NAMS CERTIFICATION LATEST PRACTICE EXAM
QUESTIONS AND ANSWERS GRADED A+
✔✔Follow up after initiating statin - ✔✔repeat lipids in 4-12 weeks
✔✔AEs of statins - ✔✔myalgia (more common in women vs men)
modest increase in DM for patients with pre-existing risk factors
Rare intolerance - rhabdomyolysis, Myositis
✔✔Statins and LFTs - ✔✔monitoring of LFTs not necessary
✔✔When to use nonstatin therapy - ✔✔high risk patients on maximal statin dose who
need additional LDL lowering
✔✔nonstatin therapies - ✔✔ezetimibe
PCSK9 inhibitors
✔✔secondary causes of severely elevated triglycerides - ✔✔oral estrogen
high fat diet
poorly controlled DM
✔✔triglyceride lowering drugs - ✔✔fenofibrate
gemfibrozil
high dose omega-3
✔✔Can you take gemfibrozil with statins? - ✔✔no, contraindicated
✔✔causes of severe triglyceride elevations (>1000mg/dL) - ✔✔monogenetic disorders
associated with pancreatitis
✔✔What is metabolic syndrome? - ✔✔A state of insulin resistance
Cluster of conditions that increase the risk of heart disease, stroke, and diabetes.
✔✔Diagnosing Metabolic Syndrome - ✔✔3 or more
Waist circumference ≥35 in (88 cm) in women
Triglycerides >150 mg/dL OR Drug treatment for elevated triglycerides
HDL-C <50 mg/dL in women OR Drug treatment for reduced HDL cholesterol
BP ≥130/85 OR Drug treatment for hypertension
, Fasting blood glucose ≥110 mg/dL OR Drug treatment for elevated glucose
✔✔When to screen for DM - ✔✔begin at 45 y/o and q 3 years
OR earlier if risk factors
-BMI > 25
-first degree relative with DM
-high-risk ethnicity (Native American, Black, Hispanic, Asian)
-h/o CVD
-HTN
-HDL < 35
-TG >250
-PCOS
-sedentary lifestyle
✔✔First line drugs for DM2 - ✔✔metformin
✔✔Second line drugs for DM with known CVD - ✔✔liraglutide
empagliflozin
canagliflozin
✔✔Second line drugs for DM WITHOUT known CVD - ✔✔sulfonylureas
dipeptidyl peptidase-4 inhibitor
sodium glucose cotransporter 2 inhibitors
GLP-1 receptor agonist drugs
✔✔Risk of breast cancer in BRCA 1 or 2 - ✔✔72% lifetime risk
✔✔Chemoprevention for breast cancer - ✔✔Tamoxifen 20mg/5yrs
Risk: emboli, endometrial cancer, Raloxifene with decreased complications
AIs
✔✔VMS treatment for women with h/o breast cancer - ✔✔gabapentin
sertraline
venlafaxine
✔✔What cancer has the highest mortality rate in women? - ✔✔lung cancer
✔✔ Physiology of VMS - ✔✔-thermoregulatory center altered by increase in KNDy
neurons
-activation of NK3R causes hot flashes
-blockade of NK3R reduces/eliminates hot flashes
QUESTIONS AND ANSWERS GRADED A+
✔✔Follow up after initiating statin - ✔✔repeat lipids in 4-12 weeks
✔✔AEs of statins - ✔✔myalgia (more common in women vs men)
modest increase in DM for patients with pre-existing risk factors
Rare intolerance - rhabdomyolysis, Myositis
✔✔Statins and LFTs - ✔✔monitoring of LFTs not necessary
✔✔When to use nonstatin therapy - ✔✔high risk patients on maximal statin dose who
need additional LDL lowering
✔✔nonstatin therapies - ✔✔ezetimibe
PCSK9 inhibitors
✔✔secondary causes of severely elevated triglycerides - ✔✔oral estrogen
high fat diet
poorly controlled DM
✔✔triglyceride lowering drugs - ✔✔fenofibrate
gemfibrozil
high dose omega-3
✔✔Can you take gemfibrozil with statins? - ✔✔no, contraindicated
✔✔causes of severe triglyceride elevations (>1000mg/dL) - ✔✔monogenetic disorders
associated with pancreatitis
✔✔What is metabolic syndrome? - ✔✔A state of insulin resistance
Cluster of conditions that increase the risk of heart disease, stroke, and diabetes.
✔✔Diagnosing Metabolic Syndrome - ✔✔3 or more
Waist circumference ≥35 in (88 cm) in women
Triglycerides >150 mg/dL OR Drug treatment for elevated triglycerides
HDL-C <50 mg/dL in women OR Drug treatment for reduced HDL cholesterol
BP ≥130/85 OR Drug treatment for hypertension
, Fasting blood glucose ≥110 mg/dL OR Drug treatment for elevated glucose
✔✔When to screen for DM - ✔✔begin at 45 y/o and q 3 years
OR earlier if risk factors
-BMI > 25
-first degree relative with DM
-high-risk ethnicity (Native American, Black, Hispanic, Asian)
-h/o CVD
-HTN
-HDL < 35
-TG >250
-PCOS
-sedentary lifestyle
✔✔First line drugs for DM2 - ✔✔metformin
✔✔Second line drugs for DM with known CVD - ✔✔liraglutide
empagliflozin
canagliflozin
✔✔Second line drugs for DM WITHOUT known CVD - ✔✔sulfonylureas
dipeptidyl peptidase-4 inhibitor
sodium glucose cotransporter 2 inhibitors
GLP-1 receptor agonist drugs
✔✔Risk of breast cancer in BRCA 1 or 2 - ✔✔72% lifetime risk
✔✔Chemoprevention for breast cancer - ✔✔Tamoxifen 20mg/5yrs
Risk: emboli, endometrial cancer, Raloxifene with decreased complications
AIs
✔✔VMS treatment for women with h/o breast cancer - ✔✔gabapentin
sertraline
venlafaxine
✔✔What cancer has the highest mortality rate in women? - ✔✔lung cancer
✔✔ Physiology of VMS - ✔✔-thermoregulatory center altered by increase in KNDy
neurons
-activation of NK3R causes hot flashes
-blockade of NK3R reduces/eliminates hot flashes
