Amenorrhea
Obstetrics & Gynaecology · Topic 25
Source: NMC CBME Curriculum 2024 · Volume III · Obstetrics & Gynaecology · Topic 25 · combined PDF page 436
Practice questions
- A 15-year-old has never menstruated and had thelarche 2 years ago. Which statement best reflects the threshold for evaluation of primary amenorrhea?
- A patient with previously regular menstrual cycles has had no menses for 3 months. Which classification best fits the supplied definition of secondary amenorrhea?
- A patient with longstanding irregular cycles has now had no menstrual bleeding for 6 months. Which interpretation is most appropriate?
- A reproductive-age patient presents with secondary amenorrhea. Which test should be included at the outset of evaluation?
- Which group consists entirely of routine serum tests listed in the supplied practical review for evaluation of amenorrhea?
- A patient with amenorrhea reports intensive training and recent weight loss. Which additional history domains are specifically relevant to the initial assessment?
- Which examination components are specifically emphasized in the initial evaluation of amenorrhea?
- A patient with amenorrhea has progressive headaches and visual symptoms. Which approach to brain imaging is most consistent with the supplied review?
- A patient with primary amenorrhea has findings that raise concern for a chromosomal cause. Which test is best characterized as an individualized investigation rather than a universal screening test?
- A distance runner with amenorrhea reports inadequate food intake relative to training and substantial psychological stress. Which diagnosis best integrates these contributors, after organic causes are excluded?
- Which mechanism is most directly associated with functional hypothalamic amenorrhea in the supplied literature?
- A patient with suspected functional hypothalamic amenorrhea has not yet undergone assessment for other causes. Which principle is essential before attributing amenorrhea to FHA?
- A patient with FHA related to low energy availability asks for the primary management strategy. Which recommendation is best supported by the supplied reviews?
- An adolescent athlete with FHA describes significant psychological stress in addition to inadequate energy intake. Which management approach best reflects the supplied evidence?
- A patient asks how quickly menstruation will return after dietary intervention for FHA. Which response is most consistent with the systematic review?
- An adolescent athlete with prolonged FHA is at particular concern for which skeletal outcome?
- A young athlete with FHA has a stress fracture and asks whether exercise is always beneficial for bone. Which response is most appropriate?
- In a network meta-analysis of randomized trials involving women with FHA, which intervention showed a significant benefit over control for both lumbar-spine and femoral-neck bone mineral density?
- A clinician proposes a combined oral contraceptive pill specifically to improve bone mineral density in a patient with FHA. Which statement best reflects the supplied network meta-analysis?
- A patient with premature ovarian insufficiency asks about the duration of hormone therapy. Which recommendation is stated in the supplied practical review?
- A patient with chronic oligo-amenorrhea also has clinical hyperandrogenism and metabolic risk factors. Which diagnosis is more consistent with this pattern than isolated FHA?
- A patient has amenorrhea, intense exercise, and psychosocial stress, but also has clinical features suggestive of PCOS. Which diagnostic principle is most appropriate?
- A patient with PCOS and chronic amenorrhea is being counseled about long-term care. Which risk domains are specifically highlighted in the supplied practical review?
- A patient with FHA asks whether reduced estrogen alone explains all potential cardiovascular concern. Which response best reflects the supplied review?
- A 17-year-old athlete has amenorrhea, recent weight loss, and an overuse fracture. Which interpretation best integrates these findings?
- A patient presents with amenorrhea and reports new vasomotor symptoms. Which approach is most appropriate during the initial assessment?
- A clinician is considering androgen testing in a patient with amenorrhea but no reported hyperandrogenic symptoms. Which approach best matches the supplied practical review?
- A patient with FHA asks whether a single calorie target guarantees menstrual recovery. Which answer is best supported by the dietary systematic review?
- A patient with amenorrhea and a history of chronic illness asks whether evaluation should focus only on reproductive symptoms. Which approach is most consistent with the supplied review?
- A patient with amenorrhea has an elevated concern for an endocrine or metabolic cause based on the history and examination. Which statement best describes the role of pelvic imaging in the supplied practical review?
- Which pairing of clinical pattern and underlying condition is most accurate according to the supplied reviews?
- A patient with prolonged FHA has low bone density despite efforts to restore energy balance. Which statement best reflects the supplied evidence on transdermal estrogen?
- A patient with suspected FHA has weight loss, excessive exercise, and psychosocial stress. Which additional physiologic pattern is described in the supplied review of FHA and stress?
- A patient presents for evaluation of absent menses but has not yet had a focused assessment. Which sequence best reflects the general approach described in the supplied literature?