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Secondary Amennorrhea - sachin007 - Printable Version +- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com) +-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1) +--- Forum: Step 3 (https://www.usmleforum.com/forumdisplay.php?fid=6) +--- Thread: Secondary Amennorrhea - sachin007 (/showthread.php?tid=587925) Pages:
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Secondary Amennorrhea - sachin007 - ArchivalUser - 05-24-2011 33, f, 6 month history of amenorrhea. BMI - 31.5, Pregnancy test negative. What is the best next step in management? 1. Estrogen levels 2. Progestin challenge 3. FSH & LH 4. TSH 5. Testesterone & DHEAS 0 - ArchivalUser - 05-24-2011 2.. 0 - ArchivalUser - 05-24-2011 why not 4. As far as i remember MTB has a table where they check TSH first and go on to do the others. Please explain 0 - ArchivalUser - 05-24-2011 4 ... i suspect hypothyroidism BMI 31.5 hhmmmm 0 - ArchivalUser - 05-24-2011 this question is in u world... i was confused as well... after bhcg negative next step is progesterone challenge test.... Q 102 . U World sec amenorrhea work up... 1.pregnancy test 2.progesterone challenge test 3.tsh 4.prolactin 0 - ArchivalUser - 05-24-2011 Yes. This is Uworld question. Check page 440 of MTB. I personally think TSH is a better answer. Any other suggestions? 0 - ArchivalUser - 05-24-2011 this is a case of secondary amenorrhea: according to fisher, the steps in the w/u: 1. pregnancy test 2. TSH 3.Prolactin 4. progestgerone challenge test 5. estrogen-progesterone challenge test 0 - ArchivalUser - 05-24-2011 Yes, Sachin even I think prolactin and TSH should be done first 0 - ArchivalUser - 05-24-2011 Tsh can't show the direct cause of amoenorrhoea,it is likely association. Q is asking the best next test....that should be the progesterone challenge test that can give direct clue for amoenorrhoea. 0 - ArchivalUser - 05-24-2011 But don't we test for the most common cause first? |