NAMS Certification Practice Questions with
100% Correct Answers
-3b
Late reproductive. Low FSH, Low AMH, Low inhibin B regular cycles
-3A
Late reproductive, subtle changes to menses, variable FSH, low amh, low inhibit B
-2 early menopause
Variable cycle <= 7 days, variable FSH, low amh, low inhibit b, low af
-1 late menopause
60 days or more amenorrhea, FSH >=25, low amh, low inhibit b, low af
+1a, +1b early menopause
Variable elevated FSH, low amh, low inhibin b, very low af
+1c early menopause
FSH stabilizes, very low amh, very low inhibin B, very low af, increasing GSM
Path of Osteoporosis in meno
Decreased estrogen causes more rapid bone resorption by osteoclasts, exceeding the the
ability of osteoblasts to form new bone- bone loss and gradual deterioration of micro
architecture of both trabecular and cortical bone.
Bone loss across memo transition
10-12% or 1 t-score across the meno transitions. Starts 1-3 years before menopause and lasts
5-10 years. Then 0.5% per year. By 80 -30% peak bone mass is lost.
, T-score
Comparing women's bmd to average young white adult. Standard deviations away from that.
+/- 2. Used for diagnosis.
Osteoporosis -2.5 or lowere
Z-score
Number of SD away from bmd of average person if same age, gender and ethnicity. -2 to +2.
Preferred for those premenopause.
Premenopausal osteoporosis-2.0
Fx related to osteoporosis
40-50% of postmenopausal women
Hip fracture
5-8 fold increase in mortality compared to other osteoporosis fx 20% mortality at 1 year
symptomatic vertebral 10%
Diseases that increase low bmd
Inflammatory (RA), malabsorption (celiac), endocrinopathies (Cushing, hyper parathyroid)
Drugs that increase risk low bmd
Aromatics inhibitors (bone resorption), vitamin D impairment (phenytoin), glucocorticoid
(reduce bone formation)
Area of low BMD most correlated with fracture
Hip
Secondary causes of bone loss
100% Correct Answers
-3b
Late reproductive. Low FSH, Low AMH, Low inhibin B regular cycles
-3A
Late reproductive, subtle changes to menses, variable FSH, low amh, low inhibit B
-2 early menopause
Variable cycle <= 7 days, variable FSH, low amh, low inhibit b, low af
-1 late menopause
60 days or more amenorrhea, FSH >=25, low amh, low inhibit b, low af
+1a, +1b early menopause
Variable elevated FSH, low amh, low inhibin b, very low af
+1c early menopause
FSH stabilizes, very low amh, very low inhibin B, very low af, increasing GSM
Path of Osteoporosis in meno
Decreased estrogen causes more rapid bone resorption by osteoclasts, exceeding the the
ability of osteoblasts to form new bone- bone loss and gradual deterioration of micro
architecture of both trabecular and cortical bone.
Bone loss across memo transition
10-12% or 1 t-score across the meno transitions. Starts 1-3 years before menopause and lasts
5-10 years. Then 0.5% per year. By 80 -30% peak bone mass is lost.
, T-score
Comparing women's bmd to average young white adult. Standard deviations away from that.
+/- 2. Used for diagnosis.
Osteoporosis -2.5 or lowere
Z-score
Number of SD away from bmd of average person if same age, gender and ethnicity. -2 to +2.
Preferred for those premenopause.
Premenopausal osteoporosis-2.0
Fx related to osteoporosis
40-50% of postmenopausal women
Hip fracture
5-8 fold increase in mortality compared to other osteoporosis fx 20% mortality at 1 year
symptomatic vertebral 10%
Diseases that increase low bmd
Inflammatory (RA), malabsorption (celiac), endocrinopathies (Cushing, hyper parathyroid)
Drugs that increase risk low bmd
Aromatics inhibitors (bone resorption), vitamin D impairment (phenytoin), glucocorticoid
(reduce bone formation)
Area of low BMD most correlated with fracture
Hip
Secondary causes of bone loss
