WBR1147

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Author [[PageAuthor::Pratik Bahekar, MBBS [1]]]
Exam Type ExamType::USMLE Step 2 CK
Main Category MainCategory::OB/GYN
Sub Category SubCategory::Obstetrics & Gynecology
Prompt [[Prompt::A 17-year-old female presents to a pediatrician with her mother. The mother expresses concern that her daughter has never menstruated.The physician asks the mother to leave the room and begins taking a detailed history. The patient denies any history of penetrative sex, abdominal pain or STDs. The physician notes that the patient is in Tanner stage 3, and there is an absence of androgenic hair distribution. Pelvic and vaginal exam is unremarkable. What is the next best step in the management of this patient?]]
Answer A AnswerA::Reassurance
Answer A Explanation AnswerAExp::Incorrect!
Answer B AnswerB::Beta hCG test
Answer B Explanation AnswerBExp::Correct!
Answer C AnswerC::Serum DHEAS and testosterone
Answer C Explanation AnswerCExp::Incorrect!
Answer D AnswerD::Serum FSH
Answer D Explanation AnswerDExp::Incorrect!
Answer E AnswerE::Serum Prolactin
Answer E Explanation AnswerEExp::Incorrect!
Right Answer RightAnswer::B
Explanation [[Explanation::The first step in the management of the primary and secondary amenorrhea is pregnancy test.

Educational Objective:
References: http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0CDQQFjAB&url=http%3A%2F%2Fwww.researchgate.net%2Fpublication%2F222515877_Primary_amenorrhoea_investigation_and_treatment%2Ffile%2F9fcfd50ad5f01d0a89.pdf&ei=9saHU_D7IZGYqAbjgIK4Dg&usg=AFQjCNFoc-ARvg4kXl0jZJZDD9geicFA1g&bvm=bv.67720277,d.b2k]]

Approved Approved::No
Keyword WBRKeyword::Primary amenorrhea
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