Endocrine Pharmacology USMLE Step 1 Practice Question
A 38-year-old woman with a 15-year smoking history (1 pack daily) and migraine with aura presents requesting oral contraception. She reports migraines occurring twice monthly, each accompanied by unilateral visual scotoma lasting 20 minutes before headache onset. Vital signs: BP 128/82 mmHg, HR 78/min, RR 14/min. Neurological examination is nonfocal. Recent brain MRI was normal. Fasting lipid panel shows LDL 142 mg/dL. She takes only occasional ibuprofen 400 mg as needed. Which of the following estrogen-containing oral contraceptives is relatively contraindicated due to increased thromboembolic and ischemic stroke risk?
Answer choices
- AClomiphene
- BCombined oral contraceptive pillCorrect answer
- CMifepristone
- DFinasteride
- ECabergoline
- FTransdermal estrogen patch
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