Primary Amenorrhea Quiz

2.

What are the common causes of amenorrhea?

Early menopause
Genetic defect
Severely over or under weight
All of the above

Correct Answer

A. All of the above

Explanation

Amenorrhea refers to the absence of menstrual periods, and it can be caused by various factors. Early menopause, which is the cessation of menstruation before the age of 40, can lead to amenorrhea. Genetic defects, such as Turner syndrome or androgen insensitivity syndrome, can also cause this condition. Additionally, being severely over or underweight can disrupt the hormonal balance in the body, leading to amenorrhea. Therefore, all of the mentioned causes - early menopause, genetic defects, and severe weight fluctuations - can contribute to the occurrence of amenorrhea.

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3.

Which of the following hormones is required for breast development?

FSH
LH
Progesterone
Estrogen
GnRH
Testosterone

Correct Answer

A. Estrogen

Explanation

Estrogen is the hormone required for breast development. During puberty, estrogen stimulates the growth and development of breast tissue, leading to the enlargement of the breasts. It promotes the proliferation of mammary gland cells and increases the deposition of fat in the breasts, resulting in their development and enlargement. Estrogen also plays a crucial role in the regulation of the menstrual cycle and the development of secondary sexual characteristics in females.

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4.

A 17-year-old female presents with Tanner stage IV breast development but no menses. Ultrasound confirms a blind vaginal vault and no uterus or cervix. What laboratory test would be most helpful in determining the etiology of her problem?

Serum prolactin level
Serum thyroid-stimulating hormone level
Pathologic examination of her gonads
Karyotype

Correct Answer

A. Karyotype

Explanation

A karyotype is a laboratory test that examines the number and structure of an individual's chromosomes. In this case, the absence of a uterus and cervix suggests a developmental abnormality, which may be caused by a chromosomal disorder. Therefore, performing a karyotype would be most helpful in determining the underlying cause of the patient's problem. This test can identify any chromosomal abnormalities, such as Turner syndrome (45,X), which is characterized by the absence or underdevelopment of certain reproductive structures and can lead to primary amenorrhea (lack of menstruation).

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5.

What is oligomenorrhea?

Irregular menstrual bleeding
Menstrual cycle lengths greater than 35 days
Regular bleeding occurs more frequently than every 21 days
Prolonged or excessive uterine bleeding occurs at regular intervals

Correct Answer

A. Menstrual cycle lengths greater than 35 days

Explanation

Oligomenorrhea is a condition characterized by infrequent or irregular menstrual bleeding. This means that the menstrual cycle lengths are greater than 35 days. It is not associated with regular bleeding occurring more frequently than every 21 days or with prolonged or excessive uterine bleeding occurring at regular intervals.

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6.

A 27-year-old female is concerned about the frequency of her periods. When discussing her menstrual cycle, she states that she has had 19-day cycles. Which term best matches her condition?

Menorrhagia
Metrorrhagia
Hypermenorrhea
Polymenorrhea

Correct Answer

A. Polymenorrhea

Explanation

Polymenorrhea is the term that best matches the condition described. Polymenorrhea refers to the condition in which a woman experiences menstrual cycles that are shorter than the average 28-day cycle, typically occurring every 21 days or less. In this case, the woman's cycles are only 19 days long, indicating a shorter interval between her periods. Menorrhagia refers to excessive or prolonged menstrual bleeding, metrorrhagia refers to irregular bleeding between periods, and hypermenorrhea refers to abnormally heavy menstrual flow.

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7.

What is the latest age in patients with 2° sexual characteristics (breast development, etc) in which primary amenorrhea is normal?

12
13
14
15
16
17

Correct Answer

A. 16

Explanation

In patients with 2° sexual characteristics (breast development, etc), primary amenorrhea is considered normal until the age of 16. This means that if a patient has not started menstruating by the age of 16, it is still within the normal range. After the age of 16, primary amenorrhea would be considered abnormal and further evaluation would be required to determine the cause.

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8.

What is the first test or imaging modality used to further evaluate primary amenorrhea?

X-ray
Ultrasound
FSH level
Karyotype
Cranial MRI
Serum testosterone level

Correct Answer

A. Ultrasound

Explanation

Want to establish the presence of mullerian structures: uterus, fallopian tubes, upper portion of vagina etc

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1

9.

In cases of primary amenorrhea, what is the age in patients without 2° sexual characteristics (breast development, etc) at which a “wait and see” approach is no longer appropriate?

12
13
14
15
16
17

Correct Answer

A. 14

Explanation

In cases of primary amenorrhea, a "wait and see" approach is typically taken when patients do not have secondary sexual characteristics such as breast development. However, this approach is no longer appropriate when the patient reaches the age of 14. At this point, further evaluation and intervention may be necessary to determine the cause of the amenorrhea and initiate appropriate treatment.

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1

10.

In a patient with primary amenorrhea, who has had an ultrasound demonstrating the presence of a uterus and has a decreased FSH level, which of the following tests would be most appropriate?

X-ray
Ultrasound
FSH level
Karyotype
Cranial MRI
Serum testosterone level

Correct Answer

A. Cranial MRI

Explanation

Want to look for pituitary abnormalities, tumor etc as potential causes

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Primary Amenorrhea Quiz

What is the main sign of amenorrhea?

Quiz Preview

What are the common causes of amenorrhea?

Which of the following hormones is required for breast development?

A 17-year-old female presents with Tanner stage IV breast development but no menses. Ultrasound confirms a blind vaginal vault and no uterus or cervix. What laboratory test would be most helpful in determining the etiology of her problem?

What is oligomenorrhea?

A 27-year-old female is concerned about the frequency of her periods. When discussing her menstrual cycle, she states that she has had 19-day cycles. Which term best matches her condition?

What is the latest age in patients with 2° sexual characteristics (breast development, etc) in which primary amenorrhea is normal?

What is the first test or imaging modality used to further evaluate primary amenorrhea?

In cases of primary amenorrhea, what is the age in patients without 2° sexual characteristics (breast development, etc) at which a “wait and see” approach is no longer appropriate?

In a patient with primary amenorrhea, who has had an ultrasound demonstrating the presence of a uterus and has a decreased FSH level, which of the following tests would be most appropriate?