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39 yo woman, hasnot had mens for past 2 months. B4 that time, she was having reg monthly mens of 28ds with 4 day menses. Lately she has been feeling cold and experiencing "on and off" constipation. Hx of migraines and lap. left ovarian cystectomy 15 yrs ago. Divorced and has 2 chlidren, 10 and 8 yo. PE shows puffy eyes, pale and dry skin, diffuse alopecia. the other PE including breast and pelvic exams are normal.
A. Endometrial biopsy
B. serum FSH
C. serum TSH
D. urine hCG
E. Pelvic CT
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I chose the same, but there is diff Ans !
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is it urine hcg i mean pregnancy is the mcc of secondary amenorrhoea
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B.serum FSH...she is going into premature ovarian failure...
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sec amenorrhea-rule is to rule out preg first
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Yes you have to r/o preg 1st in secondary ammenorrhea than if negative next step esp w/ her h/o constipation.....e.t.c TSH levels next to check for hypothyroidsm as incr TSH levels inhibit the Hyp-pit axisis
