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16 Cards in this Set
- Front
- Back
Key History -
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Primary vs. secondary
duration possible pregnancy associated Sxs - headache decreased peripheral vision galactorrhea hirsutism virilization hot flashes vaginal dryness Sxs of thyroid disease h/o anorexia nervosa excessive dieting vigorous exercise pregnancies D&C uterine infections drug use medications |
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Key PE -
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VS
breast exam complete pelvic exam |
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40 y/o F
presents with amenorrhea, morning n/v, fatigue and polyuria. Her LMP was 6 wks ago and her breasts are full and tender. She uses the rhythm method for contraception. What is Differential? |
Pregnancy
anovulatory cycle hyperprolactinemia UTI thyroid disease |
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40 y/o F
presents with amenorrhea, morning n/v, fatigue and polyuria. Her LMP was 6 wks ago and her breasts are full and tender. She uses the rhythm method for contraception. What is Workup? |
Pelvic exam
urine hCG US - pelvis CBC, electrolytes UA, UC prolactin, TSH baseline pap smear, cervical cultures, rubella Ab, HIV Ab, HBsAg and RPR/VDRL |
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23 y/o obese F
presents with amenorrhea for six months, facial hair and infertility for the past three years. What is Differential? |
Polycystic ovarian syndrome
thyroid disease hyperprolactinemia pregnancy ovarian or adrenal malignancy premature ovarian failure |
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23 y/o obese F
presents with amenorrhea for six months, facial hair and infertility for the past three years. What is Workup? |
Pelvic exam
urine hCG US - pelvis LH/FSH, TSH, prolactin testosterone, DHEAS |
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35 y/o F
presents with amenorrhea, galactorrhea, visual field defects and headaches for the past 6 months. What is Differential? |
Amenorrhea secondary to
prolactinoma pregnancy thyroid disease premature ovarian failure pituitary tumor |
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35 y/o F
presents with amenorrhea, galactorrhea, visual field defects and headaches for the past 6 months. What is Workup? |
Pelvic and breast exams
urine hCG prolactin LH/FSH, TSH MRI - brain |
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48 y/o F
presents with amenorrhea for the past 6 months accompanied by hot flashes, night sweats, emotional lability and dyspareunia. What is Differential? |
Menopause
pregnancy pituitary tumor thyroid disease |
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48 y/o F
presents with amenorrhea for the past 6 months accompanied by hot flashes, night sweats, emotional lability and dyspareunia. What is Workup? |
Pelvic exam
urine hCG LH/FSH, TSH, prolactin, testosterone, DHEAS CBC MRI - brain |
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35 y/o F
presents with amenorrhea, cold intolerance, coarse hair, weight loss and fatigue. She has a h/o abruptio placentae followed by hypovolemic shock and failure of lactation 2 yrs. ago. What is Differential? |
Sheehan's syndrome
premature ovarian failure pituitary tumor thyroid disease Asherman's syndrome |
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35 y/o F
presents with amenorrhea, cold intolerance, coarse hair, weight loss and fatigue. She has a h/o abruptio placentae followed by hypovolemic shock and failure of lactation 2 yrs. ago. What is Workup? |
Pelvic exam
urine hCG CBC LH/FSH, prolactin TSH, FT4 ACTH MRI - brain hysteroscopy |
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18 y/o F
presents with amenorrhea for the past 4 mos. She has lost 95 lbs. and has a h/o vigorous exercise and cold intolerance. What is Differential? |
Anorexia nervosa
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18 y/o F
presents with amenorrhea for the past 4 mos. She has lost 95 lbs. and has a h/o vigorous exercise and cold intolerance. What is Workup? |
CBC
TSH FT4 ACTH FSH LH |
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29 y/o F
presents with amenorrhea for the past 6 mos. She has a h/o occasional palpitations and dizziness. She lost her fiance in a car accident. What is Differential? |
Anxiety-induced amenorrhea
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29 y/o F
presents with amenorrhea for the past 6 mos. She has a h/o occasional palpitations and dizziness. She lost her fiance in a car accident. What is Workup? |
CBC
TSH FT4 ACTH urine cortisol level progesterone challenge test |