AMENORRHEA

Question 1

Pregnancy DDx:

4

Answer 1

1. Anovulatory cycle.
2. Hyperprolactinemia.
3. UTI.
4. Hypothyroidism.

Question 2

Pregnancy workup:

7

Answer 2

1. Urine hCG.
2. US abdo/pelvis.
3. Pelvic exam.
4. CBC.
5. UA, urine culture.
6. Prolactin, TSH.
7. Baseline pap, cervical cultures, rubella antibody, HIV antibody, HBsAg, VDRL/RPR.

Question 3

PCOS DDx:

5

Answer 3

1. Thyroid disease.
2. Hyperprolactinemia.
3. Pregnancy.
4. Ovarian or adrenal malignancy.
5. Premature ovarian failure.

Question 4

PCOS workup:

4

Answer 4

1. Urine hCG.
2. LH/FSH, TSH, prolactin.
3. Pelvic exam.
4. Testosterone, DHEAS.

Question 5

Amenorrhea 2o to prolactinoma DDx:

4

Answer 5

1. Pregnancy.
2. Thyroid disease.
3. Premature ovarian failure.
4. Pituitary tumor.

Question 6

Amenorrhea 2o to prolactinoma workup:

4

Answer 6

1. Urine hCG.
2. LH/FSH, TSH, prolactin.
3. MRI brain.
4. Pelvic and breast exams.

Question 7

Menopause DDx:

3

Answer 7

1. Pregnancy.
2. Pituitary tumor.
3. Thyroid disease.

Question 8

Menopause workup:

6

Answer 8

1. Urine hCG.
2. LH/FSH, TSH, prolactin.
3. Testosterone, DHEAS.
4. Pelvic exam.
5. CBC.
6. MRI brain.

Question 9

Sheehan’s syndrome DDx:

4

Answer 9

1. Premature ovarian failure.
2. Pituitary tumor.
3. Thyroid disease.
4. Asherman’s syndrome.

Question 10

Sheehan’s syndrome workup:

8

Answer 10

1. Urine hCG.
2. LH/FSH, prolactin.
3. CBC.
4. Pelvic exam.
5. TSH, FT4.
6. ACTH.
7. MRI brain.
8. Hysteroscopy.

Question 11

Anorexia nervosa DDx:

2

Answer 11

1. Pregnancy.

2. Hyperthyroidism.

Question 12

Anorexia nervosa workup:

4

Answer 12

1. Urine hCG.
2. CBC.
3. TSH, FT4.
4. LH/FSH.

Question 13

Anxiety-induced amenorrhea DDx:

3

Answer 13

1. Posttraumatic stress disorder.
2. Depression.
3. Hyperthyroidism.

Question 14

Anxiety-induced amenorrhea workup:

5

Answer 14

1. CBC.
2. TSH, FT4.
3. Urine cortisol level.
4. Progesterone challenge test.
5. LH/FSH, estradiol level.