NAMS Menopause Certification Exam 2025| Comprehensive Q&A For Certification Success. VERIFIED TEST (GRADED A+)

NAMS Menopause Certification Exam 2025| Comprehensive Q&A For Certification Success. VERIFIED TEST (GRADED A+) In the menopause transition, women spend more time in what phase?-correct- answer-Luteal-more PMS symptoms, more frequent menstrual periods. HPO axis theory and the menopause transition- CORRECT ANSIt is felt that the HPO axis may become less sensitive to estrogen, so even with good follicle growth and estradiol secretion, LH surges can fail which can lead to more cycle irregularity. In the first year after the FMP, there is no production of what hormone? correct- answer-progesterone What region of the adrenal gland secretes the androgens? - CORRECT ANSzona reticularis 2 | P a g e what are considered the 'adrenal androgens'?- CORRECT ANSDHEA, DHEAS, Androstenedione. Aldosterone secretion from the zona reticularis in the adrenal gland is regulated by 3 main factors.- CORRECT ANSAngiotensin II, potassium concentration, adrenocorticotropic hormone secreted by the anterior pituitary. What part of the pituitary gland secretes adrenocorticotropic hormone? correct- answer-Anterior pituitary. The posterior only secretes vasopressin and oxytosin. Cortisol and HRT- CORRECT ANSMost serum cortisol circulates bound to cortisol binding globulin. Oral estrogen increases the cortisol binding globulin, which increases total cortisol concentration. Oral tamoxifen acts similarly. Transdermal does not increase it, so it has a minimal effect on serum cortisol concentration. 3 | P a g e Do cortisol levels associate with VMS severity?- CORRECT ANSNo, cortisol levels have NOT been associated with more severe VMS. Local DHEA has been proven to help with what?- CORRECT ANSvaginal pain and dyspareunia How to DX POI?- CORRECT ANSMenstrual disturbance-oligomenorrhea or amenorrhea for at least 4 months. AND elevated FSH over 25 on two occasions at least 4 weeks apart. Anyone 40years old who misses 3+ consecutive cycles gets these labs-correct- answer-prolactin FSH estradiol TSH pregnancy test 4 | P a g e treatment of POI- CORRECT ANS100 microgram estradiol patch 1.25 mg CEE 2mg oral estradiol If intact uterus-progesterone for 12 days of the month. Physiologic is better than continuous hormonal contractption, but if menorrhagia- IUD plus estrogen patch, or if really not wanting to risk pregnancy, continuous HRT can be used. Hair loss. Difference between FPHL and telogen efluvium?- CORRECT ANSFPHL is gradual, telogen efluvium is sudden and usually precipitated by a life stressor, chronic illness, beta blockers or anticoagulants-usually more patchy hair loss. FPHL pattern- CORRECT ANSthinning at the crown of the head and widening of the hair part Treating FPHL- CORRECT ANSMINOXIDIL spironolactone finasteride 5 | P a g e What ethnicity has the least likely chance of having bad hot flashes?-correct- answer-Japanese What ethnicity is the most likely to have bad hot flashes?- CORRECT ANSblack more frequent, longer duration. Median length of hot flashes- CORRECT ANS10 years, early menopause transition women have them the longest. Theories about etiology of hot flashes (6)- CORRECT ANSlower ovarian estradiol thermoregulation zone is narrowed neurokinins-regulate GnRH secretion. KNDy new meds serotonin cortisol and HPI axis dysregulation endothelial dysfunction. VIN low grade-what to do high grade-what to do differentiated VIN-what to do- CORRECT ANSlow grade is not precancerous 6 | P a g e high grade is precancerous-GYN ONC differentiated-wide local excision-high risk of invasive carcinoma. most common type of vulvar cancer- CORRECT ANSsquamous cell carcinoma Vulvar disorder commonly misdiagnosed as eczema or dermatitis?-correct- answer-paget's disease will not improve on steroids screen for co-existing breast, GI or GU cancer. They are present 20-30% of the time. Normal PVR- CORRECT ANS100mL systemic and vaginal estrogen will not help with this type of urinary incontinence?- CORRECT ANSwill NOT help with stress incontinence. 7 | P a g e Which topical vaginal estrogen has the highest dose?- CORRECT ANSthe vaginal rings FEMRING IS THE HIGHEST Most common cause of vulvovaginitis?- CORRECT ANSBV post menopause burning and diffuse yellow/brown discharge and dyspareunia that does not respond to local ET?- CORRECT ANSdesquamative inflammatory vaginitis. treat different with clindamycin or hydrocortisone+ET What hormones are associated with sexual desire in women?- CORRECT ANS circulating androgens