BCACP Women's Health and Reproductive Pharmacology

Question 1

A 28-year-old woman with a history of migraine with aura presents requesting contraception. Which of the following is the MOST appropriate recommendation?

Accepted Answer

Progestin-only pill (minipill)

Answer

Combined oral contraceptive pill (estrogen + progestin)

Answer

Combined transdermal contraceptive patch

Answer

Combined vaginal contraceptive ring

Question 2

A 62-year-old postmenopausal woman is diagnosed with osteoporosis (T-score –2.7 at the hip) and no prior fragility fractures. She has no contraindications to therapy. What is the preferred first-line pharmacological treatment?

Accepted Answer

Alendronate 70 mg orally once weekly

Answer

Raloxifene 60 mg orally once daily

Answer

Zoledronic acid 5 mg IV once yearly

Answer

Teriparatide 20 mcg subcutaneously once daily

Question 3

A 51-year-old woman with vasomotor symptoms of menopause (hot flashes) asks about non-hormonal pharmacological options because she has a history of estrogen receptor-positive breast cancer. Which agent has the strongest evidence for this indication?

Accepted Answer

Paroxetine 7.5 mg once daily

Answer

Gabapentin 300 mg three times daily

Answer

Clonidine 0.1 mg twice daily

Answer

Megestrol acetate 20 mg twice daily

Question 4

A woman of childbearing age is starting valproic acid for epilepsy. Which intervention is MOST important for a pharmacist to address during preconception counseling?

Accepted Answer

Advise high-dose folic acid supplementation (4 mg/day) and discuss teratogenic risk

Answer

Recommend switching to carbamazepine, which is safer in pregnancy

Answer

Recommend discontinuing all antiepileptic drugs before attempting pregnancy

Answer

No additional counseling is needed as all antiepileptic drugs carry equal risk

Question 5

A 38-year-old woman with polycystic ovary syndrome (PCOS) presents with irregular menses and difficulty conceiving. She has no diabetes but has insulin resistance. Which pharmacological agent is most commonly used off-label to improve menstrual regularity and insulin sensitivity in PCOS?

Accepted Answer

Metformin

Answer

Clomiphene citrate

Answer

Spironolactone

Answer

Letrozole

Question 6

Which of the following statements correctly describes the timing of initiating hormone therapy (HT) for menopausal symptom management according to current evidence and guidelines?

Accepted Answer

HT is most beneficial and carries the lowest risk when initiated within 10 years of menopause onset or before age 60

Answer

HT should be avoided in all women over age 50 due to cardiovascular risk

Answer

HT should only be initiated when a woman is over 65 and symptoms are severe

Answer

HT efficacy is equivalent regardless of when it is initiated after menopause