NAMS MENOPAUSE STUDYS ACTUAL QUESTIONS
AND ANSWERS SURE A+
✔✔Evaluation of incontinence - ✔✔Type: provoking factors, sense of urgency,
frequency, ability to defer; Severity and Impact on QoL: leak frequency, pad use, impact
on ADL, complexity & safety: bladder emptying, blood, stones, pain, comorbidities
✔✔Main types of incontinence - ✔✔Stress incontinence, Overactive bladder, Overflow
incontinence
✔✔Screening for thyroid disease - ✔✔Every 5 years starting at age 35
✔✔Most common thyroid disease - ✔✔Hypothyroidism caused by Hashimoto thyroiditis
✔✔Normal range of serum TSH - ✔✔.4 mIU/L to 4.5 mIU/L; if TSH level is elevated,
free T4 and antithyroperoxidase antibodies should be measured
✔✔Levo dosing - ✔✔1.6ug per KG; Over 50 start w/ 25ug to 50 with progression every
2-3 weeks until euthyroid is reached; With CHD start lower titrate every 6-8 weeks;
Monitor TSH every 4-6 weeks after any change
✔✔Thyroid medication and oral ET - ✔✔TSH levels should be monitored 6-8 weeks
later; anticipate that dose of Levo may need to be increased; oral (not transdermal)
estrogens increase thyroid binding globulin which reduces FT4
✔✔Hyperthyroidism/Grave's disease - ✔✔Abnormally high secretion of thyroid
hormones; Low TSH (persistently less than .1mIU/L in all persons aged 65 and older)
✔✔Bone effects of TSH - ✔✔3 fold increase in hip fractures for patients with excess
endogenous thyroid hormone production (i.e. TSH <.1mIU/L)
✔✔Hot thyroid nodule - ✔✔Rarely associated with thyroid cancer
, ✔✔Definition of insomnia - ✔✔Sleep complaint that occurs at least 3 times per week for
at least 3 months and is associated with distress or impaired daytime personal
functioning
✔✔Screening tool for eating disorder - ✔✔SCOFF
✔✔Screening tool for drug abuse - ✔✔DAST10
✔✔Screening tool for intimate partner violence - ✔✔HARK
✔✔Screening tool for depression - ✔✔PHQ
✔✔Screening tool for anxiety - ✔✔GAD-7
✔✔Rate of bone loss at menopause - ✔✔An average annual loss of about 2%
beginning 1-3 years before menopause and lasting 5-10 years. Across the menopause
transition women lose up to 10-12% of bone loss (one T-score)
✔✔Bone loss by age 80 - ✔✔30%
✔✔Normal T score range for BMD - ✔✔-2 to +2 (comparison to a young white woman)
✔✔Definition of osteoporosis - ✔✔T score < -2.5
✔✔Definition of osteopenia - ✔✔T score between -1 and -2.5
✔✔Definition of osteoporosis in premenopausal women - ✔✔Women who have a low
BMD (z-score < -2) and have a history of fragility fracture
✔✔FRAX score - ✔✔Used to predict the 10 year risk of fracture; Elements include Age -
40-90, Gender, BMI, Previous fracture, Previous hip fracture, Current smoking,
Glucocorticoid use (3 months at more than 5mg/day), Rheumatoid arthritis, Secondary
osteoporosis, EtOH - more than 3 drinks a day, Bone mineral density
✔✔Risk factors for low bone mineral density - ✔✔Age, thinness, genetics, smoking, hx
of fracture, diseases and drugs (AI, steroids), excessive EtOH, infertility
✔✔FRAX score is ____ - ✔✔Screening tool for osteoporosis; tells 10 year probability of
hip fx or major osteoporotic fracture (hip, proximal humerus, distal radius, symptomatic
spine fracture)
AND ANSWERS SURE A+
✔✔Evaluation of incontinence - ✔✔Type: provoking factors, sense of urgency,
frequency, ability to defer; Severity and Impact on QoL: leak frequency, pad use, impact
on ADL, complexity & safety: bladder emptying, blood, stones, pain, comorbidities
✔✔Main types of incontinence - ✔✔Stress incontinence, Overactive bladder, Overflow
incontinence
✔✔Screening for thyroid disease - ✔✔Every 5 years starting at age 35
✔✔Most common thyroid disease - ✔✔Hypothyroidism caused by Hashimoto thyroiditis
✔✔Normal range of serum TSH - ✔✔.4 mIU/L to 4.5 mIU/L; if TSH level is elevated,
free T4 and antithyroperoxidase antibodies should be measured
✔✔Levo dosing - ✔✔1.6ug per KG; Over 50 start w/ 25ug to 50 with progression every
2-3 weeks until euthyroid is reached; With CHD start lower titrate every 6-8 weeks;
Monitor TSH every 4-6 weeks after any change
✔✔Thyroid medication and oral ET - ✔✔TSH levels should be monitored 6-8 weeks
later; anticipate that dose of Levo may need to be increased; oral (not transdermal)
estrogens increase thyroid binding globulin which reduces FT4
✔✔Hyperthyroidism/Grave's disease - ✔✔Abnormally high secretion of thyroid
hormones; Low TSH (persistently less than .1mIU/L in all persons aged 65 and older)
✔✔Bone effects of TSH - ✔✔3 fold increase in hip fractures for patients with excess
endogenous thyroid hormone production (i.e. TSH <.1mIU/L)
✔✔Hot thyroid nodule - ✔✔Rarely associated with thyroid cancer
, ✔✔Definition of insomnia - ✔✔Sleep complaint that occurs at least 3 times per week for
at least 3 months and is associated with distress or impaired daytime personal
functioning
✔✔Screening tool for eating disorder - ✔✔SCOFF
✔✔Screening tool for drug abuse - ✔✔DAST10
✔✔Screening tool for intimate partner violence - ✔✔HARK
✔✔Screening tool for depression - ✔✔PHQ
✔✔Screening tool for anxiety - ✔✔GAD-7
✔✔Rate of bone loss at menopause - ✔✔An average annual loss of about 2%
beginning 1-3 years before menopause and lasting 5-10 years. Across the menopause
transition women lose up to 10-12% of bone loss (one T-score)
✔✔Bone loss by age 80 - ✔✔30%
✔✔Normal T score range for BMD - ✔✔-2 to +2 (comparison to a young white woman)
✔✔Definition of osteoporosis - ✔✔T score < -2.5
✔✔Definition of osteopenia - ✔✔T score between -1 and -2.5
✔✔Definition of osteoporosis in premenopausal women - ✔✔Women who have a low
BMD (z-score < -2) and have a history of fragility fracture
✔✔FRAX score - ✔✔Used to predict the 10 year risk of fracture; Elements include Age -
40-90, Gender, BMI, Previous fracture, Previous hip fracture, Current smoking,
Glucocorticoid use (3 months at more than 5mg/day), Rheumatoid arthritis, Secondary
osteoporosis, EtOH - more than 3 drinks a day, Bone mineral density
✔✔Risk factors for low bone mineral density - ✔✔Age, thinness, genetics, smoking, hx
of fracture, diseases and drugs (AI, steroids), excessive EtOH, infertility
✔✔FRAX score is ____ - ✔✔Screening tool for osteoporosis; tells 10 year probability of
hip fx or major osteoporotic fracture (hip, proximal humerus, distal radius, symptomatic
spine fracture)
