Secondary Amenorrhea

Question 1

What type of amenorrhea?

(a) Failure of menarche to appear
(b) Menarche ordinarily occurs between 11-15 years

Answer 1

Primary Amenorrhea

Question 2

What type of amenorrhea?

Absence of menses for 3 consecutive months in women who have passed menarche

Answer 2

Secondary Amenorrhea

Question 3

What issue?

(a) Terminal episode of naturally occurring menses
(b) Retrospective diagnosis
(c) Usually after 6 months of amenorrhea

Answer 3

Menopause

Question 4

Premature ovarian failure

a) _____ -before age 45
(b) _____ - before age 40
(c) Frequently familial
(d) Usually (reversible or irreversible

Answer 4

a) Early menopause
b) Premature menopause
d) irreversible

Question 5

Menopause

-Normal age is what?

Answer 5

48-55 yo

Question 6

Women with premature menopause have

(a) A __% increased risk of coronary disease,
(b) A __% increased risk for stroke,
(c) A __% increased overall mortality.

Answer 6

a) 50%
b) 23%
c) 12%

Question 7

Disposition AMENORRHEA

(1) Any patient found to be pregnant should be _______
(2) Any non-pregnant patient who presents with secondary amenorrhea should be ______

Answer 7

1) MEDEVAC to Obstetrics.

2) routine referred to physician supervisor or gynecology for further evaluation.

Question 8

Initial operational labs for secondary amenorrhea

Answer 8

hCG

Question 9

Further laboratory work up for amenorrhea

Answer 9

(a) FSH
(b) LH
(c) TSH
(d) Prolactin
(e) Testosterone
- —-1) If hirsutism or virilization are present

Question 10

Your Amenorrhea patient has hirsutism or virilization present.
What lab would you run?

Answer 10

Testosterone

Question 11

If you suspect a Pituitary tumor what imaging is helpful?

Answer 11

MRI