NAMS MENOPAUSE PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION

NAMS MENOPAUSE PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION 1. The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the time of menopause. - answer climacteric phase 2. Menopause that occurs before age 40 - answer primary ovarian insufficiency 3. Persistent difference of 7 days or more in the length of consecutive cycles. - answer early menopause transition (stage -2) 4. 60 or more consecutive days of amenorrhea - answer late menopause transition (stage -1) 5. 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. - answer luteal out of phase event (loop) 6. 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) - answer obese women and estradiol levels during menopause 7. These ethnic groups have lower estradiol levels then white, black and hispanic women. - answer chinese and japanese women 8. Late menopause stage: 5-8 years after fmp. Somatic aging predominates. Increased genitourinary symptoms. - answer stage +2 9. Early post menopause: 2 years after fmp. Fsh rises, estradiol decreases. Vms predominate. - answer stages +1a, +1b, +1c 10. Endocrine labs after menopause - answer elevated fsh, lh 11. These hormones work during reproductive years to not deplete follicle pool too quickly. - answer amh, inhibin b 12. Menstrual cycle variable, persistent 7 day difference between difference in length of consecutive cycles. - answer phases during menopause transition and pms symptoms 13. Many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low fsh is not helpful. - answer how to respond if a patient requests fsh lab? 14. Amh - answer the potentially superior marker of menopause, a lab. 15. Adrenal androgens: precursor hromones produced by the adrenal gland that are enzymatically converted to active androgens or estrogens in peripheral tissues. - answer dhea (dehydroepiandrosterone) 16. Vagina, vulva, urethra, trigone of the bladder - answer location of estrogen receptors 17. Maintain blood flow, the collagen, and ha within the epithelial surfaces. Supports microbiome which supports acidity of vagina and protects tissue from pathogens. - answer effects of estrogen on tissue 18. Thinning, loss of elasticity, loss or absence or rugae. - answer vaginal changes with menopause 19. Vagina narrows, urethra moves closer to the introitus. - answer vagina and urethra in menopause 20. Vaginal estrogen and urinary incontinence: what type does it help with? - answer stress urinary incontinence 21. Minoxidil, spironolactone, finasteride, estrogen therapy - answer treatment for fphl -3b: menstrual cycles normal, fsh normal, amh low, afc low, inhibin low. 22. -3a: subtle menstrual changes, variable fsh, amh low, afc low, inhibin low. - answer late reporoductive years -3b and -3a. What happens with menstrual cycles, fsh, amh, afc, inhibin? 23. Cycle day #3. Elevated estradiol can suppress fsh giving a falsely normal fsh level. - answer when it is appropriate to check an fsh during the cycle if you check it? And why? 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. 24. It is influenced by exogenous hormones. Lower in hormonal contraception users, but increases after d/cing. - answer amh Produced by... Used to test... Is it a screening tool for fertility? When does it peak? 25. Antral follicle count Number of follicles that are detectable with ultrasound. They are sensitive to fsh and considered to represent the availability pool of follicles. - answer afc 26. 25 or higher - answer late menopause transition (-1) fsh level on random draw 27. Higher - answer black women have higher or lower fsh levels? 28. Lower - answer chinese and japanese women have higher or lower estradiol levels compared to white, black and hispanic women? 29. Shbg decreases Testosterone/shbg ratio increases by 80%. - answer menopause transition-changes in shbg and testosterone? Ratio? 30. The free androgen index - answer testosterone/shgb ratio is called what? 31. +1b (generally last 2 years) - answer what stage are vms more likely? 32. Estrone-via aromatization. - answer what hormone is generally higher in obese women? 33. Testosterone and androstenedione - answer the postmenopausal ovary continues to produce what two hormones?