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In addition to pregnancy testing, what other testing should Nurse Aretha have encouraged Maria to undergo? and Mine de bune
Chapter 35: Teen Pregnancy Student Case Studies Aretha R. is a school nurse at Belington Middle School. Late one Friday after
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Answer #1

This is case of secondary amenorrhea

In any case of secondary amenorrhea the answer to two major questions are essential to arrive at a diagnosis quickly

  • Is the patient pregnant?
  • Are her hormone assays normal?

Hence along with pregnancy testing Nurse Aretha should have also recommended Hormone assays for Prolactin, FSH and LH

High prolactin levels could be due to hypothalamic/pituitary tumours, hypothyroidism, drugs like antidepressants, cocaine, antipsychotics, some cases of PCOD etc

LH:FSH > 3:1.. PCOD

FSH increased, could be due to Turners syndrome

FSH AND LH decreased.. Pituitary failure or hypothalamic failure

Progesterone challenge test may be performed too. A postive test is commonly due to hypothalamic dysfunction or PCOD

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