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NAMS MENOPAUSE CERTIFICATION EXAM ACTUAL EXAM WITH COMPETE QUESTIONS AND CORRECT ANSWERS RATED A+
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NAMS MENOPAUSE CERTIFICATION EXAM ACTUAL EXAM WITH COMPETE QUESTIONS AND CORRECT ANSWERS RATED A+
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NAMS MENOPAUSE CERTIFICATION EXAMACTUAL EXAM WITH COMPETE
QUESTIONS AND CORRECT ANSWERS
RATED A+
What hormone is generally higher in obese women? Correct
Answer Estrone-via aromatization.
The postmenopausal ovary continues to produce what two
hormones? Correct Answer testosterone and androstenedione
Surgical menopause causes women to have lower levels of what
hormone? Correct Answer testosterone. 40-50% lower than in
women w/ intact ovaries.
Driving piece of menopause is ovarian follicles depleting. What
does this do to the inhibin B and AMH? Correct Answer inhibin
and AMH decrease
therefore, follicle growth is not restrained, this allows for the
growth of the remaining, diminished follicle pool.
In the menopause transition, women spend more time in what
phase? Correct Answer Luteal-more PMS symptoms, more
frequent menstrual periods.
HPO axis theory and the menopause transition Correct Answer It
is felt that the HPO axis may become less sensitive to estrogen,
so even with good follicle growth and estradiol secretion, LH
surges can fail which can lead to more cycle irregularity.
,In the first year after the FMP, there is no production of what
hormone? Correct Answer progesterone
What region of the adrenal gland secretes the androgens?
Correct Answer zona reticularis
what are considered the 'adrenal androgens'? Correct Answer
DHEA, DHEAS, Androstenedione.
Aldosterone secretion from the zona reticularis in the adrenal
gland is regulated by 3 main factors. Correct Answer Angiotensin
II, potassium concentration, adrenocorticotropic hormone
secreted by the anterior pituitary.
What part of the pituitary gland secretes adrenocorticotropic
hormone? Correct Answer Anterior pituitary. The posterior only
secretes vasopressin and oxytosin.
Cortisol and HRT Correct Answer Most serum cortisol circulates
bound to cortisol binding globulin.
Oral estrogen increases the cortisol binding globulin, which
increases total cortisol concentration.
Oral tamoxifen acts similarly.
Transdermal does not increase it, so it has a minimal effect on
serum cortisol concentration.
Do cortisol levels associate with VMS severity? Correct Answer
No, cortisol levels have NOT been associated with more severe
VMS.
Local DHEA has been proven to help with what? Correct Answer
vaginal pain and dyspareunia
,How to DX POI? Correct Answer Menstrual disturbance-
oligomenorrhea or amenorrhea for at least 4 months.
AND
elevated FSH over 25 on two occasions at least 4 weeks apart.
Anyone <40years old who misses 3+ consecutive cycles gets
these labs Correct Answer prolactin
FSH
estradiol
TSH
pregnancy test
treatment of POI Correct Answer 100 microgram estradiol patch
1.25 mg CEE
2mg oral estradiol
If intact uterus-progesterone for 12 days of the month.
Physiologic is better than continuous hormonal contractption, but
if menorrhagia-IUD plus estrogen patch, or if really not wanting to
risk pregnancy, continuous HRT can be used.
Hair loss. Difference between FPHL and telogen effluvium?
Correct Answer FPHL is gradual, telogen effluvium is sudden and
usually precipitated by a life stressor, chronic illness, beta
blockers or anticoagulants-usually more patchy hair loss.
FPHL pattern Correct Answer thinning at the crown of the head
and widening of the hair part
Treating FPHL Correct Answer MINOXIDIL
spironolactone
, finasteride
What ethnicity has the least likely chance of having bad hot
flashes? Correct Answer Japanese
What ethnicity is the most likely to have bad hot flashes? Correct
Answer black
more frequent, longer duration.
Median length of hot flashes Correct Answer 10 years, early
menopause transition women have them the longest.
Theories about etiology of hot flashes (6) Correct Answer lower
ovarian estradiol
thermoregulation zone is narrowed
neurokinins-regulate GnRH secretion. KNDy new meds
serotonin
cortisol and HPI axis dysregulation
endothelial dysfunction.
VIN
low grade-what to do
high grade-what to do
differentiated VIN-what to do Correct Answer low grade is not
precancerous
high grade is precancerous-GYN ONC
differentiated-wide local excision-high risk of invasive carcinoma.
most common type of vulvar cancer Correct Answer squamous
cell carcinoma
Vulvar disorder commonly misdiagnosed as eczema or
dermatitis? Correct Answer paget's disease
will not improve on steroids
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