NU 664D Exam 2025 With 100% Correct
Answers
clinical manifestations of primary amenorrhea - CORRECT ANSWER✔✔absence of menarche by
age 15
differential diagnoses for primary amenorrhea - CORRECT ANSWER✔✔pregnancy, turner
syndrome, mullerian agenesis, delay of puberty, PCOS, weight loss, excessive exercise, anorexia
diagnostic workup for primary amenorrhea - CORRECT ANSWER✔✔pelvic US, HCG, FSH, TSH,
prolactin
clinical manifestations of secondary amenorrhea - CORRECT ANSWER✔✔absence of menses for
more than 3 cycle intervals or 6 months in women who were previously menstruating
what is the provera challenge? - CORRECT ANSWER✔✔start with progestin for 10 days and then
stop. if bleeding starts again, she has estrogen but is not ovulating. If she does not start bleeding
again, she is ovulating but has outflow tract problem like scarring or adhesions.
bleed = not ovulating
no bleed = ovulating, scarring adhesions
when is the provera challenge used? - CORRECT ANSWER✔✔for diagnostic of secondary
amenorrhea with normal labs and history of uterine instrumentation
turner's syndrome clinical manifestations - CORRECT ANSWER✔✔1. hypogonadism
-absent/non functioning sex chromosome (45X0) -> gonadal dysgenesis -> rudimentary, fibrosed
ovaries -> primary amenorrhea in 80% (menopause before menarche) or early ovarian failure
, with secondary amenorrhea (20%), delayed secondary sex characteristics (absence of breasts),
infertility in a majority of patients
2. physical exam
-short stature, webbed neck, prominent ears, posterior hairline, broad chest with hypoplastic
widely spaced nipples, (congenital lymphedema seen in neonates), short 4th metacarpals, high
arched palate, nail dysplasia, may have hearing loss
3. cardiovascular
-coarctation of the aorta
-MVP
-bicuspid aortic valves
-aortic dissection
-HTN
4. renal
-congenital abnormalities (horseshoe kidney)
-hydronephrosis
5. endocrine
-osteoporosis
-hypothyroidism
-DM
-dyslipidemia
6. GI
-telangiectasis (may present with GI bleeding)
Answers
clinical manifestations of primary amenorrhea - CORRECT ANSWER✔✔absence of menarche by
age 15
differential diagnoses for primary amenorrhea - CORRECT ANSWER✔✔pregnancy, turner
syndrome, mullerian agenesis, delay of puberty, PCOS, weight loss, excessive exercise, anorexia
diagnostic workup for primary amenorrhea - CORRECT ANSWER✔✔pelvic US, HCG, FSH, TSH,
prolactin
clinical manifestations of secondary amenorrhea - CORRECT ANSWER✔✔absence of menses for
more than 3 cycle intervals or 6 months in women who were previously menstruating
what is the provera challenge? - CORRECT ANSWER✔✔start with progestin for 10 days and then
stop. if bleeding starts again, she has estrogen but is not ovulating. If she does not start bleeding
again, she is ovulating but has outflow tract problem like scarring or adhesions.
bleed = not ovulating
no bleed = ovulating, scarring adhesions
when is the provera challenge used? - CORRECT ANSWER✔✔for diagnostic of secondary
amenorrhea with normal labs and history of uterine instrumentation
turner's syndrome clinical manifestations - CORRECT ANSWER✔✔1. hypogonadism
-absent/non functioning sex chromosome (45X0) -> gonadal dysgenesis -> rudimentary, fibrosed
ovaries -> primary amenorrhea in 80% (menopause before menarche) or early ovarian failure
, with secondary amenorrhea (20%), delayed secondary sex characteristics (absence of breasts),
infertility in a majority of patients
2. physical exam
-short stature, webbed neck, prominent ears, posterior hairline, broad chest with hypoplastic
widely spaced nipples, (congenital lymphedema seen in neonates), short 4th metacarpals, high
arched palate, nail dysplasia, may have hearing loss
3. cardiovascular
-coarctation of the aorta
-MVP
-bicuspid aortic valves
-aortic dissection
-HTN
4. renal
-congenital abnormalities (horseshoe kidney)
-hydronephrosis
5. endocrine
-osteoporosis
-hypothyroidism
-DM
-dyslipidemia
6. GI
-telangiectasis (may present with GI bleeding)
