NAMS MENOPAUSE CERTIFICATION EXAM STUDY SET
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+|
|BRAND NEW VERSION!!
1. secondary causes of osteoporosis
which 3 common drugs?: Hyperthyroidism, hyperparathyroidism, hypercalciuria, certain drugs (eg: tamox- ifen, steroids,
PPIs), calcium/vitamin D deficiency, RA, celiac disease, malabsorptive diseases such as Crohn disease, and ulcerative colitis
2. Median age of menopause in US women: 52.54 y
3. POI: Intermittent ovarian function & insuflcient estrogen levels occurring at age <40 y
4. which STRAW stage?
menarche / early reproductive: -5
5. which STRAW stage?
peak reproductive: -4
6. which STRAW stage?
late reproductive: -3
7. which STRAW stage?
perimenopause: -2 to -1 & +1a
8. which STRAW stage?
FMP &
12 months after final menstrual period: FMP = 0 12
months after = +1a
9. which STRAW stage?
VMS most likely: +1a (most likely)
-1 (likely)
,aka perimenopause/menopause transition
10. which STRAW stage?
early post menopause: +1a to +1c
11. which STRAW stage?
late postmenopause: +2
12. which STRAW stage?
amenorrhea >60 days: -1
aka late menopause transition
13. which STRAW stage?
variable cycle lengths of >7 days differences: -2 aka early
menopause transition
14. difference between menopause transition vs perimenopause per STRAW criteria?:
menopause transition: -2 and -1, prior to FMP
perimenopause: -2 to +1a, includes 12 mo of amenorrhea following FMP
15. which STRAW stage?
initial drop in AMH/AFC/inhibin, cycles still regular, FSH normal: -3b
aka late reproductive
16. which STRAW stage?
cycles shorter, first increase in FSH: -3a
aka late reproductive
17. levels spike with ovulation, marker of ovarian reserve: inhibin B
18. Produced by granulosa cells of activated follicles, most reflective of true ovarian
reserve; provides the best single prediction of time to menopause: AMH
, 19. what day of cycle to draw FSH to predict ovarian response/reserve?: day 3
20. normal day 3 FSH?
FSH value for menopause?: < 10
>25
21. # of ultrasound detected follicles 2-10 mm in size: AFC (antral follicle count)
22. normal AFC: >12
23. Luteal-Out-Of-Phase (LOOP) event: - FSH elevation recruits follicles for the subsequent cycle before the
current cycle is over
- Excess estradiol production as new follicles start growing
- Increase chance of TWINS
- Very short follicular phase
- More time spent in luteal phase (more PMS/PMDD sx)
24. symptoms of LOOP event: —Mastalgia
—Worsening migraine
—Growing fibroids
—Risk of endometrial hyperplasia
- longer time in luteal phase (worsening PMDD in peri)
25. premenopausal vs postmenopausal estradiol levels in obesity: pre: lower, more anovulatory
cycles
post: higher
26. consequence of inhibin B and AMH drop in early menopause transition?: FSH spikes --> fas
growth of remaining follicles (twins more likely) --> shorter follicular phase --> follicle atresia --> LOOP cycles --> pronounced PMS sx
from longer luteal phase --> cycle irregularity by >7 days
27. dec ovarian reserve causes the drop in what 2 hormones?: inhibin B and AMH
28. 4 adrenal androgens: —Dehydroepiandrosterone (DHEA)
—Dehydroepiandrosterone sulfate (DHEAS)
—Androstenedione
—Testosterone
29. where are adrenal androgens converted to estrogen?: peripheral tissue
30. what happens to DHEA levels during menopause transition?: transient increase then return to
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+|
|BRAND NEW VERSION!!
1. secondary causes of osteoporosis
which 3 common drugs?: Hyperthyroidism, hyperparathyroidism, hypercalciuria, certain drugs (eg: tamox- ifen, steroids,
PPIs), calcium/vitamin D deficiency, RA, celiac disease, malabsorptive diseases such as Crohn disease, and ulcerative colitis
2. Median age of menopause in US women: 52.54 y
3. POI: Intermittent ovarian function & insuflcient estrogen levels occurring at age <40 y
4. which STRAW stage?
menarche / early reproductive: -5
5. which STRAW stage?
peak reproductive: -4
6. which STRAW stage?
late reproductive: -3
7. which STRAW stage?
perimenopause: -2 to -1 & +1a
8. which STRAW stage?
FMP &
12 months after final menstrual period: FMP = 0 12
months after = +1a
9. which STRAW stage?
VMS most likely: +1a (most likely)
-1 (likely)
,aka perimenopause/menopause transition
10. which STRAW stage?
early post menopause: +1a to +1c
11. which STRAW stage?
late postmenopause: +2
12. which STRAW stage?
amenorrhea >60 days: -1
aka late menopause transition
13. which STRAW stage?
variable cycle lengths of >7 days differences: -2 aka early
menopause transition
14. difference between menopause transition vs perimenopause per STRAW criteria?:
menopause transition: -2 and -1, prior to FMP
perimenopause: -2 to +1a, includes 12 mo of amenorrhea following FMP
15. which STRAW stage?
initial drop in AMH/AFC/inhibin, cycles still regular, FSH normal: -3b
aka late reproductive
16. which STRAW stage?
cycles shorter, first increase in FSH: -3a
aka late reproductive
17. levels spike with ovulation, marker of ovarian reserve: inhibin B
18. Produced by granulosa cells of activated follicles, most reflective of true ovarian
reserve; provides the best single prediction of time to menopause: AMH
, 19. what day of cycle to draw FSH to predict ovarian response/reserve?: day 3
20. normal day 3 FSH?
FSH value for menopause?: < 10
>25
21. # of ultrasound detected follicles 2-10 mm in size: AFC (antral follicle count)
22. normal AFC: >12
23. Luteal-Out-Of-Phase (LOOP) event: - FSH elevation recruits follicles for the subsequent cycle before the
current cycle is over
- Excess estradiol production as new follicles start growing
- Increase chance of TWINS
- Very short follicular phase
- More time spent in luteal phase (more PMS/PMDD sx)
24. symptoms of LOOP event: —Mastalgia
—Worsening migraine
—Growing fibroids
—Risk of endometrial hyperplasia
- longer time in luteal phase (worsening PMDD in peri)
25. premenopausal vs postmenopausal estradiol levels in obesity: pre: lower, more anovulatory
cycles
post: higher
26. consequence of inhibin B and AMH drop in early menopause transition?: FSH spikes --> fas
growth of remaining follicles (twins more likely) --> shorter follicular phase --> follicle atresia --> LOOP cycles --> pronounced PMS sx
from longer luteal phase --> cycle irregularity by >7 days
27. dec ovarian reserve causes the drop in what 2 hormones?: inhibin B and AMH
28. 4 adrenal androgens: —Dehydroepiandrosterone (DHEA)
—Dehydroepiandrosterone sulfate (DHEAS)
—Androstenedione
—Testosterone
29. where are adrenal androgens converted to estrogen?: peripheral tissue
30. what happens to DHEA levels during menopause transition?: transient increase then return to
