OB/gyn Question #5 - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 3 Forum

USMLE Step 3 Forum USMLE Step 3 Discussion Forum: Let's talk about anything related to USMLE Step 3 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 08-09-2013
XpaezX's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,216
Threads: 41
Thanked 1,327 Times in 711 Posts
Reputation: 1342
Embarrassed OB/gyn Question #5

A 58 y/o woman comes to the office because of concerns regarding breast cancer. She has been menopausal for the past 3 years and has been taking estrogen replacement therapy. Her past surgical history is significant for hysterectomy due leyomyomas. She has heard the addition or progesterone can decrease the risk of 'female cancers'. And she wants to know more about that. In counseling the pt the most appropriate response is:
A. HRT is contraindicated in your case.
B. Progesterone does not appear to be protective against cancer, despite the rumors.
C. Progesterone is protective and we should add it.
D. You should not have had an hysterectomy.
E. You have a high risk of developing breast cancer while on estrogen
Reply With Quote Quick reply to this message



  #2  
Old 08-09-2013
Kais_MD's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 299
Threads: 26
Thanked 177 Times in 103 Posts
Reputation: 187
Default

Quote:
Originally Posted by XpaezX View Post
A 58 y/o woman comes to the office because of concerns regarding breast cancer. She has been menopausal for the past 3 years and has been taking estrogen replacement therapy. Her past surgical history is significant for hysterectomy due leyomyomas. She has heard the addition or progesterone can decrease the risk of 'female cancers'. And she wants to know more about that. In counseling the pt the most appropriate response is:
A. HRT is contraindicated in your case.
B. Progesterone does not appear to be protective against cancer, despite the rumors.
C. Progesterone is protective and we should add it.
D. You should not have had an hysterectomy.
E. You have a high risk of developing breast cancer while on estrogen
Ok i pick E....only because HRT is not contraindicated in her case because no info is given. Progesterone is protective against endometrial cancer but that wont be her problem. No use of adding progesterone now there is no uterus and the doctor cant really say that she shouldn't have had a hysterectomy as he doesnt know the extent of her leiomyomas and may be she just completed her family...I hope my reasoning is right....Oh and estrogen does inc risk of breast cancer
__________________
Always Remember (The Devil is in the Details) @_@
Reply With Quote Quick reply to this message
The above post was thanked by:
Hitman (08-09-2013)
  #3  
Old 08-09-2013
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 791
Threads: 76
Thanked 673 Times in 317 Posts
Reputation: 691
Default

Would pick E.....estrogen does increase your risk of breast cancer.
Reply With Quote Quick reply to this message
The above post was thanked by:
XpaezX (08-10-2013)
 
  #4  
Old 08-10-2013
XpaezX's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,216
Threads: 41
Thanked 1,327 Times in 711 Posts
Reputation: 1342
Default

The correct answer is B
There is a well-established link between unopposed estrogen and endometrial hyperplasia+cancer. Progestins have found to protect against this particular cancer. This is the female cancer the patient is probably talking about. Breast tissue, however, appears to react differently than endometrial tissue in that progesterone does not appear to protect against the development of breast cancer in patients on estrogen replacement therapy. In fact, some studies have shown that progesterone increases the relative risk of developing breast cancer over estrogen ALONE!. Therefore this patient who has had a hysterectomy should not be placed on Progesterone.

Source: Kaplan
Reply With Quote Quick reply to this message
The above post was thanked by:
geo82 (08-10-2013)
  #5  
Old 08-10-2013
Kais_MD's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 299
Threads: 26
Thanked 177 Times in 103 Posts
Reputation: 187
Default

Quote:
Originally Posted by XpaezX View Post
The correct answer is B
There is a well-established link between unopposed estrogen and endometrial hyperplasia+cancer. Progestins have found to protect against this particular cancer. This is the female cancer the patient is probably talking about. Breast tissue, however, appears to react differently than endometrial tissue in that progesterone does not appear to protect against the development of breast cancer in patients on estrogen replacement therapy. In fact, some studies have shown that progesterone increases the relative risk of developing breast cancer over estrogen ALONE!. Therefore this patient who has had a hysterectomy should not be placed on Progesterone.

Source: Kaplan
aaaaaaaaaaaaaah...I know lol but that was an unfair question. although after 5 years of estrogen treatment her breast cancer risk will go up too. i hope the real exam doesnt have questions like these
__________________
Always Remember (The Devil is in the Details) @_@
Reply With Quote Quick reply to this message
  #6  
Old 08-10-2013
XpaezX's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,216
Threads: 41
Thanked 1,327 Times in 711 Posts
Reputation: 1342
Default

Quote:
Originally Posted by Kais_MD View Post
aaaaaaaaaaaaaah...I know lol but that was an unfair question. although after 5 years of estrogen treatment her breast cancer risk will go up too. i hope the real exam doesnt have questions like these
This question is hard but is not unfair.. The patient wants information about Progesterone.. She specifically asks about progesterone addition to her regimen.. the answer must be tailored to what the patient is asking... I got this question right by answering it like that.
Reply With Quote Quick reply to this message
The above post was thanked by:
Kais_MD (08-10-2013)
  #7  
Old 08-10-2013
Kais_MD's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 299
Threads: 26
Thanked 177 Times in 103 Posts
Reputation: 187
Default

Quote:
Originally Posted by XpaezX View Post
This question is hard but is not unfair.. The patient wants information about Progesterone.. She specifically asks about progesterone addition to her regimen.. the answer must be tailored to what the patient is asking... I got this question right by answering it like that.
you are correct.> I have to keep that in mind. I 've noticed my mind racing lately. I need to calm down lol
__________________
Always Remember (The Devil is in the Details) @_@
Reply With Quote Quick reply to this message
The above post was thanked by:
XpaezX (08-10-2013)
  #8  
Old 08-10-2013
XpaezX's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,216
Threads: 41
Thanked 1,327 Times in 711 Posts
Reputation: 1342
Default

Quote:
Originally Posted by Kais_MD View Post
you are correct.> I have to keep that in mind. I 've noticed my mind racing lately. I need to calm down lol

Yes.. DOnt worry ! chill out man get laid or go out with friends and rest for a couple of days.
Reply With Quote Quick reply to this message
  #9  
Old 08-10-2013
Kais_MD's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 299
Threads: 26
Thanked 177 Times in 103 Posts
Reputation: 187
Default

Quote:
Originally Posted by XpaezX View Post
Yes.. DOnt worry ! chill out man get laid or go out with friends and rest for a couple of days.
hahhaa...i only have 11 days left can't be wasting time on vacations
__________________
Always Remember (The Devil is in the Details) @_@
Reply With Quote Quick reply to this message
The above post was thanked by:
XpaezX (08-10-2013)
  #10  
Old 08-13-2013
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 48
Threads: 14
Thanked 13 Times in 8 Posts
Reputation: 23
Default

HRT is only indicated for the vasomotor symptoms of menopause. If given it is never given as estrogen alone, it is always given as combination estrogen and progesterone. Estrogen is oncogenic while progesterone is protective, therefor the correct answer is C.
Reply With Quote Quick reply to this message
  #11  
Old 08-13-2013
XpaezX's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,216
Threads: 41
Thanked 1,327 Times in 711 Posts
Reputation: 1342
Default

Quote:
Originally Posted by zeemd View Post
HRT is only indicated for the vasomotor symptoms of menopause. If given it is never given as estrogen alone, it is always given as combination estrogen and progesterone. Estrogen is oncogenic while progesterone is protective, therefor the correct answer is C.
Nope you are wrong, re-read the question and the answer, Progesterone is also oncogenic regarding breast cancer.

Dont come here answering an old question and thinking that what you say is right without reading the discussion.

Even if your analysis was correct (which is not, because progesterone is also oncogenic in breast cancer) that is not what the question asks. The question asks to what would be the effect of progesterone, not Estrogen..
Reply With Quote Quick reply to this message



Reply

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
question help: diabetic foot related question dezirablize USMLE Step 2 CK Forum 5 01-15-2015 02:42 PM
Peds question #10 (and last question!) XpaezX USMLE Step 3 Forum 5 08-06-2013 06:18 AM
Peds question #8 (this question is tricky)! XpaezX USMLE Step 3 Forum 6 08-05-2013 11:38 AM
a question concerning step1 question length sfsheran USMLE Step 1 Forum 2 01-30-2012 08:29 PM
Set Question list/Different Question for each CC tbk568 USMLE Step 2 CS Forum 0 12-13-2011 01:47 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)