structure
Forum Junior
Topics: 26
Posts: 28
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A 32 yrs old nuligravid woman comes to the physician because she has been unable to conceive for 3 yrs. Menarche was at the age of 13 yrs. Menses occur atirregular 1-to6-month intervals and often last more than 2 weeks. she has been sexually active since the age of 17 yrs and has never uesed contracepion. She weighs 100kg and is 168 cm tall. Examination shows increased facial and abdomianl hair, excessive sebum production, and facial acne vulgaris. Pelvic examination shows m=normal external genitalia, a well-estrogenized vagina, and a normal cervix and uterus. Bimanual examination shows enlarged(5x5 cm) ovaries bilaterally; they are mildly tender and multicystic on palpation. Which of rhe following is the most appropriate next step in management?
A. measurement of the early serum cortisol level
B. Measurement of the serum testosterone and dehydroepiandrosterone sulfate levels
C. Dexamethasone suppression test
D. Pitutary stimulation test
E. Exploratatory operation
I will go with B
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| HighHopes
Forum Senior
Topics: 12
Posts: 165
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I also pick B
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| frank100
Forum Guru
Topics: 48
Posts: 586
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yes, me too (b)
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| shumaila
Forum Elite
Topics: 58
Posts: 347
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b too
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| Perhaps
Forum Elite
Topics: 61
Posts: 162
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I also picked B
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| juanma0
Forum Senior
Topics: 10
Posts: 146
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Please explain B, can't quite reason it.
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| Dragonfly
Forum Elite
Topics: 27
Posts: 338
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i also go with B.
E. is too invasive right off the bed.
A. and C. are testing for Cushings
D. is too vague
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| Naca
Forum Newbie
Topics: 1
Posts: 26
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B .
She has all caracteristic for Stein Leventhal syndrome- obesity, hirsuitisam, anovulation, enlarged probably polycystic ovaries. In that case the levels of anrogen and estrogen are elevated.
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| cbenitesch
Forum Senior
Topics: 10
Posts: 141
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I am agree Stein-Leventhal Syndrome... so the answer is B
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