NAMs Menopause Certification Exam Questions and Answers 100% Solved
Climacteric phase --*correct answer*-- The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the time of menopause.Early menopause --*correct answer*-- LMP before age 45 Late menopause --*correct answer*-- LMP after age 54 Primary ovarian insufficiency --*correct answer*-- Menopause that occurs before age 40 Early menopause transition (stage -2) --*correct answer*-- Persistent difference of 7 days or more in the length of consecutive cycles.Late menopause transition (stage -1) --*correct answer*-- 60 or more consecutive days of amenorrhea Luteal out of phase event (LOOP) --*correct answer*-- Explains why some perimenopausal women have elevated estrogen level sometimes...In the early menopause transition, elevated FSH levels are adequate to recruit a second follicle which results in a follicular phase-like rise in estradiol secretion superimposed on the mid-to-late luteal phase of the ongoing ovulatory cycle.Obese women and estradiol levels during menopause --*correct answer*-- Obese women are more likely to have anovulatory cycles with high estradiol levels. They are also more likely to have lower premenopause yet higher postmenopause estradiol levels compared with women of normal weight.(why they are at higher risk of endometrial cancer) Chinese and Japanese women --*correct answer*-- These ethnic groups have lower estradiol levels then white, black and hispanic women.
stage +2 --*correct answer*-- late menopause stage: 5-8 years after FMP.
Somatic aging predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c --*correct answer*-- early post menopause: 2 years
after FMP. FSH rises, estradiol decreases. VMS predominate.Elevated FSH, LH --*correct answer*-- Endocrine labs after menopause AMH, inhibin B --*correct answer*-- These hormones work during reproductive years to not deplete follicle pool too quickly.Phases during menopause transition and PMS symptoms --*correct answer*-
- Menstrual cycle shortenes, follicular phase compresses, women spend
more time in luteal phase.. meaning more premenstrual symptoms and more frequent menstrual periods.How to respond if a patient requests FSH lab? --*correct answer*-- many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low FSH is not helpful.The potentially superior marker of menopause, a lab. --*correct answer*-- AMH
DHEA (dehydroepiandrosterone) --*correct answer*-- Adrenal androgens:
precursor hromones produced by the adrenal gland that are enzymatically converted to active androgens or estrogens in peripheral tissues.Location of estrogen receptors --*correct answer*-- Vagina, vulva, urethra, trigone of the bladder Effects of estrogen on tissue --*correct answer*-- maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports microbiome and protects tissue from pathogens.Vaginal changes with menopause --*correct answer*-- Thinning, loss of elasticity, loss or absence or rugae.Vagina and urethra in menopause --*correct answer*-- vagina narrows, urethra moves closer to the introitus.
Stress urinary incontinence --*correct answer*-- Vaginal estrogen and
urinary incontinence: what type does it help with?
Treatment for FPHL --*correct answer*-- Minoxidil, spironolactone, finasteride, estrogen therapy Late reporoductive years -3b and -3a. What happens with menstrual cycles,
FSH, AMH, AFC, inhibin? --*correct answer*-- -3b: menstrual cycles normal,
FSH normal, AMH low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin
low.When it is appropriate to check an FSH during the cycle if you check it? and why? --*correct answer*-- Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH level.
AMH produced by...used to test...Is it a screening tool for fertility?When does it peak? --*correct answer*-- produced by granulosa cells
used to test damage to ovarian follicle reserve. If AMH is low, the woman has a low ovarian reserve.
not recommended as a screening tool to predict fertility.
Peaks at around 25 years old. So before age 25, this test is not helpful.
It is influenced by exogenous hormones. Lower in hormonal contraception users, but increases after d/cing.AFC --*correct answer*-- Antral follicle count
Number of follicles that are detectable with ultrasound.They are sensitive to FSH and considered to represent the availability poo of follicles.Late menopause transition (-1) FSH level on random draw --*correct answer*-- 25 or higher Black women have higher or lower FSH levels? --*correct answer*-- Higher Chinese and Japanese women have higher or lower estradiol levels compared to white, black and hispanic women? --*correct answer*-- lower Menopause transition-changes in SHBG and testosterone? ratio? --*correct answer*-- SHBG decreases Testosterone/SHBG ratio increases by 80%.Testosterone/SHGB ratio is called what? --*correct answer*-- The free androgen index What stage are VMS more likely? --*correct answer*-- +1b (generally last 2 years) 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.
