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16 Cards in this Set

  • Front
  • Back
Key History -
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
Key PE -
VS
breast exam
complete pelvic exam
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
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
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
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
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
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
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
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
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
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
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
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
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
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