Secondary amenorrhea
In a case of secondary amenorrhea who fails to get withdrawl bleeding after taking E and P, the fault lies at the level of :
| A |
Pituitary |
|
| B |
Hypothalamus |
|
| C |
Ovary |
|
| D |
Endometrium |
In a case of secondary amenorrhea who fails to get withdrawl bleeding after taking E and P, the fault lies at the level of :
| A |
Pituitary |
|
| B |
Hypothalamus |
|
| C |
Ovary |
|
| D |
Endometrium |
Ans. is d i.e. Endometrium
Read the question carefully, it says absence of withdraw! bleeding after estrogen-progesterone challenge test.
Oestrogen progesterone challenge test
Procedure : Ethinyl estradiol (.02 mg) or conjugated equine estrogen (1.25 mg) is given daily for 25 days. Medroxy progesterone acetate 10mg daily is added from day 15 – 25 (Alternatively estrogen is given for 21 days and progesterone is added in last 5 days).
The test creates a condition similar to normal Menstrual cycle
Withdraw! bleeding occurs
Means endometrium and outflow tract are normal and if provided by normal hormonal levels, result in menstruation.
Defect lies in production of estrogen i.e. either in ovare/Pituitarya/Hypothalamus
No withdraw! bleeding
Means their is a defect in endometrium° or outflow tract° (As despite normal hormonal sequence no bleeding occurs).
In secondary amenorrhea the cause could be :
| A |
Stein leventhal syndrome |
|
| B |
Premature ovarian failure |
|
| C |
Imperforate hymen |
|
| D |
Option A and B both |
In secondary amenorrhea the cause could be :
| A |
Stein leventhal syndrome |
|
| B |
Premature ovarian failure |
|
| C |
Imperforate hymen |
|
| D |
Option A and B both |
Option A and B both
Commonest cause of secondaryamenorrhea is :
| A |
TB |
|
| B |
Pregnancy |
|
| C |
Post pill amenorrhea |
|
| D |
Anaemia |
Commonest cause of secondaryamenorrhea is :
| A |
TB |
|
| B |
Pregnancy |
|
| C |
Post pill amenorrhea |
|
| D |
Anaemia |
Pregnancy
A lady presented with secondary amenorrhea 6 months after having an abortion. Her FSH levels were measured as 6 mlU/ml what is the most probable diagnosis:
| A |
Pituitary failure |
|
| B |
Ovarian failure |
|
| C |
Fresh pregnancy |
|
| D |
Uterine synechiae |
A lady presented with secondary amenorrhea 6 months after having an abortion. Her FSH levels were measured as 6 mlU/ml what is the most probable diagnosis:
| A |
Pituitary failure |
|
| B |
Ovarian failure |
|
| C |
Fresh pregnancy |
|
| D |
Uterine synechiae |
Since the lady in the question is having secondary amenorrhea following an abortion, uterine synechiae is the most likely cause.
Low normal FSH level is consistent with uterine abnormality. (Normal serum FSH value in adult is woman is 5-20 mlU).
Female with secondary amenorrhea with serum prolactin level 75 ng/ml is to be treated with ‑
| A |
Cabergoline |
|
| B |
Ganirelix |
|
| C |
Clomiphene |
|
| D |
Estradiol |
Female with secondary amenorrhea with serum prolactin level 75 ng/ml is to be treated with ‑
| A |
Cabergoline |
|
| B |
Ganirelix |
|
| C |
Clomiphene |
|
| D |
Estradiol |
Ans. is ‘a’ i.e., Cabergoline
A young women with secondary amenorrhea and galactorrhea. MRI shows a tumour of < lOmm diameter in the pituitary fossa. Treatment is:
| A |
Hormonal therapy for withdrawal bleeding |
|
| B |
Radiotherapy |
|
| C |
Chemotherapy |
|
| D |
Bromocriptine |
A young women with secondary amenorrhea and galactorrhea. MRI shows a tumour of < lOmm diameter in the pituitary fossa. Treatment is:
| A |
Hormonal therapy for withdrawal bleeding |
|
| B |
Radiotherapy |
|
| C |
Chemotherapy |
|
| D |
Bromocriptine |
Answer is D (Bromocriptine):
Secondary Amenorrhea and galactorrhea in a young women with evidence of microadenoma (tumor I Omm) in the pituitary fossa suggest a diagnosis of prolactinoma.
Oral dopamine agonists (Dopamine or Cabergoline) are the treatment of choice for patients with prolactinomas.
