AMENORRHEA Flashcards
1
Q
40 yo F presents with amenorrhea, morning nausea and vomiting, fatigue, and polyuria. Her last menstrual period was six weeks ago, and her breasts are full and tender. She uses the rhythm method for contraception.
A
Pregnancy Anovulatory cycle Hyperprolactinemia UTI Thyroid disease
Pelvic exam Urine hCG U/S—pelvis CBC, electrolytes UA, urine culture Prolactin, TSH Baseline Pap smear, cervical cultures, rubella antibody, HIV antibody, hepatitis B surface antigen, and VDRL/ RPR
2
Q
23 yo obese F presents with amenorrhea
for six months, facial hair, and infertility
for the past three years.
A
Polycystic ovary syndrome Thyroid disease Hyperprolactinemia Pregnancy Ovarian or adrenal malignancy Premature ovarian failure
Pelvic exam Urine hCG U/S—pelvis LH/FSH, TSH, prolactin Testosterone, DHEAS
3
Q
35 yo F presents with amenorrhea,
galactorrhea, visual fi eld defects, and
headaches for the past six months
A
Amenorrhea secondary to prolactinoma Pregnancy Thyroid disease Premature ovarian failure Pituitary tumor
Pelvic and breast exam Urine hCG Prolactin LH/FSH, TSH MRI—brain
4
Q
48 yo F presents with amenorrhea for the
past six months accompanied by hot
fl ashes, night sweats, emotional lability,
and dyspareunia.
A
Menopause
Pregnancy
Pituitary tumor
Thyroid disease
Pelvic exam Urine hCG LH/FSH, TSH, prolactin, testosterone, DHEAS CBC MRI—brain
5
Q
35 yo F presents with amenorrhea, cold intolerance, coarse hair, weight loss, and fatigue. She has a history of abruptio placentae followed by hypovolemic shock and failure of lactation two years ago.
A
Sheehan’s syndrome Premature ovarian failure Pituitary tumor Thyroid disease Asherman’s syndrome
Pelvic exam Urine hCG CBC LH/FSH, prolactin TSH, FT4 ACTH MRI—brain Hysteroscopy
6
Q
18 yo F presents with amenorrhea for the
past four months. She has lost 95 pounds
and has a history of vigorous exercise and
cold intolerance.
A
Anorexia nervosa
CBC TSH FT4 ACTH FSH LH
7
Q
29 yo F presents with amenorrhea for the
past six months. She has a history of
occasional palpitations and dizziness. She
lost her fi ancé in a car accident.
A
Anxiety-induced amenorrhea
CBC TSH FT4 ACTH Urine cortisol level Progesterone challenge test FSH/LH/estradiol levels
