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Chapter 40: Gonadal Hormones & Inhibitors

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

(A) Clomiphene

(B) Ethinyl estradiol

(C) Diethylstilbestrol (DES)

(D) Mifepristone

(E) Norgestrel

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.

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?

(A) Evidence of hirsutism

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

(C) History of pelvic inflammatory disease

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

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

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

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

(A) Anemia

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

(C) Hirsutism

(D) Hyperprolactinemia

(E) Testicular enlargement

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.

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?

(A) Danazol

(B) Flutamide

(C) Leuprolide

(D) Mifepristone

(E) Tamoxifen

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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