Progestins are a versatile and essential class of hormones in women’s health pharmacotherapy. From their central role in contraception to their protective function in menopausal hormone therapy, a deep understanding of the different generations and formulations of progestins is vital for pharmacists. As detailed in the “Women’s Health” module of the Patient Care 5 curriculum, this clinical knowledge is a cornerstone of endocrinology. This quiz will test your knowledge on the pharmacology, therapeutic uses, and key counseling points for this important drug class.
1. What is the primary role of the progestin component in a combined hormonal contraceptive (CHC)?
- a. To stabilize the endometrium and prevent breakthrough bleeding.
- b. To suppress the LH surge, thereby inhibiting ovulation, and to thicken cervical mucus.
- c. To counteract the androgenic effects of estrogen.
- d. To increase the risk of blood clots.
Answer: b. To suppress the LH surge, thereby inhibiting ovulation, and to thicken cervical mucus.
2. In a woman with an intact uterus receiving menopausal hormone therapy, what is the purpose of adding a progestin to the estrogen?
- a. To enhance the effect of estrogen on vasomotor symptoms.
- b. To prevent estrogen-induced endometrial hyperplasia and cancer.
- c. To improve bone mineral density.
- d. To decrease the side effect of nausea.
Answer: b. To prevent estrogen’s effect on the endometrium and reduce the risk of endometrial cancer.
3. Progestin-only pills (POPs), or “mini-pills,” primarily work by:
- a. Consistently inhibiting ovulation.
- b. Thickening the cervical mucus to prevent sperm penetration.
- c. Acting as a spermicide.
- d. Thinning the endometrial lining.
Answer: b. Thickening the cervical mucus to prevent sperm penetration.
4. A critical counseling point for a patient starting a progestin-only pill like norethindrone is:
- a. The timing of the dose can be flexible.
- b. It must be taken at the same time every day within a strict 3-hour window for maximum efficacy.
- c. It provides protection against STIs.
- d. It is more effective than combined oral contraceptives.
Answer: b. It must be taken at the same time every day within a strict 3-hour window for maximum efficacy.
5. Which of the following is a long-acting reversible contraceptive (LARC) that contains a progestin?
- a. The transdermal patch
- b. The vaginal ring
- c. The etonogestrel implant (Nexplanon)
- d. The copper IUD
Answer: c. The etonogestrel implant (Nexplanon)
6. The “Women’s Health” module, which covers progestins, is a specific learning module in which course?
- a. PHA5787C Patient Care 5
- b. PHA5104 Sterile Compounding
- c. PHA5703 Pharmacy Law and Ethics
- d. PHA5878C Patient Care 3
Answer: a. PHA5787C Patient Care 5
7. Depot medroxyprogesterone acetate (DMPA) is an injectable progestin that carries a black box warning for:
- a. An increased risk of VTE.
- b. A significant loss of bone mineral density with long-term use.
- c. An increased risk of ovarian cancer.
- d. Severe liver injury.
Answer: b. A significant loss of bone mineral density with long-term use.
8. Drospirenone is a fourth-generation progestin that is unique because it has:
- a. High androgenic activity.
- b. Anti-androgenic and anti-mineralocorticoid activity.
- c. A very short half-life.
- d. No effect on the endometrium.
Answer: b. Anti-androgenic and anti-mineralocorticoid activity.
9. Due to its anti-mineralocorticoid properties, drospirenone can increase which electrolyte, requiring caution in patients with renal impairment?
- a. Sodium
- b. Calcium
- c. Magnesium
- d. Potassium
Answer: d. Potassium
10. Levonorgestrel, when used as an emergency contraceptive (e.g., Plan B One-Step), primarily works by:
- a. Disrupting an established pregnancy.
- b. Acting as a spermicide.
- c. Delaying or inhibiting ovulation.
- d. Thickening cervical mucus after fertilization has already occurred.
Answer: c. Delaying or inhibiting ovulation.
11. The management of contraception and menopause are topics within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
12. The most common side effect associated with progestin-only contraceptives, especially during the first few months, is:
- a. Increased risk of VTE
- b. Hypertension
- c. Irregular bleeding and spotting
- d. Weight loss
Answer: c. Irregular bleeding and spotting
13. In the normal menstrual cycle, which hormone is dominant during the luteal phase?
- a. Estrogen
- b. FSH
- c. LH
- d. Progesterone
Answer: d. Progesterone
14. A patient with a history of an estrogen-sensitive breast cancer who needs contraception could be a candidate for which method?
- a. A combined oral contraceptive
- b. The transdermal patch
- c. A non-hormonal method like the copper IUD
- d. The vaginal ring
Answer: c. A non-hormonal method like the copper IUD
15. Counseling patients on the appropriate use of hormonal therapies is a key objective for student pharmacists.
- a. True
- b. False
Answer: a. True
16. Which of the following progestins is considered to have higher androgenic activity?
- a. Drospirenone
- b. Norgestimate
- c. Levonorgestrel
- d. Desogestrel
Answer: c. Levonorgestrel
17. A patient receiving the DMPA injection every 3 months should be counseled on supplementing with:
- a. Folic acid and iron
- b. Vitamin B12
- c. Calcium and Vitamin D for bone health
- d. A potassium supplement
Answer: c. Calcium and Vitamin D for bone health
18. The “Introduction to Women’s Health” is a lecture within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
19. Progestins are used in combination with mifepristone for what purpose?
- a. Emergency contraception
- b. Medical termination of pregnancy
- c. Treatment of menopause
- d. Treatment of osteoporosis
Answer: b. Medical termination of pregnancy
20. An active learning session on women’s health is part of the Patient Care 5 course.
- a. True
- b. False
Answer: a. True
21. A key advantage of progestin-only methods (like the mini-pill or implant) for postpartum women is that they:
- a. Are the most effective methods available.
- b. Are generally considered safe during breastfeeding and do not affect milk supply.
- c. Only need to be taken once a week.
- d. Also provide protection against STIs.
Answer: b. Are generally considered safe during breastfeeding and do not affect milk supply.
22. Which of the following is NOT a primary effect of progestins?
- a. Thickening of cervical mucus
- b. Thinning of the endometrium
- c. Suppression of the LH surge
- d. Proliferation of the endometrium
Answer: d. Proliferation of the endometrium
23. The lecture on contraception is part of the women’s health module.
- a. True
- b. False
Answer: a. True
24. An active learning session on women’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
25. A levonorgestrel-releasing IUD (e.g., Mirena) provides contraception primarily through:
- a. A high systemic level of progestin that inhibits ovulation.
- a. A local effect on the uterus, thickening cervical mucus and thinning the endometrium.
- c. Acting as a copper-based spermicide.
- d. Preventing the release of FSH.
Answer: b. A local effect on the uterus, thickening cervical mucus and thinning the endometrium.
26. A patient using the etonogestrel implant (Nexplanon) has contraceptive coverage for how long?
- a. 1 year
- b. 3 years
- c. 5 years
- d. 10 years
Answer: b. 3 years
27. The pharmacist’s role in progestin therapy includes:
- a. Identifying appropriate candidates and contraindications.
- b. Counseling on administration, side effects, and what to do for missed doses.
- c. Assisting in the selection of a product based on patient preferences and needs.
- d. All of the above.
Answer: d. All of the above.
28. An active learning session on women’s health is part of which course module?
- a. Module 3: Women’s Health
- b. Module 1: Diabetes Mellitus
- c. Module 4: Medication Safety
- d. Module 8: Men’s Health
Answer: a. Module 3: Women’s Health
29. A common reason for discontinuation of the DMPA injection is:
- a. Irregular bleeding and weight gain.
- b. Increased risk of pregnancy.
- c. Its high cost.
- d. The convenience of a 3-month injection.
Answer: a. Irregular bleeding and weight gain.
30. The “Management of Women’s Health” is a lecture within the Patient Care 5 curriculum.
- a. True
- b. False
Answer: a. True
31. Progestins with lower androgenic activity (e.g., drospirenone, norgestimate) may be preferred for patients with:
- a. Hypertension
- b. Acne
- c. A history of VTE
- d. Migraines
Answer: b. Acne
32. What is meant by “withdrawal bleeding” with combined hormonal contraceptives?
- a. Bleeding that occurs when a pill is missed.
- b. Bleeding that occurs during the hormone-free (placebo) interval.
- c. A sign of pregnancy.
- d. A serious adverse effect.
Answer: b. Bleeding that occurs during the hormone-free (placebo) interval.
33. The “morning after pill” is a form of:
- a. Regular contraception
- b. Emergency contraception
- c. A method for terminating a pregnancy
- d. A fertility treatment
Answer: b. Emergency contraception
34. The primary source of progesterone in the body during the second and third trimesters of pregnancy is the:
- a. Ovaries
- b. Adrenal gland
- c. Pituitary gland
- d. Placenta
Answer: d. Placenta
35. A patient taking a progestin-only pill who has an episode of vomiting within 2 hours of taking her dose should be advised to:
- a. Do nothing, the dose was absorbed.
- b. Take another pill immediately and use backup contraception.
- c. Skip her dose the next day.
- d. Go to the emergency room.
Answer: b. Take another pill immediately and use backup contraception.
36. Medroxyprogesterone acetate can be used to treat what condition besides contraception?
- a. Dysfunctional uterine bleeding and endometriosis.
- b. Osteoporosis.
- c. Diabetes.
- d. Hypertension.
Answer: a. Dysfunctional uterine bleeding and endometriosis.
37. Progestins are what type of chemical molecule?
- a. A peptide
- b. A carbohydrate
- c. A steroid
- d. An alkaloid
Answer: c. A steroid
38. The lecture “Emergency Contraception” is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
39. A potential disadvantage of the levonorgestrel IUD is:
- a. It is the least effective method.
- b. It requires a procedure for insertion and removal.
- c. It must be replaced every year.
- d. It has a high risk of systemic side effects.
Answer: b. It requires a procedure for insertion and removal.
40. An active learning session covering women’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
41. The term “progestin” refers to:
- a. The natural hormone produced by the body.
- b. Any synthetic compound that has progesterone-like effects.
- c. A type of estrogen.
- d. A non-hormonal compound.
Answer: b. Any synthetic compound that has progesterone-like effects.
42. Which of the following is NOT a mechanism by which progestins provide contraception?
- a. Thickening cervical mucus.
- b. Inhibiting the LH surge.
- c. Thinning the endometrium.
- d. Preventing the sperm and egg from meeting by creating a physical barrier.
Answer: d. Preventing the sperm and egg from meeting by creating a physical barrier.
43. A pharmacist’s counseling for progestin-only contraceptives should heavily emphasize:
- a. The need for regular blood clot screening.
- b. The critical importance of adherence and timing.
- c. The need to take the pill with food.
- d. The risk of weight loss.
Answer: b. The critical importance of adherence and timing.
44. A delay in the return to fertility is a well-known issue after discontinuing which contraceptive method?
- a. Progestin-only pills
- b. Combined oral contraceptives
- c. The etonogestrel implant
- d. The DMPA injection
Answer: d. The DMPA injection
45. What is the role of progesterone in the luteal phase?
- a. To prepare the uterus for potential implantation of a fertilized egg.
- b. To trigger the release of an egg from the ovary.
- c. To stimulate the growth of new follicles.
- d. To cause menstruation.
Answer: a. To prepare the uterus for potential implantation of a fertilized egg.
46. A patient using a levonorgestrel IUD for contraception may also experience what non-contraceptive benefit?
- a. Protection from STIs.
- b. A significant reduction in menstrual bleeding.
- c. Weight loss.
- d. Improved bone density.
Answer: b. A significant reduction in menstrual bleeding.
47. The management of contraception is covered in the women’s health module.
- a. True
- b. False
Answer: a. True
48. An active learning session on women’s health is part of which course?
- a. PHA5787C Patient Care 5
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5782C Patient Care 2
Answer: a. PHA5787C Patient Care 5
49. The overall management of progestin-based therapy requires:
- a. A “one-size-fits-all” approach.
- b. Selecting a product based on patient needs, preferences, and medical history.
- c. Always choosing the oldest available formulation.
- d. Never using a progestin-only method.
Answer: b. Selecting a product based on patient needs, preferences, and medical history.
50. The ultimate goal of learning about progestins is to:
- a. Be able to safely and effectively manage these medications to meet a patient’s reproductive health goals.
- b. Memorize all the brand names.
- c. Pass the final exam.
- d. Only recommend non-hormonal methods.
Answer: a. Be able to safely and effectively manage these medications to meet a patient’s reproductive health goals.