Question 1

A 16-year-old female is diagnosed with primary amenorrhea. A pregnancy test is negative. Further testing reveals a normal TSH and an elevated prolactin level. Which test will the provider order next?&#10;A) Clomiphene challenge test&#10;B) Magnetic resonance imaging (MRI)&#10;C) Progesterone challenge test&#10;D) Serum dehydroepiandrosterone (DHEA)

Accepted Answer

An elevated prolactin level can be a sign of a pituitary tumor or other abnormalities in the pituitary gland. An MRI can help diagnose any structural issues with the gland. The other tests listed are not appropriate for diagnosing pituitary issues.

Question 2

A 15-year-old female who participates in high school track and gymnastics is experiencing amenorrhea after having eight normal periods. A pregnancy test is negative. What may be included in management of this patient's amenorrhea to restore normal periods? (Select all that apply.)

A) Calcium and vitamin D supplementation
B) Clomiphene administration
C) Combination oral contraceptives
D) Dietician consultation
E) Estriol therapy

A, D

Accepted Answer

Calcium and vitamin D supplementation and dietician consultation may be included in management of this patient's amenorrhea to restore normal periods.

Question 3

An adolescent female presents with amenorrhea. The provider notes short stature, neck webbing, and a pigeon chest deformity. Based on these symptoms, what is the underlying disorder most likely causing this patient's amenorrhea?

A) Androgen insensitivity
B) Hypothyroidism
C) Polycystic ovarian disease
D) Turner's syndrome

D

Accepted Answer

The presentation of short stature, neck webbing, and a pigeon chest deformity are characteristic of Turner's syndrome, a genetic disorder where females only have one X chromosome instead of two. Amenorrhea is commonly seen in Turner's syndrome due to underdeveloped ovaries. Androgen insensitivity and polycystic ovarian disease do not present with the same physical characteristics seen in this patient. While hypothyroidism can cause amenorrhea, it does not typically present with the same physical characteristics seen in Turner's syndrome.

Deck 137: Amenorrhea