McGraw-Hill Specialty Board Review Pediatrics, Second Edition by Robert Daum & Jason Canel

Author:Robert Daum & Jason Canel [Daum, Robert]
Language: eng
Format: mobi
Publisher: McGraw-Hill
Published: 2011-06-20T14:00:00+00:00

8. (E) Obesity, thyroid dysfunction, hypothalamic amenorrhea, and functional adrenal or ovarian hyperandrogenism could explain this young woman’s 3-month history of amenorrhea. Androgen insensitivity would not be in the differential diagnosis because the patient had normal menses in the past.

9. (B) Even though there is no history of sexual activity, it is always important to exclude pregnancy in any adolescent with secondary amenorrhea. In this patient, because of her obesity and positive family history for diabetes and hyperlipidemia, she is at higher than normal long-term risk for cardiovascular disease. A fasting glucose and lipid profile should be ordered. TSH and prolactin level would help exclude hypothyroidism and hyperprolactinemia; total and free testosterone and DHEA-S levels will be useful to assess the cause of her clinical hyperandrogenism.

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