NAMS MENOPAUSE CORE MAIN ANSWERS AND
QUESTIONS SET A+
✔✔Asians have ____BMD than white people? - ✔✔lower
✔✔Black women have ____BMD than white people? - ✔✔higher
✔✔Over 3 servings of alcohol daily and risk for fracture? - ✔✔38% for osteoporotic
fracture and 68% for hip fracture
✔✔What 4 ethnic specific versions of FRAX are there? - ✔✔white, asiain, black,
hispanic
✔✔Dairy free diet amount of calicum. How much do they need to supplement? -
✔✔dairy free diet-300mg calcium daily.
Needs 800-1200mg
✔✔Tibolone and osteoporosis
where is it approved?
why wasn't it submitted for approval in the US and canada? - ✔✔approved in mexico
decreased risk of vertebral and nonvertebral fracture
increased risk of stroke
✔✔Why was estrogen not approved for osteoporosis? - ✔✔decreased risk of vertebral
and hip fracture in low fracture risk population, but estrogen has not been shown to
decrease fracture risk in women with osteoporosis. More prevention than treatment.
✔✔Black box warning for PTH receptor agonists? - ✔✔osteosarcoma
✔✔caution using PTH receptor agonists in what condition? - ✔✔hypercalcemia
✔✔when would you use PTH receptor agonists? - ✔✔someone incredibly high risk for
vertebral fracture
, ✔✔raloxifene helps with what kind of fractures? - ✔✔vertebral fractures
✔✔raloxifene risk factors - ✔✔increased risk of death from stroke in high risk patients,
estrogen like risk of VTE, worsens hot flashes
✔✔atypical femur risk in women on bisphosphonate? - ✔✔1 in 1000 after 2-3 years.
✔✔Salmon calcitonin and osteoporosis? - ✔✔small increase in spine BMD. daily SQ
injections or nasal.
✔✔ Climacteric phase - ✔✔The period of endrocrinologic, somatic, and transitory
psychologic changes that occur around the time of menopause.
✔✔Early menopause - ✔✔LMP before age 45
✔✔Late menopause - ✔✔LMP after age 54
✔✔Primary ovarian insufficiency - ✔✔Menopause that occurs before age 40
✔✔Early menopause transition (stage -2) - ✔✔Persistent difference of 7 days or more in
the length of consecutive cycles.
✔✔Late menopause transition (stage -1) - ✔✔60 or more consecutive days of
amenorrhea
✔✔Luteal out of phase event (LOOP) - ✔✔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.
✔✔Obese women and estradiol levels during menopause - ✔✔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)
✔✔Chinese and Japanese women - ✔✔These ethnic groups have lower estradiol levels
then white, black and hispanic women.
✔✔stage +2 - ✔✔late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
✔✔Stages +1a, +1b, +1c - ✔✔early post menopause: 2 years after FMP. FSH rises,
estradiol decreases. VMS predominate.
QUESTIONS SET A+
✔✔Asians have ____BMD than white people? - ✔✔lower
✔✔Black women have ____BMD than white people? - ✔✔higher
✔✔Over 3 servings of alcohol daily and risk for fracture? - ✔✔38% for osteoporotic
fracture and 68% for hip fracture
✔✔What 4 ethnic specific versions of FRAX are there? - ✔✔white, asiain, black,
hispanic
✔✔Dairy free diet amount of calicum. How much do they need to supplement? -
✔✔dairy free diet-300mg calcium daily.
Needs 800-1200mg
✔✔Tibolone and osteoporosis
where is it approved?
why wasn't it submitted for approval in the US and canada? - ✔✔approved in mexico
decreased risk of vertebral and nonvertebral fracture
increased risk of stroke
✔✔Why was estrogen not approved for osteoporosis? - ✔✔decreased risk of vertebral
and hip fracture in low fracture risk population, but estrogen has not been shown to
decrease fracture risk in women with osteoporosis. More prevention than treatment.
✔✔Black box warning for PTH receptor agonists? - ✔✔osteosarcoma
✔✔caution using PTH receptor agonists in what condition? - ✔✔hypercalcemia
✔✔when would you use PTH receptor agonists? - ✔✔someone incredibly high risk for
vertebral fracture
, ✔✔raloxifene helps with what kind of fractures? - ✔✔vertebral fractures
✔✔raloxifene risk factors - ✔✔increased risk of death from stroke in high risk patients,
estrogen like risk of VTE, worsens hot flashes
✔✔atypical femur risk in women on bisphosphonate? - ✔✔1 in 1000 after 2-3 years.
✔✔Salmon calcitonin and osteoporosis? - ✔✔small increase in spine BMD. daily SQ
injections or nasal.
✔✔ Climacteric phase - ✔✔The period of endrocrinologic, somatic, and transitory
psychologic changes that occur around the time of menopause.
✔✔Early menopause - ✔✔LMP before age 45
✔✔Late menopause - ✔✔LMP after age 54
✔✔Primary ovarian insufficiency - ✔✔Menopause that occurs before age 40
✔✔Early menopause transition (stage -2) - ✔✔Persistent difference of 7 days or more in
the length of consecutive cycles.
✔✔Late menopause transition (stage -1) - ✔✔60 or more consecutive days of
amenorrhea
✔✔Luteal out of phase event (LOOP) - ✔✔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.
✔✔Obese women and estradiol levels during menopause - ✔✔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)
✔✔Chinese and Japanese women - ✔✔These ethnic groups have lower estradiol levels
then white, black and hispanic women.
✔✔stage +2 - ✔✔late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
✔✔Stages +1a, +1b, +1c - ✔✔early post menopause: 2 years after FMP. FSH rises,
estradiol decreases. VMS predominate.
