NAMS CERTIFICATION LATEST 2026 EXAM QUESTIONS
AND ANSWERS GRADED A+
✔✔Osepemifene has antiestrogenic effects on breast. Can you use for pts with hx of
breast Ca? - ✔✔no, not approved
✔✔Define vulvodynia - ✔✔vulvar pain for at least 3 months w/o clear cause
✔✔Vulvovaginitis causes - ✔✔BV, candida, trich
✔✔Yeast infection more common in - ✔✔HT users
DM
Immunocompromised
✔✔Most common cause of vaginitis - ✔✔BV
✔✔Amsel criteria - ✔✔abnormal thin gray discharge
ph > 4.5
fishy amine odor with 10% hydrogen peroxide
> 20% clue cells
✔✔3rd MCC vagintiis - ✔✔trich
up to 50% may be asx
✔✔vaginitis n to responsive to treatment with ET with severe introital and vaginal
erythema - ✔✔desquamative inflammatory vaginitis
✔✔which vulvar disorders are associated with vulvar SCC - ✔✔lichen sclerosis and
lichen planus
✔✔immune mediated disorder of the vulva, more common in prepubertal and
menopausal women but can occur at any age. white papule and plaque with purpora
and hyperkeratosis and fissures. severe pruritus - ✔✔lichen sclerosis
✔✔chronic AI disorder T cell mediated
includes vulva, vagina, oral mucous membranes
affects 50-60yo - ✔✔lichen planus
✔✔chronic inflammatory condition
intense pruritus
disturbs sleep
itch scratch cycle - ✔✔lichen simplex chronicus
✔✔low grade VIN - ✔✔not precancerous
, ✔✔high grade VIN - ✔✔precancerous
✔✔not associated with usual risk factors, but associated with dermatologic disorders
like lichen sclerosis - ✔✔VIN Differentiated type
✔✔differentiated VIN treatment - ✔✔surgical excision rather than ablation or
pharmacology
✔✔LG VSIL - ✔✔treat for symptoms
not precancerous
✔✔HG VSIL - ✔✔excision, CO2, or imiquimod
✔✔fourth most common gyn cancer - ✔✔vulvar
✔✔most common type of vulvar cancer - ✔✔SCC
✔✔dark lesion - ✔✔BCC or melanoma
✔✔adenocarcinoma of vulva with itchy well demarcated erythematous lesion on labia
major not improving with corticosteroids - ✔✔extramammary paget = intraepithelial
adenocarcinoma
coexisting adenocarcinoma of breast, GItract, or GU tract 20-30% of time
✔✔do you need to treat epidermal inclusion cysts? - ✔✔no
✔✔when do you biopsy bartholin? - ✔✔menopause
✔✔RF for postmenopausal UTIs - ✔✔increased vaginal pH
use ET to restore microbiome
✔✔abnormal PVR - ✔✔200mL or more
✔✔any FDA approved meds for SUI? - ✔✔no
✔✔Does systemic HT or local ET help SUI? - ✔✔no
✔✔treatment of SUI - ✔✔midurethral sling
✔✔tx of urge incontinence - ✔✔antimuscarinic agents
MOA stop detrusor contractions
AE: dry mouth constipation
AND ANSWERS GRADED A+
✔✔Osepemifene has antiestrogenic effects on breast. Can you use for pts with hx of
breast Ca? - ✔✔no, not approved
✔✔Define vulvodynia - ✔✔vulvar pain for at least 3 months w/o clear cause
✔✔Vulvovaginitis causes - ✔✔BV, candida, trich
✔✔Yeast infection more common in - ✔✔HT users
DM
Immunocompromised
✔✔Most common cause of vaginitis - ✔✔BV
✔✔Amsel criteria - ✔✔abnormal thin gray discharge
ph > 4.5
fishy amine odor with 10% hydrogen peroxide
> 20% clue cells
✔✔3rd MCC vagintiis - ✔✔trich
up to 50% may be asx
✔✔vaginitis n to responsive to treatment with ET with severe introital and vaginal
erythema - ✔✔desquamative inflammatory vaginitis
✔✔which vulvar disorders are associated with vulvar SCC - ✔✔lichen sclerosis and
lichen planus
✔✔immune mediated disorder of the vulva, more common in prepubertal and
menopausal women but can occur at any age. white papule and plaque with purpora
and hyperkeratosis and fissures. severe pruritus - ✔✔lichen sclerosis
✔✔chronic AI disorder T cell mediated
includes vulva, vagina, oral mucous membranes
affects 50-60yo - ✔✔lichen planus
✔✔chronic inflammatory condition
intense pruritus
disturbs sleep
itch scratch cycle - ✔✔lichen simplex chronicus
✔✔low grade VIN - ✔✔not precancerous
, ✔✔high grade VIN - ✔✔precancerous
✔✔not associated with usual risk factors, but associated with dermatologic disorders
like lichen sclerosis - ✔✔VIN Differentiated type
✔✔differentiated VIN treatment - ✔✔surgical excision rather than ablation or
pharmacology
✔✔LG VSIL - ✔✔treat for symptoms
not precancerous
✔✔HG VSIL - ✔✔excision, CO2, or imiquimod
✔✔fourth most common gyn cancer - ✔✔vulvar
✔✔most common type of vulvar cancer - ✔✔SCC
✔✔dark lesion - ✔✔BCC or melanoma
✔✔adenocarcinoma of vulva with itchy well demarcated erythematous lesion on labia
major not improving with corticosteroids - ✔✔extramammary paget = intraepithelial
adenocarcinoma
coexisting adenocarcinoma of breast, GItract, or GU tract 20-30% of time
✔✔do you need to treat epidermal inclusion cysts? - ✔✔no
✔✔when do you biopsy bartholin? - ✔✔menopause
✔✔RF for postmenopausal UTIs - ✔✔increased vaginal pH
use ET to restore microbiome
✔✔abnormal PVR - ✔✔200mL or more
✔✔any FDA approved meds for SUI? - ✔✔no
✔✔Does systemic HT or local ET help SUI? - ✔✔no
✔✔treatment of SUI - ✔✔midurethral sling
✔✔tx of urge incontinence - ✔✔antimuscarinic agents
MOA stop detrusor contractions
AE: dry mouth constipation
