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First Aid: Step 2 CS > Differential & Work-up: Amennorhea, Abuse > Flashcards

Differential & Work-up: Amennorhea, Abuse Flashcards

1
Q

40 yo F presents with amenorrhea, morning nausea and vomiting, fatigue, and polyuria. Her last menstrual period was 6 weeks ago. Her breasts are full and tender. She uses the rhythm method for contraception.

A
  1. Pregnancy
  2. Anovulatory cycle
  3. Hyperprolactinemia
  4. UTI
  5. Hypothyroidism
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2
Q

WORK UP FOR:

  1. Pregnancy
  2. Anovulatory cycle
  3. Hyperprolactinemia
  4. UTI
  5. Hypothyroidism
A
  1. Urine hCG
  2. Pelvic exam
  3. U/S-transvaginal
  4. CBC
  5. UA, urine culture
  6. Prolactin, TSH
  7. Baseline Pap smear, cervical cultures, rubella antibody, HIV antibody, HBs Ag, VDRL/RPR
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3
Q

23 yo obese F presents with amenorrhea for 6 months, facial hair, and infertility for the past 3 years.

A
  1. Polycystic ovary syndrome
  2. Thyroid disease
  3. Hyperprolactinemia
  4. Pregnancy
  5. Ovarian or adrenal malignancy
  6. Premature ovarian failure
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4
Q

WORK UP FOR:

  1. Polycystic ovary syndrome
  2. Thyroid disease
  3. Hyperprolactinemia
  4. Pregnancy
  5. Ovarian or adrenal malignancy
  6. Premature ovarian failure
A
  1. Pelvic exam
  2. Urine hCG
  3. Transabdominal & transvaginal ultrasound
  4. LH/FSH, TSH, prolactin
  5. Testosterone, DHEAS
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5
Q

35 yo F presents with amenorrhea, galactorrhea, visual field defects, and headaches for the past 6 months.

A
  1. Amenorrhea secondary to prolactinoma
  2. Pregnancy
  3. Thyroid disease
  4. Premature ovarian failure
  5. Pituitary tumor
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6
Q

WORK UP FOR:

  1. Amenorrhea secondary to prolactinoma
  2. Pregnancy
  3. Thyroid disease
  4. Premature ovarian failure
  5. Pituitary tumor
A
  1. Pelvic and breast exams
  2. Urine hCG
  3. LH/FSH, TSH, prolactin
  4. MRI-brain
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7
Q

48 yo F presents with amenorrhea for the past 6 months accompanied by hot flashes, night sweats, emotional lability. and dyspareunia.

A
  1. Menopause
  2. Pregnancy
  3. Pituitary tumor
  4. Thyroid disease
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8
Q

WORK UP FOR:

  1. Menopause
  2. Pregnancy
  3. Pituitary tumor
  4. Thyroid disease
A
  1. Pelvic exam
  2. Urine hCG
  3. LH/FSH, TSH, prolactin
  4. Testosterone, DHEAS
  5. CBC
  6. MRI-brain
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9
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 2 years ago.

A
  1. Pituitary infarction (Sheehan syndrome)
  2. Premature ovarian failure
  3. Pituitary tumor
  4. Thyroid disease
  5. Asherman syndrome
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10
Q

WORK UP FOR:

  1. Pituitary infarction (Sheehan syndrome)
  2. Premature ovarian failure
  3. Pituitary tumor
  4. Thyroid disease
  5. Asherman syndrome
A
  1. ACTH
  2. Pelvic exam
  3. Urine hCG
  4. LH/FSH, prolactin
  5. CBC
  6. TSH, FT4
  7. MRI-brain
  8. Hysteroscopy
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11
Q

18 yo F presents with amenorrhea for the past 4 months. BMI is 14.5 kg/m2. She attends vigorous exercise classes frequently and has a history of heat intolerance.

A
  1. Anorexia nervosa
  2. Pregnancy
  3. Hyperthyroidism
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12
Q

WORK UP FOR:

  1. Anorexia nervosa
  2. Pregnancy
  3. Hyperthyroidism
A
  1. Urine hCG
  2. CBC
  3. Electrolytes
  4. TSH, FT4
  5. LH/FSH
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13
Q

29 yo F presents with amenorrhea for the past 6 months. She has a history of occasional palpitations and dizziness. She lost her fiance in a car accident in which she was a passenger.

A
  1. Anxiety-induced amenorrhea
  2. Pregnancy
  3. Posttraumatic stress disorder
  4. Depression
  5. Hyperthyroidism
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14
Q

WORK UP FOR:

  1. Anxiety-induced amenorrhea
  2. Pregnancy
  3. Posttraumatic stress disorder
  4. Depression
  5. Hyperthyroidism
A
  1. Urine hCG
  2. CBC
  3. TSH, FT4
  4. Urine cortisol level
  5. Progesterone challenge test
  6. LH/FSH, estradiol levels
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15
Q

28 yo F c/o multiple facial and bodily injuries. She claims that she fell on the stairs. She was hospitalized for physical injuries 7 months ago. She presents with her husband.

A
  1. Domestic violence
  2. Osteogenesis imperfecta
  3. Substance abuse
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16
Q

WORK UP FOR:

  1. Domestic violence
  2. Osteogenesis imperfecta
  3. Substance abuse
A
  1. XR-skeletal survey
  2. CT -maxillofacial
  3. Urine toxicology
17
Q

30 yo F presents with multiple facial and physical injuries. She states that she was attacked and raped by two men.

A
  1. Forensic exam (Sexual Assault Forensic Evidence: SAFE collection kit)
  2. Pelvic exam
  3. Urine B-hCG
  4. Wet mount, KOH prep
  5. Cervical cultures
  6. Chlamydia and gonorrhea testing
  7. XR-skeletal survey
  8. CBC
  9. HIV antibody
  10. Viral hepatitis serologies

First Aid: Step 2 CS (23 decks)

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