WBR1147

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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