NAMS MENOPAUSE CERTIFI
g g
CATION EXAM QUESTIONS A
g g g
ND ANSWERS GRADED A+
g g g
Locationgofgestrogengreceptorsg-
gANSWERS>>>>>Vagina,gvulva,gurethra,gtrigonegofgthegbladde
r
Effectsgofgestrogengongtissueg-
gANSWERS>>>>>maintaingbloodgflow,gthegcollagen,gandgHAgwith
ingthegepithelialgsurfaces.gSupportsgmicrobiomegwhichgsuppo
rtsgaciditygofgvaginagandgprotectsgtissuegfromgpathogens.
Vaginalgchangesgwithgmenopauseg-
gANSWERS>>>>>Thinning,glossgofgelasticity,glossgorgabsenceg
orgrugae.
Vaginagandgurethragingmenopauseg-
gANSWERS>>>>>vaginagnarrows,gurethragmovesgclosergtogthegin
troitus.
Stressgurinarygincontinenceg-
gANSWERS>>>>>Vaginalgestrogengandgurinarygincontinence:gwh
atgtypegdoesgitghelpgwith?
TreatmentgforgFPHLg-
gANSWERS>>>>>Minoxidil,gspironolactone,gfinasteride,gestr
ogengtherapy
Lategreporoductivegyearsg-3bgandg-
3a.gWhatghappensgwithgmenstrualgcycles,gFSH,gAMH,gAFC,ginhi
bin?g-gANSWERS>>>>>-
3b:gmenstrualgcyclesgnormal,gFSHgnormal,gAMHglow,gAFCglow,gi
,nhibinglow.
,-
3a:gsubtlegmenstrualgchanges,gvariablegFSH,gAMHglow,gAFCglo
w,ginhibinglow.
WhengitgisgappropriategtogcheckgangFSHgduringgthegcyclegifgyo
ugcheckgit?gandgwhy?g-gANSWERS>>>>>Cyclegdayg#3.
ElevatedgestradiolgcangsuppressgFSHggivinggagfalselygnormal
gFSHglevel.
AMH
producedgby...guse
dgtogtest...
Isgitgagscreeninggtoolgforgfertility?
Whengdoesgitgpeak?g-
gANSWERS>>>>>producedgbyggranulosagcells
usedgtogtestgdamagegtogovariangfolliclegreserve.gIfgAMHgisglo
w,gthegwomanghasgaglowgovariangreserve.
notgrecommendedgasgagscreeninggtoolgtogpredictgfertility.
Peaksgatgaroundg25gyearsgold.gSogbeforegageg25,gthisgtestgisg
notghelpful.
Itgisginfluencedgbygexogenousghormones.gLowerginghormonalgc
ontraceptiongusers,gbutgincreasesgaftergd/cing.
Climactericgphaseg-
gANSWERS>>>>>Thegperiodgofgendrocrinologic,gsomatic,gandgt
ransitorygpsychologicgchangesgthatgoccurgaroundgthegtimegof
gmenopause.
Earlygmenopauseg-gANSWERS>>>>>LMPgbeforegageg45
Lategmenopauseg-gANSWERS>>>>>LMPgaftergageg54
, Primarygovarianginsufficiencyg-
gANSWERS>>>>>Menopausegthatgoccursgbeforegageg40
Earlygmenopausegtransitiong(stageg-2)g-
gANSWERS>>>>>Persistentgdifferencegofg7gdaysgorgmoregingtheg
lengthgofgconsecutivegcycles.
Lategmenopausegtransitiong(stageg-1)g-
gANSWERS>>>>>60gorgmoregconsecutivegdaysgofgamenorrhea
Lutealgoutgofgphasegeventg(LOOP)g-
gANSWERS>>>>>Explainsgwhygsomegperimenopausalgwomenghavegel
evatedgestrogenglevelgsometimes...Ingthegearlygmenopausegt
ransition,gelevatedgFSHglevelsgaregadequategtogrecruitgagse
condgfolliclegwhichgresultsgingagfolliculargphase-
likegrisegingestradiolgsecretiongsuperimposedgongthegmid-
to-lateglutealgphasegofgthegongoinggovulatorygcycle.
Obesegwomengandgestradiolglevelsgduringgmenopauseg-
gANSWERS>>>>>Obesegwomengaregmoreglikelygtoghaveganovulator
ygcyclesgwithghighgestradiolglevels.gTheygaregalsogmoreglike
lygtoghaveglowergpremenopausegyetghighergpostmenopausegestr
adiolglevelsgcomparedgwithgwomengofgnormalgweight.g(whygthe
ygaregatghighergriskgofgendometrialgcancer)
ChinesegandgJapanesegwomeng-
gANSWERS>>>>>Thesegethnicggroupsghaveglowergestradiolglev
elsgthengwhite,gblackgandghispanicgwomen.
stageg+2g-gANSWERS>>>>>lategmenopausegstage:g5-
8gyearsgaftergFMP.gSomaticgaginggpredominates.gIncreasedgge
nitourinarygsymptoms.
Stagesg+1a,g+1b,g+1cg-
gANSWERS>>>>>earlygpostgmenopause:g2gyearsgaftergFMP.gFSHg
rises,gestradiolgdecreases.gVMSgpredominate.
g g
CATION EXAM QUESTIONS A
g g g
ND ANSWERS GRADED A+
g g g
Locationgofgestrogengreceptorsg-
gANSWERS>>>>>Vagina,gvulva,gurethra,gtrigonegofgthegbladde
r
Effectsgofgestrogengongtissueg-
gANSWERS>>>>>maintaingbloodgflow,gthegcollagen,gandgHAgwith
ingthegepithelialgsurfaces.gSupportsgmicrobiomegwhichgsuppo
rtsgaciditygofgvaginagandgprotectsgtissuegfromgpathogens.
Vaginalgchangesgwithgmenopauseg-
gANSWERS>>>>>Thinning,glossgofgelasticity,glossgorgabsenceg
orgrugae.
Vaginagandgurethragingmenopauseg-
gANSWERS>>>>>vaginagnarrows,gurethragmovesgclosergtogthegin
troitus.
Stressgurinarygincontinenceg-
gANSWERS>>>>>Vaginalgestrogengandgurinarygincontinence:gwh
atgtypegdoesgitghelpgwith?
TreatmentgforgFPHLg-
gANSWERS>>>>>Minoxidil,gspironolactone,gfinasteride,gestr
ogengtherapy
Lategreporoductivegyearsg-3bgandg-
3a.gWhatghappensgwithgmenstrualgcycles,gFSH,gAMH,gAFC,ginhi
bin?g-gANSWERS>>>>>-
3b:gmenstrualgcyclesgnormal,gFSHgnormal,gAMHglow,gAFCglow,gi
,nhibinglow.
,-
3a:gsubtlegmenstrualgchanges,gvariablegFSH,gAMHglow,gAFCglo
w,ginhibinglow.
WhengitgisgappropriategtogcheckgangFSHgduringgthegcyclegifgyo
ugcheckgit?gandgwhy?g-gANSWERS>>>>>Cyclegdayg#3.
ElevatedgestradiolgcangsuppressgFSHggivinggagfalselygnormal
gFSHglevel.
AMH
producedgby...guse
dgtogtest...
Isgitgagscreeninggtoolgforgfertility?
Whengdoesgitgpeak?g-
gANSWERS>>>>>producedgbyggranulosagcells
usedgtogtestgdamagegtogovariangfolliclegreserve.gIfgAMHgisglo
w,gthegwomanghasgaglowgovariangreserve.
notgrecommendedgasgagscreeninggtoolgtogpredictgfertility.
Peaksgatgaroundg25gyearsgold.gSogbeforegageg25,gthisgtestgisg
notghelpful.
Itgisginfluencedgbygexogenousghormones.gLowerginghormonalgc
ontraceptiongusers,gbutgincreasesgaftergd/cing.
Climactericgphaseg-
gANSWERS>>>>>Thegperiodgofgendrocrinologic,gsomatic,gandgt
ransitorygpsychologicgchangesgthatgoccurgaroundgthegtimegof
gmenopause.
Earlygmenopauseg-gANSWERS>>>>>LMPgbeforegageg45
Lategmenopauseg-gANSWERS>>>>>LMPgaftergageg54
, Primarygovarianginsufficiencyg-
gANSWERS>>>>>Menopausegthatgoccursgbeforegageg40
Earlygmenopausegtransitiong(stageg-2)g-
gANSWERS>>>>>Persistentgdifferencegofg7gdaysgorgmoregingtheg
lengthgofgconsecutivegcycles.
Lategmenopausegtransitiong(stageg-1)g-
gANSWERS>>>>>60gorgmoregconsecutivegdaysgofgamenorrhea
Lutealgoutgofgphasegeventg(LOOP)g-
gANSWERS>>>>>Explainsgwhygsomegperimenopausalgwomenghavegel
evatedgestrogenglevelgsometimes...Ingthegearlygmenopausegt
ransition,gelevatedgFSHglevelsgaregadequategtogrecruitgagse
condgfolliclegwhichgresultsgingagfolliculargphase-
likegrisegingestradiolgsecretiongsuperimposedgongthegmid-
to-lateglutealgphasegofgthegongoinggovulatorygcycle.
Obesegwomengandgestradiolglevelsgduringgmenopauseg-
gANSWERS>>>>>Obesegwomengaregmoreglikelygtoghaveganovulator
ygcyclesgwithghighgestradiolglevels.gTheygaregalsogmoreglike
lygtoghaveglowergpremenopausegyetghighergpostmenopausegestr
adiolglevelsgcomparedgwithgwomengofgnormalgweight.g(whygthe
ygaregatghighergriskgofgendometrialgcancer)
ChinesegandgJapanesegwomeng-
gANSWERS>>>>>Thesegethnicggroupsghaveglowergestradiolglev
elsgthengwhite,gblackgandghispanicgwomen.
stageg+2g-gANSWERS>>>>>lategmenopausegstage:g5-
8gyearsgaftergFMP.gSomaticgaginggpredominates.gIncreasedgge
nitourinarygsymptoms.
Stagesg+1a,g+1b,g+1cg-
gANSWERS>>>>>earlygpostgmenopause:g2gyearsgaftergFMP.gFSHg
rises,gestradiolgdecreases.gVMSgpredominate.
