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