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Year |
2001 |
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Question Number |
83. |
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Category |
Select |
Question
A 16-year-old girl who is an elite runner has not had a menstrual cycle for the past 6 months. History reveals menarche at age 13 with menstrual cycle of 36 days. What is the most likely diagnosis?
1- Primary amenorrhea
2- Secondary amenorrhea
3- Oligomenorrhea
4- Thyroid disease
5- Klinefelter’s syndrome
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Answer (click for answer)
Answer 2 This is a very common in service question. High performance female athletes frequently have the female triad of anorexia, osteoporosis, and amenorrhea. She should be referred for evaluation and possible placement on oral hormone therapy. Primary amenorrhea is never getting a first period (she has). Oligomenorrhea is having a cycle that is longer then twenty-eight days (like she was having). Thyroid disease or other hormonal problems such as polycystic ovary disease are come causes of secondary amenorrhea but this girl is more likely secondary to her athletic endeavors. Klinefelter’s is a major chromosomal disorder with karyotype XYY. These are males with above average height, usually low IQ, and hypogonadism(they are infertile). Turner’s is XO with female phenotypes shield chest, wide carrying angles, short stature, web neck, and normal intelligence, they have primary amenorrhea and are also infertile.
Reference: Elizabeth Arendt, MD (eds) Sports medicine OKU American Academy of Orthopaedic Surgery Rosemont, IL, 2000 pp 55.