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NAMS Certification – Questions With Solutions
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NAMS Certification – Questions With Solutions
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NAMS Certification – Questions With SolutionsPhysiology of VMS ✔️Ans - -thermoregulatory center altered by increase
in KNDy neurons
-activation of NK3R causes hot flashes
-blockade of NK3R reduces/eliminates hot flashes
-may also be affected by: serotonin, epinephrine, and norepinephrine;
parasympathetic nerve activity
Off label rx for VMS ✔️Ans - -SSRIs
-SNRIs
-Gabapentinoids
-Clonidine
-Oxybutynin
Studies on Fractional Co2 Laser for GSM ✔️Ans - -not FDA approved
-vaginal symptoms and sexual function scores increased significantly at 3
mon; noted continued improvement at 1y
Ospemifene (Osphena) indications and MOA ✔️Ans - -for treatment of
dyspareunia
-decreases vaginal pH
-improves vaginal dryness
-shifts vaginal maturational index to superficial cells
-estrogen agonist/antagonist
Ospemifene (Osphena) adverse effects ✔️Ans - -increase in uterine polyps
-proliferative endometrium
-slight increased risk of hemorrhagic stroke and VTE
-can increase VMS
treatment of urge incontinence ✔️Ans - -behavioral modifications
-overactivity of the detrusor muscle
-antimuscarinics: *oxybutynin*
-nerve stimulation
-botox
pelvic floor muscles - superficial ✔️Ans - -transverse perineal
, -bulbospongiosus,
-ischiocavernosus
pelvic floor muscles - deep ✔️Ans - -pubococcygeus
-iliococcygeus
-obturator internus
-coccygeus
What is low-tone pelvic floor dysfunction? ✔️Ans - -weak, underactive
and hypotonic muscles that cannot maintain adequate contraction
What is high-tone Pelvic Floor Dysfunction? ✔️Ans - -weak pelvic floor
muscles cannot attain or maintain adequate relaxation
-muscles are overactive, hypertonic, spastic, shortened
What are the symptoms of low-tone PFD? ✔️Ans - -heaviness
-pressure
-pelvic organ prolapse
-incontinence
-altered sexual sensation
What are the symptoms of high-tone PFD? ✔️Ans - -urinary retention
-frequency
-urgency
-dysuria
-fecal retention/constipation
-penetrative dyspareunia and/or vaginismus
Vaginal dilators for PFD ✔️Ans - -Choose size that does not cause pain
-Show how to insert with a mirror
-Apply lubricant to dilator, insert dilator as far as is comfortable, leave
dilator in place
for 5-10 min 1-2 times daily
-Use each for 4 wk before progressing to a size similar to partner size
HRT and cognition - natural menopause ✔️Ans - In RCT, HRT has little or
no overall effect on short or long-term cognition
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