WBR1036

Author	[[PageAuthor::Ahmed Zaghw, M.D. [1]]]
Exam Type	ExamType::
Main Category
Sub Category
Prompt	[[Prompt::A 16 year old girl comes to the clinic, complaining of irregular vaginal spotting for the last 2 months. She has never had any bleeding between periods in the past. She has been taking oral contraceptive pills for the last two months and occasional pain killers for her ankle strain. She is a professional tennis player and trains daily for more than 4 hours. She reports that she has been stressed for the last month trying to catch up with her schedule for the next national championship. The pelvic examination is unremarkable. Her lab tests does not reveal any abnormality. Her pregnancy test is negative. What is the best next step?]]
Answer A	AnswerA::Abdominal US
Answer A Explanation	[[AnswerAExp::Incorrect-[[]]]]
Answer B	AnswerB::Endometrial biopsy
Answer B Explanation	[[AnswerBExp::Incorrect-[[]].]]
Answer C	AnswerC::TSH
Answer C Explanation	[[AnswerCExp::Incorrect-[[]]]]
Answer D	AnswerD::LH
Answer D Explanation	[[AnswerDExp::Incorrect-[[]].]]
Answer E	AnswerE::Reassurance
Answer E Explanation	[[AnswerEExp::Correct-[[]]]]
Right Answer	RightAnswer::C
Explanation	[[Explanation::Educational Objective: Secondary amenorrhea could be caused due stress that alter hypophthalmic pituitary axis. Educational Objective: References: ]]
Approved	Approved::No
Keyword	WBRKeyword::Secondary Amenorrhea, WBRKeyword::stress induced amenorrhea, WBRKeyword::Hypothalamic pituitary axis
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::