Question

A 53 year old female presents complaining of depression, insomnia, and increasing fatigue. She also describes occasional episodes where her face and neck become red and flushed. These frequently occur at night and wake her from sleep. Her last menstrual period was five months ago. Her menses had been irregular for one year, but before then, her menstrual history was normal. Physical exam is remarkable for an atrophic vaginal mucosa with decreased secretions. Which of the following diagnostic tests is most likely to menstrual history was normal. Which of the following diagnostic tests is most likely to confirm the cause of this patient's amenorrhea?

A. Urine beta-hCG
B. FSH
C. TSH
D. Karyotyping
E. Prolactin

Answer 1

An FSH level test is most likely to confirm the cause of the patient's amenorrhea because her symptoms and age suggest she is undergoing menopause, during which FSH levels typically increase.

Step-by-step explanation:

The 53-year-old female patient with symptoms of depression, insomnia, fatigue, hot flashes, and an atrophic vaginal mucosa, along with the fact that her last menstrual period was five months ago, suggests she may be undergoing menopause. Menopause is typically diagnosed clinically, but the most appropriate test to confirm the cause of her amenorrhea would be measuring the Follicle-stimulating hormone (FSH) levels.

During menopause, there is an increase in FSH levels due to a decrease in the hormone inhibin, which normally helps to regulate FSH production through a negative feedback loop. As a woman approaches menopause, the number of viable ovarian follicles decreases, leading to a decrease in estrogen production, and causing menopausal symptoms. Therefore, an elevated FSH level is indicative of menopause, which would confirm the diagnosis in this patient.