Large Group 2: Amenorrhea and Oligomenorrhea -Gambone

Question 1

What will the pt presentation be in Kallman Syndrome and Turner Syndrome? what will be needed to differentiate?

Answer 1

both will present with primary amenorrhea with sexual infantilism

FSH low in Kallman

FSH high in Turner’s (45XO)

Question 2

Can Kallman Syndrome present with secondary amenorrhea? Turners?

Answer 2

Kallman==> probably not

Turners is not as rare, but not likely
-can ger pregnant (rare) but normally needs IVF

Question 3

If a pt presents with primary amenorrhea and breast development with Mullerian abnormalities, what test should be ordered?

Answer 3

Serum testosterone

• Androgen Insensitivity
• 46 XX karyotype (varying absence of Mullerian structures, WILL have ovaries)

Question 4

Can androgen insensitivity present with secondary amenorrhea?

Answer 4

NO

No uterus

Question 5

Can 46 XX (Meyer-Rokitansky-Kuster-Hauser Syndrome) present with secondary amenorrhea?

Answer 5

NO –> no uterus

only small amount of uterus in some –> not common to bleed

Question 6

What is the central defect presumed in women with PCOS?

Answer 6

increased sensitivity to LH