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2025 - NAMS Menopause Certification Exam Study Set questions with answers

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2025 - NAMS Menopause Certification Exam Study Set questions with answers2025 - NAMS Menopause Certification Exam Study Set questions with answers2025 - NAMS Menopause Certification Exam Study Set questions with answers

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2025 - NAMS Menopause Certification Exam Study e u . e u . e u . e u . e u . e u .




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1. secondary causes of osteoporosis eu. eu. eu .




which 3 common drugs?:Hyperthyroidism, hyperparathyroidism, hypercalciuria,
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certain drugs (eg: tamoxifen, steroids, PPIs), calcium/vitamin D deficiency, RA, celiac
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disease,malabsorptivediseasessuchasCrohndisease,andulcerativecolitis
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2. Median age of menopause in US women:52.54 y eu. eu. eu. eu. eu. eu. .
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3. POI:Intermittent ovarian function & insufficient estrogen levels occurring at age
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<40 y eu.




4. whichSTRAWstage? .
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menarche/early reproductive:-5 eu
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5. whichSTRAWstage? .
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peak reproductive:-4 eu. .
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6. whichSTRAWstage? .
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late reproductive:-3 eu. .
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7. whichSTRAWstage? .
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perimenopause:-2 to -1 & +1a .
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8. whichSTRAWstage? .
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FMP & eu.




12months afterfinal menstrual period:FMP = 0 12
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months after = +1a
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9. whichSTRAWstage? .
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VMS most likely:+1a (most likely)
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-1 (likely)
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aka perimenopause/menopause transition
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early post menopause:+1a to +1c eu. eu. .
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11. whichSTRAWstage? .
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late postmenopause:+2 eu. .
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12. whichSTRAWstage? .
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1/19
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, 2025 - NAMS Menopause Certification Exam Study e u . e u . e u . e u . e u . e u .




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amenorrhea >60 days:-1 eu. eu. .
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aka late menopause transition
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13. whichSTRAWstage? .
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variable cycle lengths of >7 days differences:-2 eu. eu. eu. eu. eu. eu. .
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aka early menopause transition
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14. difference between menopause transition vs perimenopause per STRAW eu
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criteria?: menopause transition: -2 and -1, prior to FMP
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perimenopause:-2 to +1a, includes 12 mo of amenorrhea following FMP .
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15. whichSTRAWstage? .
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initial drop in AMH/AFC/inhibin,cycles still regular,FSH normal:-3b
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aka late reproductive
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16. whichSTRAWstage? .
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cyclesshorter,first increase inFSH:-3aeu. .
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aka late reproductive
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17. levels spike with ovulation,marker of ovarian reserve:inhibin B eu. eu. eu. .
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18. Produced by granulosa cells of activated follicles, most reflective of true eu. eu. eu. eu. eu. eu. .
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ovarianreserve;providesthebest single predictionof time tomenopause:- AMH
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19. whatdayofcycletodrawFSHtopredictovarianresponse/reserve?:day3 .
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20. normal day 3 FSH? eu. eu. eu.




FSH value for menopause?:< 10
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>25
21. #ofultrasounddetectedfollicles2-10mminsize:AFC(antralfolliclecount)
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22. normal AFC:>12 eu. .
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23. Luteal-Out-Of-Phase(LOOP)event:-FSHelevationrecruitsfolliclesforthe eu
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subsequent cycle before the current cycle is over
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- Excess estradiol production as new follicles start growing eu. eu. eu. eu. eu. eu. eu.




- Increase chance ofTWINS eu. eu. .
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- Very short follicular phase
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- More time spent in luteal phase (more PMS/PMDD sx)
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2/19 eu. eu.

, 2025 - NAMS Menopause Certification Exam Study e u . e u . e u . e u . e u . e u .




Set e u .




24. symptoms of LOOP event:—Mastalgia eu. eu. eu. .
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—Worseningmigraine .
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—Growing fibroids eu.




—Risk of endometrial hyperplasia eu. eu . eu .




- longer time in luteal phase (worsening PMDD in peri)
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25. premenopausalvspostmenopausalestradiollevelsinobesity:pre:lower, eu. eu
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more anovulatory cycles
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post:higher .
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26. consequence of inhibin B and AMH drop in early menopause transition?- eu. eu. eu. eu. eu. eu. eu. eu. eu. eu.




:FSH spikes --> fast growth of remaining follicles (twins more likely) --> shorter follicular
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phase -->follicle atresia -->LOOP cycles -->pronounced PMS sx from longer luteal
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phase --> cycle irregularity by >7 days
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27. dec ovarian reserve causes the drop in what 2 hormones?:inhibin B and AMH
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28. 4 adrenal androgens:—Dehydroepiandrosterone (DHEA)
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—Dehydroepiandrosteronesulfate(DHEAS) .
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—Androstenedione
—Testosterone
29. where are adrenal androgens converted to estrogen?:peripheral tissue eu. eu. eu. eu. eu. eu. .
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30. whathappenstoDHEA levelsduring menopausetransition?:transient eu. eu. eu. eu. eu. eu. eu. .
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increase then return to premenopause baseline
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31. is DHEA supplementation in menopause recommended?:no
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(Systematicreviewandmeta-analysisofDHEAuseinpostmenopausalwomenwith .
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normal adrenal function found no evidence of improvement in sexual symptoms, serum
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lipids, serum glucose, weight, or bone mineral density)
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32. dx of POI?:amenorrhea >4 mo in age <40 eu. eu. .
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FSH >25 on 2 occasions
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33. 4 etiologies of POI
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most common?:(1) Genetic (turner, fragile X)
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(2) Autoimmune(adrenalAb/Addison's) eu. eu.




(3) Cancer(chemo, radiation, surgical oophrectomy) eu. eu. eu. eu.




(4) Idiopathic --> most common eu. eu. eu.




34. mostcommongeneticcauseof POI?:Turnersyndrome/Xchromosomeab- eu. eu. eu. eu. eu. .
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normalities
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35. treatmentforTurnersyndromewithdelayedpuberty?:Startedestrogen .
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replacement at age 12, add progestin at age of menarche
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3/19
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