HRT Decision Making Quiz

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What is the most likely diagnosis for the 52-year-old university lecturer?

Thyroid disorder

Menopause (correct)

Ovarian cancer

Pregnancy

What supports the diagnosis of menopause in the given history?

Family history of heart disease and breast cancer

Average age of menopause in the UK (correct)

History of hypertension

Early onset of menstruation

What additional symptoms should be considered to support the diagnosis?

Vision changes and hearing loss

Joint pain and muscle weakness

Depression and hair loss (correct)

Fever and cough

What family history factors are important to consider in this case?

Osteoporosis, breast cancer, and heart disease Signup and view all the answers

What clinical examination is necessary for this patient?

General examination including blood pressure measurement Signup and view all the answers

What additional symptoms of menopause should be considered in the history?

Depression, loss of libido, hair loss, dry skin, and painful intercourse (dyspareunia) Signup and view all the answers

What are the important family history factors to consider in this case?

Family history of osteoporosis, breast cancer, or ischaemic heart disease, or early menopause Signup and view all the answers

What clinical examination is necessary to perform and why?

General examination, including blood pressure measurement, to exclude hypertension Signup and view all the answers

What would warrant further investigations in this case?

Any evidence of vaginal bleeding Signup and view all the answers

What supports the diagnosis of menopause in the given history?

The patient has been suffering from menopausal symptoms for 3 years, indicating that the climacteric and menopause are occurring at the appropriate age Signup and view all the answers

Should I take HRT. A slim 52-year-old university lecturer presents with an 18month history of amenorrhea and a 3-year history of hot flushes and night sweats. She has a family history of heart disease and breast cancer. Should I take HRT. Q1: What is the likely differential diagnosis. A1

Menopause Signup and view all the answers

Q2: What issues in the given history support the diagnosis. A2

The average age of menopause in the UK is 51 years. This patient has been suffering from menopausal symptoms for 3 years, indicating that the climacteric and menopause are occurring at the appropriate age. Signup and view all the answers

Q3: What additional features in the history would you seek to support a particular diagnosis. A3

Other symptoms of the menopause include depression, loss of libido, hair loss, dry skin and painful intercourse as a result of a dry vagina (dyspareunia). It is important to check whether there is any family history of osteoporosis, breast cancer or ischaemic heart disease, or early menopause, as well as checking factors such as smoking, previous Colles’ or hip fracture, sedentary lifestyle and low body mass index. It would be important to exclude any evidence of vaginal bleeding, which would warrant further investigations (see Case 10.3) Signup and view all the answers