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NAMs Menopause Certification Exam With Complete Solutions.
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NAMs Menopause Certification Exam With Complete Solutions.Climacteric phase - Answer The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the time of menopause.
Early menopause - Answer LMP before age 45
Late menopause - Answer LMP after age 54
Primary ovarian insufficiency - Answer Menopause that occurs before age 40
Early menopause transition (stage -2) - Answer Persistent difference of 7 days or more in the length of consecutive cycles.
Late menopause transition (stage -1) - Answer 60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP) - Answer 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.
Obese women and estradiol levels during menopause - Answer 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)
Chinese and Japanese women - Answer These ethnic groups have lower estradiol levels then white, black and hispanic women.
stage +2 - Answer late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c - Answer early post menopause: 2 years after FMP. FSH rises,
estradiol decreases. VMS predominate.
Elevated FSH, LH - Answer Endocrine labs after menopause
AMH, inhibin B - Answer These hormones work during reproductive years to not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms - Answer Menstrual cycle shortenes, follicular phase compresses, women spend more time in luteal phase.. meaning more premenstrual symptoms and more frequent menstrual periods.
How to respond if a patient requests FSH lab? - Answer many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low FSH is not helpful. NAMs Menopause Certification Exam With Complete Solutions.
The potentially superior marker of menopause, a lab. - Answer AMH
DHEA (dehydroepiandrosterone) - Answer Adrenal androgens: precursor hromones produced by the adrenal gland that are enzymatically converted to active androgens or estrogens in peripheral tissues.
Location of estrogen receptors - Answer Vagina, vulva, urethra, trigone of the bladder
Effects of estrogen on tissue - Answer maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports microbiome and protects tissue from pathogens.
Vaginal changes with menopause - Answer Thinning, loss of elasticity, loss or absence or rugae.
Vagina and urethra in menopause - Answer vagina narrows, urethra moves closer to
the introitus.
Stress urinary incontinence - Answer Vaginal estrogen and urinary incontinence: what type does it help with?
Treatment for FPHL - Answer Minoxidil, spironolactone, finasteride, estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH, AFC, inhibin? - Answer -3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low. -3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
When it is appropriate to check an FSH during the cycle if you check it? and why? - Answer Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH level.
AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak? - Answer 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.
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