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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}
|QuestionAuthor={{Rim}}, {{AJL}} {{Alison}}
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Pathophysiology
|MainCategory=Pathophysiology
Line 20: Line 20:
|MainCategory=Pathophysiology
|MainCategory=Pathophysiology
|SubCategory=Genitourinary
|SubCategory=Genitourinary
|Prompt=A 38 year old woman presents to the physician's office complaining of fatigue, hot flashes, and facial flushing. Upon further questioning, she also informs the physician that she has not had her menses for 14 months. Following appropriate work-up, the diagnosis of premature ovarian failure (POF) is made. Which of the following set of lab results are most likely seen in this patient?
|Prompt=A 38-year-old female 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 for 14 months. Following appropriate work-up, the diagnosis of premature ovarian failure (POF) is made. Which of the following set of lab results are most likely seen in this patient?


[[Image:WBR0170.png|500px]]  
[[Image:WBR0170.png|500px]]  
|Explanation=The patient is presenting with premature ovarian failure (POF), a state of 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 stopped having menses before 40 years. The clinical signs and symptoms of POF are similar to menopause. Patients 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, that are no longer regulated by feedback inhibition.
|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. Ovarian hormones are decreased, while pituitary hormones are increased due to absence of feedback inhibition.
|EducationalObjectives= 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.


Reference:
|References= Beck-Peccoz P, Persani L. Premature ovarian failure. Orphanet J Rare Dis. 2006; 1:9.
Beck-Peccoz P, Persani L. Premature ovarian failure. Orphanet J Rare Dis. 2006; 1:9.
|AnswerA=A
|AnswerA=A
|AnswerAExp=This is not the correct set of lab results.
|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.
|AnswerB=B
|AnswerB=B
|AnswerBExp=This is the correct set of lab results.
|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.
|AnswerC=C
|AnswerC=C
|AnswerCExp=This is not the correct set of lab results.
|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.
|AnswerD=D
|AnswerD=D
|AnswerDExp=This is not the correct set of lab results.
|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.
|AnswerE=E
|AnswerE=E
|AnswerEExp=This is not the correct set of lab results.
|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.
|RightAnswer=B
|RightAnswer=B
|WBRKeyword=premature, ovarian, failure, menopause, postmenopause, post, post-menopause, LH, FSH, progesterone, hormone, hormonal, changes, change, fatigue, facial, flushing, flush, flushes, flash, flashes, heat, hot
|WBRKeyword=premature, ovarian, failure, menopause, postmenopause, post, post-menopause, LH, FSH, progesterone, hormone, hormonal, changes, change, fatigue, facial, flushing, flush, flushes, flash, flashes, heat, hot
|Approved=No
|Approved=Yes
}}
}}

Revision as of 17:56, 10 July 2014
Author [[PageAuthor::Rim Halaby, M.D. [1], Alison Leibowitz [2] (Reviewed by Alison Leibowitz)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Pathophysiology
Sub Category SubCategory::Genitourinary
Prompt [[Prompt::A 38-year-old female 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 for 14 months. Following appropriate work-up, the diagnosis of premature ovarian failure (POF) is made. Which of the following set of lab results are most likely seen 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::postmenopause, WBRKeyword::post, WBRKeyword::post-menopause, WBRKeyword::LH, WBRKeyword::FSH, WBRKeyword::progesterone, WBRKeyword::hormone, WBRKeyword::hormonal, WBRKeyword::changes, WBRKeyword::change, WBRKeyword::fatigue, WBRKeyword::facial, WBRKeyword::flushing, WBRKeyword::flush, WBRKeyword::flushes, WBRKeyword::flash, WBRKeyword::flashes, WBRKeyword::heat, WBRKeyword::hot
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