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Carpal Tunnel and Effects of Hormone Therapy

1. Incidence of CTS has a female to male ratio of 8 to 1.

A. True B. False

2. The epidemiology of CTS varies by geography but incidence increases with age, suggesting that menopausal factors may play an important role in the pathogenesis of CTS.

A. True B. False

3. It is believed that CTS occurs due to:

A. Anatomic compression from repeated use. B. Idiopathic increase in the pressure within the carpal tunnel. C. Ischemic injury. D. Local inflammation of the flexor tenosynovium.

4. Small case series have suggested that severe CTS unresponsive to traditional non-surgical treatments may benefit from HT prescribed for menopausal symptoms.

A. True B. False

5. In both conjugated equine estrogen alone and conjugated equine estrogen plus medroxyprogesterone acetate trials, use of HT reduced CTS risk by approximately:

A. 20% B. 40% C. 60% D. 80%

6. The risk of therapeutic CTS procedures was statistically significantly decreased in both CEE and CEE+MPA intervention groups.

A. True B. False

7. Changes in _____ that occurs during and after menopause, which may be mitigated or reversed by HT, could result in reduced risk of CTS.

A. Bone density B. Thyroid function C. Glucose control D. Forearm fat content

8. Which of the following receptors is present in the transverse carpal ligament and flexor tenosynovium?

A. Insulin B. Interleukin-6 C. Progesterone D. Apolipoprotein B-48

9. Which two markers are specifically excessively expressed in synovial biopsy tissue from patients with symptomatic CTS?

A. C-reactive protein and procalcitonin B. Prostaglandin E2 and vascular endothelial factor C. Interleukin-6 and tumor necrosis factor-alpha D. Alpha-1-acid glycoprotein and haptoglobin

10. Which of the following, which may lower serum estrogen levels, can increase the incidence of CTS and arthralgia in breast cancer patients by contributing to tenosynovitis and edema specifically in the flexor compartments of the wrist?

A. Estrogen modulators B. Tamoxifen C. Monoclonal antibodies D. Aromatase inhibitors

11. Menopause induced by surgery or radiation increases CTS incidence.

A. True B. False

12. Immunohistochemical studies suggest that _____ receptors are upregulated in tenosynovial tissue in postmenopausal women with idiopathic CTS.

A. Progesterone B. Interleukin-6 C. Estrogen D. C-reactive protein


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