HRT HRT Contraindications & Risk Factors

Question 1

Which condition is an ABSOLUTE contraindication to systemic estrogen-containing HRT?

Accepted Answer

Active or history of estrogen receptor-positive breast cancer

Answer

Estrogen receptor-positive breast cancer is an absolute contraindication because estrogen can stimulate tumor growth in ER+ tissue.

Question 2

A patient with a personal history of deep vein thrombosis (DVT) who requires HRT should preferably use which route to minimize thrombotic risk?

Accepted Answer

Transdermal estrogen

Answer

Transdermal estrogen does not increase hepatic clotting factor synthesis (as oral estrogen does), significantly reducing the risk of VTE in high-risk patients.

Question 3

Undiagnosed abnormal vaginal bleeding is a contraindication to HRT initiation because it may indicate which serious underlying condition?

Accepted Answer

Endometrial cancer or hyperplasia

Answer

Undiagnosed vaginal bleeding must be evaluated to exclude endometrial cancer or hyperplasia before starting estrogen, which could worsen malignant conditions.

Question 4

Active liver disease is a relative or absolute contraindication to HRT primarily because the liver is responsible for what?

Accepted Answer

Metabolizing and clearing exogenous hormones

Answer

The liver metabolizes sex hormones; active liver disease impairs this clearance, leading to hormone accumulation and increased side effects.

Question 5

Which inherited thrombophilia markedly increases VTE risk with oral HRT and may prompt use of transdermal route instead?

Accepted Answer

Factor V Leiden mutation

Answer

Factor V Leiden mutation causes resistance to activated protein C, significantly elevating thrombotic risk that is compounded by the procoagulant effect of oral estrogen.

HRT - Hormone Replacement Therapy Certification Practice Test

HRT - Hormone Replacement Therapy Certification Practice Test

HRT HRT Contraindications & Risk Factors