogens/medroxyprogesterone |
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A patient has been using calcium citrate 315 mg elemental calcium/tablet for many years. She takes two tablets with breakfast and two tablets at bedtime. She does not consume dairy products or much in the way of vegetables. She had a stroke recently and has been choking on some of her medications. Her daughter has come into the pharmacy to ask if her mother needs to take these "horse pills." She is wondering if calcium can be taken in a different formulation that is easier to swallow. Which of the following statements are correct: (Select ALL that apply.) Answer AShe can purchase calcium in chewable formulations. BCalcium carbonate has a higher percentage of calcium; she can use smaller tablets. CShe should not be using calcium supplements. DThe calcium she is using requires acid in her stomach to be absorbed.
EShe is already using the densest (smallest) formulation of calcium that is available over-the-counter. |
AShe can purchase calcium in chewable formulations. BCalcium carbonate has a higher percentage of calcium; she can use smaller tablets. |
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A woman suffers from severe hot flashes and night sweats. She has no cardiovascular or breast cancer risk and wishes to use the most effective therapy available to treat these vasomotor symptoms of menopause. Which of the following represents the most effective therapy for this patient? Answer AMedroxyprogesterone BBlack cohosh CEstrogen DSoy
EYam |
CEstrogen |
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Mike is using the Androderm patch. Counseling points should include: (Select ALL that apply.) Answer AApply each evening. BYou can apply the patch on your back, abdomen (lower stomach), on the thighs or the upper parts of your arms. CDo not apply more than one patch. DIf your skin is irritated apply over the counter hydrocortisone cream to the skin right before you apply the patch.
ERemove during an MRI or the skin under the patch will burn. |
AApply each evening. BYou can apply the patch on your back, abdomen (lower stomach), on the thighs or the upper parts of your arms. CDo not apply more than one patch.
ERemove during an MRI or the skin under the patch will burn. |
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A patient will be counseled on the AndroGel pump. He is using it for the first time. Which of the following are correct counseling statements? (Select ALL that apply.) Answer AWipe your hands well on a towel after applying the medication. BAndroGel can catch fire when wet on the skin; it is flammable until dry. CDo not shower, bathe or go swimming until two hours after application. DDo not let young children touch the wet skin or go near the medicine pump.
EThe lower strength (1%) can be applied to the abdomen; the 1.62% strength cannot, and never apply any testosterone to the penis or scrotum. |
BAndroGel can catch fire when wet on the skin; it is flammable until dry. CDo not shower, bathe or go swimming until two hours after application. DDo not let young children touch the wet skin or go near the medicine pump.
EThe lower strength (1%) can be applied to the abdomen; the 1.62% strength cannot, and never apply any testosterone to the penis or scrotum. |
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A teenager eats a poor diet (primarily carbohydrates and fruit) and has heavy menstrual cycles. The pharmacist will recommend calcium sources. Which of the following statements is correct? Answer AShe does not need calcium supplements at this age. BWhen recommending calcium to a teenager the pharmacist should recommend senna 2 tablets QHS taken concurrently. CCalcium requires vitamin E for absorption. DCalcium citrate is about twice as dense in elemental calcium than calcium carbonate. EIf she takes two calcium supplements, they should be taken at different meals.
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EIf she takes two calcium supplements, they should be taken at different meals. |
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In 2012 the osteoporosis treatment guidelines were updated. Which of the following statements are correct regarding the latest update? (Select ALL that apply.) Answer AEstrogen contraindications include any history of clotting, including heart attack and stroke, and any history of estrogen-dependent cancer. BEstrogen use typically decreases HDL and increases triglycerides. CDue to the risk of atypical vertebral fracture and osteonecrosis of the jaw, the use of bisphosphonates is limited to 3-5 years. DAfter the bisphonates are discontinued the patient should be switched to a different class of agent.
ERather than use a bisphosphonate early, a younger woman with low DVT risk and no related cancer risk could use estrogen until she was older and, consequently, at a higher risk of clotting. |
AEstrogen contraindications include any history of clotting, including heart attack and stroke, and any history of estrogen-dependent cancer. bisphosphonates is limited to 3-5 years.
DAfter the bisphonates are discontinued the patient should be switched to a different class of agent.
ERather than use a bisphosphonate early, a younger woman with low DVT risk and no related cancer risk could use estrogen until she was older and, consequently, at a higher risk of clotting. |
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Which of the following are common side effects of the bisphosphonates? (Select ALL that apply.) Answer AJoint pain BBack pain CStomach upset, nausea, heartburn DDizziness EPancreatitis
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AJoint pain BBack pain CStomach upset, nausea, heartburn |
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What medication might be used in the perimenopause to help a female who experiences uncomfortable vasomotor symptoms? (Select ALL that apply.) Answer AEstrogen prescription products BEstradiol topical therapy, prepared by a compounding pharmacist CVivelle Dot DPremarin
EEvista |
AEstrogen prescription products BEstradiol topical therapy, prepared by a compounding pharmacist CVivelle Dot DPremarin |
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What is the mechanism of action of Brisdelle? Answer ASerotonin and norepinephrine reuptake inhibitor BDopamine type 2 receptor blocker CAdrenergic neurotransmitter DSelective serotonin reuptake inhibitor EMonoamine oxidase inhibitor
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DSelective serotonin reuptake inhibitor |
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Sandra has rheumatoid arthritis, hypertension, dyslipidemia and chronic renal disease. She uses the following medications: etanercept weekly, methotrexate weekly, prednisone daily, atorvastatin and enalapril. Which of Sandra's medications puts her at the highest risk for low bone density? Answer AEtanercept BMethotrexate CPrednisone DAtorvastatin
EEnalapril |
CPrednisone |
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Esther had a history of breast cancer at age 42. She is entering the perimenopause and is asking for an agent for relief of hot flashes. Her only known medical condition has been "mild depression that comes and goes" and dry skin. Which of the following agents are contraindicated in this patient? (Select ALL that apply.) Answer ARaloxifene BFemring CClimara DBrisdelle EPremphase
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BFemring CClimara
EPremphase
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Sandra has a creatinine clearance of 20 mL/min. Which bisphosphonate is the best option in this patient? Answer ABoniva BReclast CActonel DFosamax ENone of the above
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ENone of the above |
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Select the correct statements concerning Brisdelle: (Select ALL that apply.) Answer AIt contains paroxetine. BIt is indicated for hot flashes associated with menopause. CIt can cause hypernatremia; sodium should be monitored during initiation of therapy. DIt can be used safely with warfarin.
EIt cannot be used with tamoxifen. |
AIt contains paroxetine. BIt is indicated for hot flashes associated with menopause.
EIt cannot be used with tamoxifen. |
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Ann is an 82 year-old female patient with very low bone density. Which of the following represent options for improving bone density and reducing the risks of falls? (Select ALL that apply.) Answer ALoop diuretics such as furosemide BWeight bearing exercise, such as walking CEnsuring adequate calcium and vitamin D DBisphosphonates, teriparatide hormone
ESteroids |
BWeight bearing exercise, such as walking CEnsuring adequate calcium and vitamin D DBisphosphonates, teriparatide hormone |
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Select the statements concerning bone fractures and causes of osteoporosis. (Select ALL that apply.) Answer AOsteoclasts build bone and osteoblasts break down bone. BHip fracture is generally an "older" age fracture, as hip bone is dense and loses density slower than the spine. CVertebral (spine) fractures are the most common type of osteoporotic fracture. DMen are at risk for osteoporosis if they are using certain medications, such as systemic steroids, drugs for prostate cancer or if they have conditions that increase the risk of poor bone health, such as rheumatoid arthritis and lupus.
EIf men sustain a hip fracture, they have a higher mortality rate at 12 months than women. |
BHip fracture is generally an "older" age fracture, as hip bone is dense and loses density slower than the spine. CVertebral (spine) fractures are the most common type of osteoporotic fracture. DMen are at risk for osteoporosis if they are using certain medications, such as systemic steroids, drugs for prostate cancer or if they have conditions that increase the risk of poor bone health, such as rheumatoid arthritis and lupus.
EIf men sustain a hip fracture, they have a higher mortality rate at 12 months than women. |
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Marvin is a 65 year-old male who uses valsartan, metoprolol extended-release, hydrochlorothiazide, tamsulosin, finasteride and donepezil. He recently began therapy with AndroGel. Marvin's four-year old grandson Evan came to visit. It was quite a surprise to Evan's mother to find that during the visit Evan's testicles grew at an alarming rate, and pubic hair became visible. What is the likely cause of the premature virilization? Answer AEvan played with his grandfather's testosterone and got it on his hands. BEvan ate his grandfather's testosterone. CEvan swallowed the angiotensin receptor blocker. DEvan swallowed the finasteride.
EEvan is maturing at a typical age. |
AEvan played with his grandfather's testosterone and got it on his hands. |
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Carla is having trouble swallowing her alendronate 70 mg weekly medication due to very dry mouth. What should the pharmacist suggest? Answer ATake the medication with food. BCrush the tablet and mix with a small amount of applesauce (approximately one teasponful). CTake after eating something bready and with a full glass of water. DDiscuss switching to a bisphosphonate injection, given once yearly. ESwitch to monthly ibandronate for improved tolerability.
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DDiscuss switching to a bisphosphonate injection, given once yearly. |
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Mary is a 54 year-old female who suffers from dry, painful intercourse. This started about a year ago after she underwent a total hysterectomy. The following drug may provide benefit and would reduce her exposure to systemic estrogen: Answer APrempro BPremphase CVivelle-Dot DClimara
EEstring |
EEstring |
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A patient asks her pharmacist what to expect when she begins menopause. What is the characteristic symptom of menopause? Answer AHot flashes BNight sweats CIt varies from woman to woman DMood swings EInsomnia
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CIt varies from woman to woman |
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The Women’s Health Initiative Trial exposed increased risks of certain health conditions with the use of hormone therapy. The risks included an increase in the following in older women: (Select ALL that apply.) Answer AMyocardial infarction BBrain tumors CStroke DLiver cancer
EMultiple sclerosis |
AMyocardial infarction
CStroke |
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Doris is a 75 year-old female who has been prescribed weekly alendronate for osteoporosis. Which dosing is required? Answer AAlendronate 70 mg once weekly BAlendronate 10 mg once weekly CAlendronate 35 mg once weekly DAlendronate 5 mg once weekly
EAlendronate 150 mg once weekly |
AAlendronate 70 mg once weekly |
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A woman is going through perimenopause and gets what she describes as "waves of heat" that leave her sweaty. At night she sometimes wakes up sweaty. This is surprising as for most of her life she was usually cold at night. Select the correct statements below. (Select ALL that apply.) Answer AEstrogen decreases in the perimenopause as estradiol, from the ovaries, is becoming depleted. BWhen the estrogen level is low, a rise in luteinizing hormone occurs. CThe increase in luteinizing hormone causes disruption in the woman's temperature control system in the brain. DLuteinizing hormone causes an increase in progesterone.
EAn increase in progesterone puts women at risk for uterine cancer during the menopause. |
AEstrogen decreases in the perimenopause as estradiol, from the ovaries, is becoming depleted. BWhen the estrogen level is low, a rise in luteinizing hormone occurs. CThe increase in luteinizing hormone causes disruption in the woman's temperature control system in the brain. |
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The Institute of medicine and the National Institutes of Health recommend this daily vitamin D dose for adults up to and including 70 years of age: Answer A100 IU daily B200 IU daily C300 IU daily D400 IU daily
E600 IU daily |
E600 IU daily |
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Lilly is a 49 year-old female who went to her physician complaining of hot flashes, depression and irritability. She started feeling this way about six months ago and states she "can't shake her mood." The physician took blood tests and confirmed that Lilly is in the perimenopause. He prescribed Vivelle-DOT. Choose the correct statement concerning Vivelle-DOT. Answer AVivelle-DOT contains conjugated equine estrogens. BVivelle-DOT is an oral formulation. CVivelle-DOT is applied twice weekly. DVivelle-DOT contains a progestin; if she has a uterus she will not need a separate progestin.
EVivelle-DOT is known to be more dangerous in cardiovascular risk than Premarin. |
CVivelle-DOT is applied twice weekly. |
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Estrogen in any form is contraindicated in the following situations: (Select ALL that apply.) Answer ACurrent or past deep vein thrombosis, pulmonary embolism or stroke or heart attack BLiver disease CCurrent or past breast or estrogen-dependent cancer DHistory of severe depression EHistory of suicide attempts |
ACurrent or past deep vein thrombosis, pulmonary embolism or stroke or heart attack BLiver disease CCurrent or past breast or estrogen-dependent cancer |
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Choose the correct statements concerning raloxifene: (Select ALL that apply.) Answer ACommon adverse effects include hot flashes and leg cramps. BRaloxifene is a selective estrogen receptor modulator. CRaloxifene has lower clotting risk than estrogen. DThe brand name of Raloxifene is Exelon. EThe dose of raloxifene is 60 mg once daily.
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ACommon adverse effects include hot flashes and leg cramps. BRaloxifene is a selective estrogen receptor modulator.
EThe dose of raloxifene is 60 mg once daily.
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In Margot's lumbar spine the lowest T-score measurement is -1.8. In the right trochanter the T-score is -0.9 and the left trochanter the T-score is -1.1. She has not had any fractures as an adult. Margot has multiple sclerosis and takes the following medications daily: Copaxone, Zanaflex, Paxil, Detrol and Provigil. Which of the following statements are correct? (Select ALL that apply.) Answer AMargot has risk for falling due to her medical condition. BShe should begin Prolia therapy. CShe should begin Forteo therapy. DMargot has osteoporosis. EMargot has risk for falling due to her medicines. |
AMargot has risk for falling due to her medical condition.
EMargot has risk for falling due to her medicines. |
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The Fracture Assessment Tool (FRAX) is used to assess the need for prescription drug therapy in patients with low bone density. Which of the following statements apply to this tool? (Select ALL that apply.) Answer AThis tool is a computer program where the clinician enters various risk factors for an individual patient. BThe tool is not well-validated and not recommended by ACOG. CPrevious fragility fracture is an important determinant of the need for medication. DIt is not necessary to use this type of tool in most patients since it is well-established that drugs such as alendronate are safe and useful in most patients. ESteroid use of 5 mg greater for more than 3 months is an important determinant in poor bone strength as steroid use depletes bone rapidly; however, this does not apply to intraarticular and topical steroids. |
AThis tool is a computer program where the clinician enters various risk factors for an individual patient.
CPrevious fragility fracture is an important determinant of the need for medication.
ESteroid use of 5 mg greater for more than 3 months is an important determinant in poor bone strength as steroid use depletes bone rapidly; however, this does not apply to intraarticular and topical steroids. |
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Rita will use an estrogen patch for hormone replacement therapy. Counseling points should include: (Select ALL that apply.) Answer AIf you are using estrogen, such as with this patch medication, you do not need to use calcium or vitamin D. BThe patch can be used safely for the rest of your life; it helps reduce the effects of aging, as well as helping with hot flashes and bone density. CThe use of this patch can help keep your bones healthy too. DThe area where you apply the patch must be clean, dry, free of powder, oil or lotion. EMake sure you are taking adequate calcium and vitamin D to help your bones stay strong. |
CThe use of this patch can help keep your bones healthy too. DThe area where you apply the patch must be clean, dry, free of powder, oil or lotion.
EMake sure you are taking adequate calcium and vitamin D to help your bones stay strong. |
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Maria is a 60 year-old post-menopausal female who is overweight and sedentary. Last year, while taking a five hour cross-country flight, Maria developed a deep vein thrombosis (DVT). This was her second DVT in two years. She has refused warfarin, but agreed to use an aspirin daily. Aspirin is her only medication. Recently, Maria’s sister was diagnosed with breast cancer. During the work-up, Maria’s sister was found to have low bone density. Maria is inquiring if she can use raloxifene, which she heard might protect her against breast cancer and will help her build strong bones. Choose the correct statement: Answer AThe brand name of raloxifene is Aromasin. BThe brand name of raloxifene is Femara. CShe is contraindicated for raloxifene due to the DVT history. DShe is contraindicated for raloxifene due to breast cancer risk. EShe is contraindicated for raloxifene due to her age. |
CShe is contraindicated for raloxifene due to the DVT history. |
