NAMS MENOPAUSE
PRACTICE EXAM QUESTIONS
WITH CORRECT DETAILED
ANSWERS | ALREADY GRADED
A+<RECENT VERSION>
1. The period of endrocrinologic, somatic, and transitory psychologic
changes that occur around the time of menopause. - answer
climacteric phase
2. Menopause that occurs before age 40 - answer primary ovarian
insufficiency
3. Persistent difference of 7 days or more in the length of consecutive
cycles. - answer early menopause transition (stage -2)
4. 60 or more consecutive days of amenorrhea - answer late menopause
transition (stage -1)
5. 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. - answer luteal out of phase
event (loop)
6. 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) -
answer obese women and estradiol levels during menopause
7. These ethnic groups have lower estradiol levels then white, black and
hispanic women. - answer chinese and japanese women
8. Late menopause stage: 5-8 years after fmp. Somatic aging predominates.
Increased genitourinary symptoms. - answer stage +2
9. Early post menopause: 2 years after fmp. Fsh rises, estradiol decreases.
Vms predominate. - answer stages +1a, +1b, +1c
10.Endocrine labs after menopause - answer elevated fsh, lh
11.These hormones work during reproductive years to not deplete follicle
pool too quickly. - answer amh, inhibin b
12.Menstrual cycle variable, persistent >7 day difference between difference
in length of consecutive cycles. - answer phases during menopause
transition and pms symptoms
13.Many pitfalls, variable depending on the day of the cycle you draw the
lab, normal or low fsh is not helpful. - answer how to respond if a
patient requests fsh lab?
,14.Amh - answer the potentially superior marker of menopause, a lab.
15.Adrenal androgens: precursor hromones produced by the adrenal gland
that are enzymatically converted to active androgens or estrogens in
peripheral tissues. - answer dhea (dehydroepiandrosterone)
16.Vagina, vulva, urethra, trigone of the bladder - answer location of
estrogen receptors
17.Maintain blood flow, the collagen, and ha within the epithelial surfaces.
Supports microbiome which supports acidity of vagina and protects tissue
from pathogens. - answer effects of estrogen on tissue
18.Thinning, loss of elasticity, loss or absence or rugae. - answer vaginal
changes with menopause
19.Vagina narrows, urethra moves closer to the introitus. - answer vagina
and urethra in menopause
20.Vaginal estrogen and urinary incontinence: what type does it help with? -
answer stress urinary incontinence
21.Minoxidil, spironolactone, finasteride, estrogen therapy - answer
treatment for fphl
-3b: menstrual cycles normal, fsh normal, amh low, afc low, inhibin low.
22.-3a: subtle menstrual changes, variable fsh, amh low, afc low, inhibin low.
- answer late reporoductive years -3b and -3a. What happens with
menstrual cycles, fsh, amh, afc, inhibin?
, 23.Cycle day #3. Elevated estradiol can suppress fsh giving a falsely normal
fsh level. - answer when it is appropriate to check an fsh during the
cycle if you check it? And why?
Produced by granulosa cells
Used to test damage to ovarian follicle reserve. If amh is low, the woman
has a low ovarian reserve.
Not recommended as a screening tool to predict fertility.
Peaks at around 25 years old. So before age 25, this test is not helpful.
24.It is influenced by exogenous hormones. Lower in hormonal
contraception users, but increases after d/cing. - answer amh
Produced by...
Used to test...
Is it a screening tool for fertility?
When does it peak?
25.Antral follicle count
Number of follicles that are detectable with ultrasound.
They are sensitive to fsh and considered to represent the availability pool of
follicles. - answer afc
26.25 or higher - answer late menopause transition (-1) fsh level on
random draw
PRACTICE EXAM QUESTIONS
WITH CORRECT DETAILED
ANSWERS | ALREADY GRADED
A+<RECENT VERSION>
1. The period of endrocrinologic, somatic, and transitory psychologic
changes that occur around the time of menopause. - answer
climacteric phase
2. Menopause that occurs before age 40 - answer primary ovarian
insufficiency
3. Persistent difference of 7 days or more in the length of consecutive
cycles. - answer early menopause transition (stage -2)
4. 60 or more consecutive days of amenorrhea - answer late menopause
transition (stage -1)
5. 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. - answer luteal out of phase
event (loop)
6. 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) -
answer obese women and estradiol levels during menopause
7. These ethnic groups have lower estradiol levels then white, black and
hispanic women. - answer chinese and japanese women
8. Late menopause stage: 5-8 years after fmp. Somatic aging predominates.
Increased genitourinary symptoms. - answer stage +2
9. Early post menopause: 2 years after fmp. Fsh rises, estradiol decreases.
Vms predominate. - answer stages +1a, +1b, +1c
10.Endocrine labs after menopause - answer elevated fsh, lh
11.These hormones work during reproductive years to not deplete follicle
pool too quickly. - answer amh, inhibin b
12.Menstrual cycle variable, persistent >7 day difference between difference
in length of consecutive cycles. - answer phases during menopause
transition and pms symptoms
13.Many pitfalls, variable depending on the day of the cycle you draw the
lab, normal or low fsh is not helpful. - answer how to respond if a
patient requests fsh lab?
,14.Amh - answer the potentially superior marker of menopause, a lab.
15.Adrenal androgens: precursor hromones produced by the adrenal gland
that are enzymatically converted to active androgens or estrogens in
peripheral tissues. - answer dhea (dehydroepiandrosterone)
16.Vagina, vulva, urethra, trigone of the bladder - answer location of
estrogen receptors
17.Maintain blood flow, the collagen, and ha within the epithelial surfaces.
Supports microbiome which supports acidity of vagina and protects tissue
from pathogens. - answer effects of estrogen on tissue
18.Thinning, loss of elasticity, loss or absence or rugae. - answer vaginal
changes with menopause
19.Vagina narrows, urethra moves closer to the introitus. - answer vagina
and urethra in menopause
20.Vaginal estrogen and urinary incontinence: what type does it help with? -
answer stress urinary incontinence
21.Minoxidil, spironolactone, finasteride, estrogen therapy - answer
treatment for fphl
-3b: menstrual cycles normal, fsh normal, amh low, afc low, inhibin low.
22.-3a: subtle menstrual changes, variable fsh, amh low, afc low, inhibin low.
- answer late reporoductive years -3b and -3a. What happens with
menstrual cycles, fsh, amh, afc, inhibin?
, 23.Cycle day #3. Elevated estradiol can suppress fsh giving a falsely normal
fsh level. - answer when it is appropriate to check an fsh during the
cycle if you check it? And why?
Produced by granulosa cells
Used to test damage to ovarian follicle reserve. If amh is low, the woman
has a low ovarian reserve.
Not recommended as a screening tool to predict fertility.
Peaks at around 25 years old. So before age 25, this test is not helpful.
24.It is influenced by exogenous hormones. Lower in hormonal
contraception users, but increases after d/cing. - answer amh
Produced by...
Used to test...
Is it a screening tool for fertility?
When does it peak?
25.Antral follicle count
Number of follicles that are detectable with ultrasound.
They are sensitive to fsh and considered to represent the availability pool of
follicles. - answer afc
26.25 or higher - answer late menopause transition (-1) fsh level on
random draw
