INI-CET 2013 - Obstetrics and Gynecology PYQs Practice Questions

Q: Hormone replacement therapy is not indicated for which of the following conditions?

Prevention of coronary artery disease. **Explanation:** The primary goal of Hormone Replacement Therapy (HRT) is the management of menopausal symptoms and the prevention of bone loss. **Why Option D is correct:** Historically, it was believed that HRT provided cardioprotection. However, large-scale clinical trials, specifically the **Women’s Health Initiative (WHI)**, demonstrated that HRT (especially combined estrogen-progestogen) does not prevent coronary artery disease (CAD). In fact, initiating HRT in older postmenopausal women may **increase** the risk of thromboembolic events and cardiovascular morbidity. Therefore, HRT is strictly **not indicated** for the primary or secondary prevention of CAD. **Analysis of Incorrect Options:** * **A. Urogenital atrophy:** Estrogen deficiency leads to vaginal dryness, dyspareunia, and urinary urgency. Low-dose topical or systemic HRT is the gold standard treatment for these symptoms. * **B. Vasomotor symptoms:** Hot flashes and night sweats are the most common indications for HRT. It remains the most effective treatment for moderate-to-severe vasomotor instability. * **C. Prevention of osteoporosis:** Estrogen inhibits osteoclast activity. HRT is FDA-approved for the prevention of postmenopausal osteoporosis, particularly in women at high risk of fractures who cannot tolerate other therapies. **High-Yield Clinical Pearls for NEET-PG:** * **Window of Opportunity Hypothesis:** HRT is safest and most effective when started within 10 years of menopause or before age 60. * **Contraindications:** Undiagnosed vaginal bleeding, active liver disease, history of VTE, and estrogen-dependent tumors (Breast/Endometrial CA). * **Addition of Progestogen:** In women with an intact uterus, progestogen must be added to estrogen to prevent **endometrial hyperplasia/carcinoma**. For women post-hysterectomy, Estrogen-only therapy (ERT) is used. [Practice more Obstetrics and Gynecology PYQs on OnCourse]

Question 1

Which of the following is seen in pregnancy with heart disease, which is not seen in normal pregnancy?

Accepted Answer

Distended neck veins

Answer

Exertional dyspnea

Answer

Pedal edema

Answer

Supine hypotension

Question 2

Hormone replacement therapy is not indicated for which of the following conditions?

Accepted Answer

Prevention of coronary artery disease

Answer

Urogenital atrophy

Answer

Vasomotor symptoms

Answer

Prevention of osteoporosis

INI-CET 2013 — Obstetrics and Gynecology