MKSAP: 61-year-old woman with hot flushes

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 61-year-old woman is evaluated for hot flushes, which have been persistent for the last 10 years. They occur at least 7 times per day, last for approximately 60 seconds, and are associated with severe sweating, palpitations, and occasional nausea. She is awakened several times per night. She has tried herbal medications, including soy and black cohosh, but has not experienced any benefit. She has hypertension, type 2 diabetes mellitus, and hyperlipidemia. Five years ago, she developed deep venous thrombosis after hip replacement surgery. Her current medications are ramipril, metformin, atorvastatin, calcium, and vitamin D. On physical examination, vital signs are normal. BMI is 29. The remainder of the examination is normal. Which of the following is the most appropriate treatment? A: Citalopram B: Oral estrogen therapy C: Oral estrogen/progesterone therapy D: Topical (vaginal) estrogen E: Venlafaxine Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Family Physicians Tags: Conditions Heart Medications OB/GYN Source Type: blogs