WBR0170

Author	[[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Alison Leibowitz) (Reviewed by Serge Korjian)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Pathophysiology
Sub Category	SubCategory::Genitourinary
Prompt	[[Prompt::A 38-year-old woman presents to the physician's office with complaints of fatigue, hot flashes, and facial flushing. Upon further questioning, she informs the physician that she has not had her menses in 14 months. Following appropriate work-up, the diagnosis of premature ovarian failure (POF) is made. Which of the following lab results are most likely to be observed in this patient? ]]
Answer A	AnswerA::A
Answer A Explanation	AnswerAExp::This is not the correct set of lab results because in patients with POF, ovarian hormones are decreased, while pituitary hormones are increased due to an absence of feedback inhibition.
Answer B	AnswerB::B
Answer B Explanation	[[AnswerBExp::Patients with POF typically present with hot flashes, fatigue, and facial flushing. Lab work-up also reveals a marked decrease in ovarian hormones, estrogen and progesterone, and a significant increase in pituitary hormones, LH and FSH, which are no longer regulated by feedback inhibition.]]
Answer C	AnswerC::C
Answer C Explanation	AnswerCExp::This is not the correct set of lab results because in patients with POF, ovarian hormones are decreased, while pituitary hormones are increased due to an absence of feedback inhibition.
Answer D	AnswerD::D
Answer D Explanation	AnswerDExp::This is not the correct set of lab results because in patients with POF, ovarian hormones are decreased, while pituitary hormones are increased due to an absence of feedback inhibition.
Answer E	AnswerE::E
Answer E Explanation	AnswerEExp::This is not the correct set of lab results because in patients with POF, ovarian hormones are decreased, while pituitary hormones are increased due to an absence of feedback inhibition.
Right Answer	RightAnswer::B
Explanation	[[Explanation::The patient in this scenario presents with premature ovarian failure (POF), a primary ovarian defect characterized by depletion of ovarian follicle reserve before 40 years of age. Patients with POF might have primary amenorrhea, where menarche has been absent since birth, or secondary amenorrhea, where patients stop having menses before they reach the age of 40. The clinical signs and symptoms of POF are similar to those of menopause. Patients with POF typically present with hot flashes, fatigue, and facial flushing. Lab work-up also reveals a marked decrease in ovarian hormones, estrogen and progesterone, and a significant increase in pituitary hormones, LH and FSH, which are no longer regulated by feedback inhibition. Educational Objective: Premature ovarian failure (POF) is a state of primary ovarian defect, which mimics menopause, before the age of 40. In POF, ovarian hormones are decreased, while pituitary hormones are increased due to an absence of feedback inhibition. References: Beck-Peccoz P, Persani L. Premature ovarian failure. Orphanet J Rare Dis. 2006; 1:9.]]
Approved	Approved::Yes
Keyword	WBRKeyword::Premature, WBRKeyword::Ovarian, WBRKeyword::Failure, WBRKeyword::Menopause, WBRKeyword::POF, WBRKeyword::Post-menopausal, WBRKeyword::LH, WBRKeyword::FSH, WBRKeyword::Progesterone, WBRKeyword::Hormone, WBRKeyword::Flushing, WBRKeyword::Hot Flashes
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