NAMS MENOPAUSE CERTIFICATION FINAL PAPER
2025/2026 QUESTIONS WITH ANSWERS GRADED A+
✔✔Meta analysis of RCTs have shown small benefit of what diet/exercise for global
cognition and memory? - ✔✔Mediterranean diet with olive oil and tai chi exercise helps
with global cognition
Mediterranean diet with olive oil and isoflavone supplements helps with memory.
✔✔effect of HRT on cognition - ✔✔small or no overall effect on cognition
✔✔What HRT can increase your risk for dementia based on the WHIMS study in 65+
year old healthy women? - ✔✔EPT replacement was shown to double the risk of
developing dementia.
There was no significant increased risk in ET alone.
this is why HRT is not recommended after 65 for primary prevention of dementia
✔✔3 reasons supporting the idea that HRT in early menopause may decrease a
woman's chance of developing alzheimer's disease? - ✔✔1. Observational studies
imply it
2. Clinical trial of transdermal estradiol during the early postmenopause stage is
associated with reductions in AD pathology.
3. 18 year cumulative follow up data from WHI found that women randomized to ET had
significantly lower risk of dying from AD or dementia compared with women randomized
to receive placebo.
✔✔Migraine headache and pregnancy - ✔✔typically migraines improve-estrogen levels
stabilize
✔✔Migraine without aura after menopause - ✔✔usually decrease with natural
menopause
✔✔menstrual migraine after menopause - ✔✔should resolve completely
✔✔When to consider preventative medication for migraines - ✔✔>2 times per week or
severe and effecting QOL
✔✔Triptans are contraindicated in what? - ✔✔patients with cardiovascular disease, as
are NSAIDs
✔✔Menstrual migraine treatment - ✔✔NSAID or triptan 2 days before expected to get
your period, and take for 5-7 days.
, ✔✔cdc and who guidelines for migraine treatment - ✔✔migraine with aura-advise to not
use combined hormone contraception
caution in women with migraine without aura
✔✔How long can it take for arthralgia from vitamin d deficiency or hypothyroidism to
fully resolve? - ✔✔it can take several months.
✔✔what is th emost common form of arthritis? - ✔✔osteoarthritis
✔✔what areas of th ebrain have th emost estrogen receptors? - ✔✔hippocampus and
prefrontal cortex
✔✔what is the most common thyroid disorder in women? - ✔✔hashimoto thyroiditis
✔✔if a patient on levothyroxine is started on estrogen, when do you recheck and what
can you anticipate happening? - ✔✔recheck 6-8 weeks later.
anticipate that the dose of levothyroxine may need to be increased.
oral estrogens increase thyroid binding globulin which in turn reduces the levels of free
T4.
✔✔when is treatment of subclinical hypothyroidism recommended? - ✔✔when the TSH
level is higher than 10.
✔✔are hot or cold thyroid nodules typically most likely to be malignant? - ✔✔cold
nodules
✔✔how does HRT impact gallbladder disease? - ✔✔increases risk of gallstones with
oral HRT, lower risk with transdermal.
✔✔when did they start screening blood for hep c? - ✔✔1992, so women who have
received blood products or organ transplants prior to 1992 may have acquired heptatitis
c
✔✔why do we screen for hep C? - ✔✔most infections become chronic and most are
asymptomatic until liver damage is detected years later. Our treatments are improving
so if we catch this earlier in people, outcomes will be better
✔✔all adults born from what year to what year should recieve one time hep c testing? -
✔✔1945 to 1965
2025/2026 QUESTIONS WITH ANSWERS GRADED A+
✔✔Meta analysis of RCTs have shown small benefit of what diet/exercise for global
cognition and memory? - ✔✔Mediterranean diet with olive oil and tai chi exercise helps
with global cognition
Mediterranean diet with olive oil and isoflavone supplements helps with memory.
✔✔effect of HRT on cognition - ✔✔small or no overall effect on cognition
✔✔What HRT can increase your risk for dementia based on the WHIMS study in 65+
year old healthy women? - ✔✔EPT replacement was shown to double the risk of
developing dementia.
There was no significant increased risk in ET alone.
this is why HRT is not recommended after 65 for primary prevention of dementia
✔✔3 reasons supporting the idea that HRT in early menopause may decrease a
woman's chance of developing alzheimer's disease? - ✔✔1. Observational studies
imply it
2. Clinical trial of transdermal estradiol during the early postmenopause stage is
associated with reductions in AD pathology.
3. 18 year cumulative follow up data from WHI found that women randomized to ET had
significantly lower risk of dying from AD or dementia compared with women randomized
to receive placebo.
✔✔Migraine headache and pregnancy - ✔✔typically migraines improve-estrogen levels
stabilize
✔✔Migraine without aura after menopause - ✔✔usually decrease with natural
menopause
✔✔menstrual migraine after menopause - ✔✔should resolve completely
✔✔When to consider preventative medication for migraines - ✔✔>2 times per week or
severe and effecting QOL
✔✔Triptans are contraindicated in what? - ✔✔patients with cardiovascular disease, as
are NSAIDs
✔✔Menstrual migraine treatment - ✔✔NSAID or triptan 2 days before expected to get
your period, and take for 5-7 days.
, ✔✔cdc and who guidelines for migraine treatment - ✔✔migraine with aura-advise to not
use combined hormone contraception
caution in women with migraine without aura
✔✔How long can it take for arthralgia from vitamin d deficiency or hypothyroidism to
fully resolve? - ✔✔it can take several months.
✔✔what is th emost common form of arthritis? - ✔✔osteoarthritis
✔✔what areas of th ebrain have th emost estrogen receptors? - ✔✔hippocampus and
prefrontal cortex
✔✔what is the most common thyroid disorder in women? - ✔✔hashimoto thyroiditis
✔✔if a patient on levothyroxine is started on estrogen, when do you recheck and what
can you anticipate happening? - ✔✔recheck 6-8 weeks later.
anticipate that the dose of levothyroxine may need to be increased.
oral estrogens increase thyroid binding globulin which in turn reduces the levels of free
T4.
✔✔when is treatment of subclinical hypothyroidism recommended? - ✔✔when the TSH
level is higher than 10.
✔✔are hot or cold thyroid nodules typically most likely to be malignant? - ✔✔cold
nodules
✔✔how does HRT impact gallbladder disease? - ✔✔increases risk of gallstones with
oral HRT, lower risk with transdermal.
✔✔when did they start screening blood for hep c? - ✔✔1992, so women who have
received blood products or organ transplants prior to 1992 may have acquired heptatitis
c
✔✔why do we screen for hep C? - ✔✔most infections become chronic and most are
asymptomatic until liver damage is detected years later. Our treatments are improving
so if we catch this earlier in people, outcomes will be better
✔✔all adults born from what year to what year should recieve one time hep c testing? -
✔✔1945 to 1965
