NAMS MENOPAUSE ACTUAL FINALS ANSWERS AND
QUESTIONS SET A+
✔✔Weight Gain During Menopausal Transition - ✔✔2-4 fold increase in fat mass (6%,
1.6kg over 3.5 years), 0.5% loss of lean muscle.
✔✔Changes in Weight Gain During Perimenopause/Menopause - ✔✔Premenopause
weight increase, menopausal transition - steady increase, postmenopause no change.
✔✔Calorie Intake in Post Menopause - ✔✔Yes, likely driven by decreased active
energy expenditure.
✔✔HRT on Cardiovascular Risk Factors - ✔✔In women without diabetes mellitus, HRT
(oral or transdermal E+/-P) improves lean body mass, reduces abdominal adiposity,
improves insulin resistance, improves lipids, decreases blood pressure.
✔✔When to Add Anti-Obesity Medication - ✔✔Initiate weight loss medication as adjunct
to lifestyle: if BMI (27-29.9 in presence of comorbid), if BMI >30 and failure of lifestyle.
✔✔Weight Loss with Orlistat - ✔✔~8%, GI lipase inhibitor, may cause diarrhea.
✔✔Weight Loss with Phentermine/Topiramate ER - ✔✔8-12%, contraindications:
glaucoma, hyperthyroid, MAOI; side effects: insomnia, dry mouth, paresthesias,
metabolic acidosis, anxiety, tachycardia.
✔✔Weight Loss with Naltrexone SR/Bupropion SR (Contrave) - ✔✔~5-6.4%, dopamine
and norepinephrine reuptake inhibitor and u-opioid receptor antagonist;
contraindications: hypertension, seizures, eating disorder, opioid use; side effects:
nausea, headache.
✔✔Weight Loss with Liraglutide - ✔✔GLP-1 receptor agonist, dose up to 3mg daily in
0.6mg steps, weight loss ~7-10%; contraindications: pancreatitis, family history of
medullary thyroid cancer, multiple endocrine neoplasia; side effects: nausea, diarrhea,
vomiting, constipation.
, ✔✔Weight Loss with Semaglutide - ✔✔~14-16%, GLP-1 receptor agonist, dose up to
2.4mg daily in slow weekly dose titration; contraindications: pancreatitis, family history
of medullary thyroid cancer, multiple endocrine neoplasia; side effects: nausea,
diarrhea, vomiting, constipation.
✔✔Mechanism of GLP-1 Receptor Agonists - ✔✔GLP-1s help the pancreas release
more insulin, delay stomach emptying, and reduce appetite.
✔✔Weight Loss with Phentermine Monotherapy - ✔✔Short term, FDA approved for
short-term use (<12 weeks); common practice to prescribe for longer; retrospective data
suggests better weight loss with longer use >6 months; no increase in adverse events
cardiovascular; no addiction potential.
✔✔Surgical Management of Obesity - ✔✔Roux-en-Y bypass, sleeve gastrectomy,
biliopancreatic diversion with duodenal switch.
✔✔Eligibility for Bariatric Surgery - ✔✔BMI >40, BMI >35 with 1 comorbidity, BMI 30-35
with type 2 diabetes mellitus, poor glycemic control despite lifestyle.
✔✔Non-Scarring Alopecia - ✔✔Disorders that reduce or slow hair growth without
irreparably damaging the hair follicle, primarily affect the hair shaft.
✔✔Scarring Alopecia - ✔✔Replacement of hair follicles with scar tissue.
✔✔Examples of Non-Scarring Alopecia - ✔✔Androgenetic alopecia, telogen effluvium,
alopecia areata.
✔✔Treatment for Scarring Alopecia - ✔✔Send to dermatology.
✔✔Androgenetic Alopecia - ✔✔Female pattern thinning, genetic predisposition,
hormonal factors, a slow miniaturization over time, characterized by follicular
miniaturization, shorter growth cycle, and longer latent period; NOT AN ABRUPT
SHED.
✔✔Female Pattern Thinning - ✔✔Can begin in teens, usually NOT androgen excess;
first notice smaller ponytail, wider part, see scalp.
✔✔Labs to Obtain in Female Pattern Thinning - ✔✔TSH, CBC, ferritin, consider PCOS.
✔✔Topical treatment for female pattern thinning - ✔✔minoxidil 5% once daily
✔✔Systemic treatment for female pattern hair thinning - ✔✔Younger women - OCP w/
drospirenon, spironolactone 100-200 mg daily
QUESTIONS SET A+
✔✔Weight Gain During Menopausal Transition - ✔✔2-4 fold increase in fat mass (6%,
1.6kg over 3.5 years), 0.5% loss of lean muscle.
✔✔Changes in Weight Gain During Perimenopause/Menopause - ✔✔Premenopause
weight increase, menopausal transition - steady increase, postmenopause no change.
✔✔Calorie Intake in Post Menopause - ✔✔Yes, likely driven by decreased active
energy expenditure.
✔✔HRT on Cardiovascular Risk Factors - ✔✔In women without diabetes mellitus, HRT
(oral or transdermal E+/-P) improves lean body mass, reduces abdominal adiposity,
improves insulin resistance, improves lipids, decreases blood pressure.
✔✔When to Add Anti-Obesity Medication - ✔✔Initiate weight loss medication as adjunct
to lifestyle: if BMI (27-29.9 in presence of comorbid), if BMI >30 and failure of lifestyle.
✔✔Weight Loss with Orlistat - ✔✔~8%, GI lipase inhibitor, may cause diarrhea.
✔✔Weight Loss with Phentermine/Topiramate ER - ✔✔8-12%, contraindications:
glaucoma, hyperthyroid, MAOI; side effects: insomnia, dry mouth, paresthesias,
metabolic acidosis, anxiety, tachycardia.
✔✔Weight Loss with Naltrexone SR/Bupropion SR (Contrave) - ✔✔~5-6.4%, dopamine
and norepinephrine reuptake inhibitor and u-opioid receptor antagonist;
contraindications: hypertension, seizures, eating disorder, opioid use; side effects:
nausea, headache.
✔✔Weight Loss with Liraglutide - ✔✔GLP-1 receptor agonist, dose up to 3mg daily in
0.6mg steps, weight loss ~7-10%; contraindications: pancreatitis, family history of
medullary thyroid cancer, multiple endocrine neoplasia; side effects: nausea, diarrhea,
vomiting, constipation.
, ✔✔Weight Loss with Semaglutide - ✔✔~14-16%, GLP-1 receptor agonist, dose up to
2.4mg daily in slow weekly dose titration; contraindications: pancreatitis, family history
of medullary thyroid cancer, multiple endocrine neoplasia; side effects: nausea,
diarrhea, vomiting, constipation.
✔✔Mechanism of GLP-1 Receptor Agonists - ✔✔GLP-1s help the pancreas release
more insulin, delay stomach emptying, and reduce appetite.
✔✔Weight Loss with Phentermine Monotherapy - ✔✔Short term, FDA approved for
short-term use (<12 weeks); common practice to prescribe for longer; retrospective data
suggests better weight loss with longer use >6 months; no increase in adverse events
cardiovascular; no addiction potential.
✔✔Surgical Management of Obesity - ✔✔Roux-en-Y bypass, sleeve gastrectomy,
biliopancreatic diversion with duodenal switch.
✔✔Eligibility for Bariatric Surgery - ✔✔BMI >40, BMI >35 with 1 comorbidity, BMI 30-35
with type 2 diabetes mellitus, poor glycemic control despite lifestyle.
✔✔Non-Scarring Alopecia - ✔✔Disorders that reduce or slow hair growth without
irreparably damaging the hair follicle, primarily affect the hair shaft.
✔✔Scarring Alopecia - ✔✔Replacement of hair follicles with scar tissue.
✔✔Examples of Non-Scarring Alopecia - ✔✔Androgenetic alopecia, telogen effluvium,
alopecia areata.
✔✔Treatment for Scarring Alopecia - ✔✔Send to dermatology.
✔✔Androgenetic Alopecia - ✔✔Female pattern thinning, genetic predisposition,
hormonal factors, a slow miniaturization over time, characterized by follicular
miniaturization, shorter growth cycle, and longer latent period; NOT AN ABRUPT
SHED.
✔✔Female Pattern Thinning - ✔✔Can begin in teens, usually NOT androgen excess;
first notice smaller ponytail, wider part, see scalp.
✔✔Labs to Obtain in Female Pattern Thinning - ✔✔TSH, CBC, ferritin, consider PCOS.
✔✔Topical treatment for female pattern thinning - ✔✔minoxidil 5% once daily
✔✔Systemic treatment for female pattern hair thinning - ✔✔Younger women - OCP w/
drospirenon, spironolactone 100-200 mg daily
