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2023/2024 NAMS Exam study guide with questions and answers
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2023/2024 NAMS Exam study guide with questions and answers
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2023/2024 NAMS Exam study guide withquestions and answers
By 2020, number of women over 50 - ANS 64 million
By 2060, number of women over 50 - ANS 90 million
What is the US female life expectancy - ANS 81.2 years
How many oocytes in the ovary at 20 weeks pregnancy - ANS 6-7 Million
How many oocytes left at birth - ANS 1-2 million
How many oocytes left at puberty - ANS 300,000-500,000
What is the period of change at menopause - ANS Climacteric or perimenopause
What is the term for menopause that occurs before age 45 - ANS Early menopause
What is the term for menopause that occurs after age 54 - ANS Late menopause
What is the timeframe within the first 8 years after FMP (and what numerical SWAN stages
correspond?) - ANS Early post menopause (+1a, +1b, +1c)
What is the timeframe called after 8 years from FMP (and what numerical SWAN stage
corresponds?) - ANS Late post menopause (+2)
What is the time before FMP with cycle variability (and what numerical SWAN stages
correspond?) - ANS Menopause transition (-2, -1)
What is the time of 7 or more days persistent difference in cycle length (and what numerical
SWAN stage corresponds?) - ANS Early menopause transition (-2)
What is the time with 60 or more days of amenorrhea at least once (and what numerical SWAN
stage corresponds?) - ANS Late menopause transition (-1)
What is a retrospective determination of 12 months of amenorrhea - ANS Natural
menopause
What is the timeframe from onset of menstrual cycle irregularity to 1 year after final menopause
transition - ANS Perimenopause
,What is any time frame after FMP - ANS Post menopause
What is the preferred term for menopause before age 40 - ANS Primary ovarian
insufficiency (POI)
Preferred since this may not be a permanent state
What term for menopause before age 40 should no longer be used - ANS Premature
ovarian failure
What percentage of US women experience POI - ANS 1%
How many total stages in STRAW - ANS 10 total
Reproductive has 4 (-5 to -3a)
Menopause Transition has 2 (-2 to -1)
Post Menopause has 4 (+1a to +2)
How many reproductive stages in STRAW - ANS 4 (-5 early reproductive, -4 Peak
reproductive, -3b and -3b late reproductive)
How many stages in menopause transition in STRAW - ANS 2 (-2 early transition, -1 late
transition)
How many stages in postmenopause in STRAW - ANS 4 (+1a, +1b and +1c early PM, +2
late PM)
Which STRAW stage is menarche in - ANS -5 early reproductive
In which STRAW stage are cycles every 21 to 35 days - ANS -4 Peak reproductive
What differentiates STRAW stage -3b from -3a - ANS -3b cycles normal, FSH wnl, AMH,
AFC, inhibit B low
-3a shorter cycles, variable FSH
What effect do inhibin B and AMH have on follicles - ANS They prevent too many follicles
from growing at once, so the follicle pool is not depleted too quickly
What happens to inhibin b and AMH levels during menopause transition - ANS Decreased
number of follicles leads to decreased levels of both of these products.
This means more follicular atresia
What is a LOOP event - ANS Luteal Out of Phase event
Explains why some perimenopausal women have elevated estrogen levels sometimes.
In early menopause, transition, elevated FSH is adequate to recruit a second follicle.
, This results in a follicular phase-like rise in estradiol during the luteal phase
Compared to normal weight women, how do the pre-menopause and post menopause estradiol
levels of obese women compare - ANS Lower pre-menopause estradiol
Higher post menopause estradiol
Which ethnic groups have lower estradiol levels, compared to white/black/Hispanic women -
ANS Chinese and Japanese women
Where is AMH produced - ANS Granulosa cells of antral and preantral follicles
When does AMH peak - ANS Around 25 yo
(so before age 25, test is not helpful)
How does birth control affect AMH - ANS Lowers it
What is AFC - ANS Antral follicle count
Number of follicles 2-10 mm detected with ultrasound
Do African-American women have higher or lower FSH levels - ANS Higher
Do Chinese and Japanese women have higher or lower estradiol levels compared to white
women - ANS Lower
What happens to SHBG at menopause - ANS Decreases
(T:SHBG ratio increases by 80%)
What is the Free Androgen Index - ANS T:SHBG ratio
What hormone is generally higher in obese women and why - ANS Estrone
Due to aromatization of estradiol to estrone by excess adipose tissue
What 2 hormones does the postmenopausal ovary continue to produce - ANS Testosterone
Androstenedione
Surgical menopause reduces what hormone as compared to natural menopause - ANS
Testosterone
(40 to 50% lower)
In menopause transition, women spend more time in what menstrual phase - ANS Luteal
What is the HPO axis theory of menopause transition - ANS HPO access becomes less
sensitive to estrogen.
Even with good follicle, growth and estradiol, LH surges fail, leading to cycle irregularity.
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