Match each patient's clinical presentation with the most likely underlying diagnosis.
- A 24-year-old woman with irregular menses, acne, and elevated serum testosterone levels.Polycystic ovary syndrome
- A 27-year-old woman with amenorrhea, bilateral milky nipple discharge, and a normal thyroid-stimulating hormone level.Hyperprolactinemia
- A 32-year-old woman with secondary amenorrhea, vaginal dryness, hot flashes, and an elevated follicle-stimulating hormone level.Primary ovarian insufficiency
- A 19-year-old elite distance runner with secondary amenorrhea, a body mass index of 16.5 kg/m², and low luteinizing hormone and follicle-stimulating hormone levels.Functional hypothalamic amenorrhea
Cevap
The presentations match as follows: The hyperandrogenic patient has Polycystic ovary syndrome. The patient with galactorrhea has Hyperprolactinemia. The patient with hypoestrogenic symptoms and high FSH has Primary ovarian insufficiency. The elite runner with low BMI and low FSH/LH has Functional hypothalamic amenorrhea.
Each clinical scenario provides classic, pathognomonic features for a distinct etiology of amenorrhea. Polycystic ovary syndrome is characterized by hyperandrogenism and ovulatory dysfunction. Hyperprolactinemia presents with galactorrhea. Primary ovarian insufficiency presents with hypergonadotropic hypogonadism and menopausal symptoms before age 40. Functional hypothalamic amenorrhea presents with hypogonadotropic hypogonadism in the setting of low energy availability.
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Anahtar Kavram
Differential diagnosis of secondary amenorrhea based on clinical presentation and targeted screening laboratory findings.