NAMs Certification Exam Questions with
100% Correct Answers
Physiology of VMS
-thermoregulatory center altered by increase in KNDy neurons
-activation of NK3R causes hot flashes
-blockade of NK3R reduces/eliminates hot flashes
-may also be affected by: serotonin, epinephrine, and norepinephrine; parasympathetic nerve
activity
Off label rx for VMS
-SSRIs
-SNRIs
-Gabapentinoids
-Clonidine
-Oxybutynin
Studies on Fractional Co2 Laser for GSM
-not FDA approved
-vaginal symptoms and sexual function scores increased significantly at 3 mon; noted
continued improvement at 1y
Ospemifene (Osphena) indications and MOA
-for treatment of dyspareunia
-decreases vaginal pH
-improves vaginal dryness
, -shifts vaginal maturational index to superficial cells
-estrogen agonist/antagonist
Ospemifene (Osphena) adverse effects
-increase in uterine polyps
-proliferative endometrium
-slight increased risk of hemorrhagic stroke and VTE
-can increase VMS
treatment of urge incontinence
-behavioral modifications
-overactivity of the detrusor muscle
-antimuscarinics: oxybutynin
-nerve stimulation
-botox
pelvic floor muscles - superficial
-transverse perineal
-bulbospongiosus,
-ischiocavernosus
pelvic floor muscles - deep
-pubococcygeus
-iliococcygeus
-obturator internus
-coccygeus
What is low-tone pelvic floor dysfunction?
100% Correct Answers
Physiology of VMS
-thermoregulatory center altered by increase in KNDy neurons
-activation of NK3R causes hot flashes
-blockade of NK3R reduces/eliminates hot flashes
-may also be affected by: serotonin, epinephrine, and norepinephrine; parasympathetic nerve
activity
Off label rx for VMS
-SSRIs
-SNRIs
-Gabapentinoids
-Clonidine
-Oxybutynin
Studies on Fractional Co2 Laser for GSM
-not FDA approved
-vaginal symptoms and sexual function scores increased significantly at 3 mon; noted
continued improvement at 1y
Ospemifene (Osphena) indications and MOA
-for treatment of dyspareunia
-decreases vaginal pH
-improves vaginal dryness
, -shifts vaginal maturational index to superficial cells
-estrogen agonist/antagonist
Ospemifene (Osphena) adverse effects
-increase in uterine polyps
-proliferative endometrium
-slight increased risk of hemorrhagic stroke and VTE
-can increase VMS
treatment of urge incontinence
-behavioral modifications
-overactivity of the detrusor muscle
-antimuscarinics: oxybutynin
-nerve stimulation
-botox
pelvic floor muscles - superficial
-transverse perineal
-bulbospongiosus,
-ischiocavernosus
pelvic floor muscles - deep
-pubococcygeus
-iliococcygeus
-obturator internus
-coccygeus
What is low-tone pelvic floor dysfunction?
